AHRQ: Hospitals that mess up are urged to fess up

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Medical errors in U.S. hospitals result in the deaths of tens of thousands of patients and injuries of many more each year. And while not all cases of harm are avoidable, traditionally, healthcare providers deny any wrongdoing out of fear of getting sued. But a recent push by the Agency for Healthcare Research and Quality is aiming to change the attitudes and practices employed by hospitals that often accompany medical errors, according to Bloomberg.

Recently, the AHRQ published guidelines for hospitals to adopt that promote honesty regarding mistakes. The idea behind the guidelines is that being open and honest about mistakes and taking accountability can reduce hospital liability and improve safety. The guidelines, called "Communication and Optimal Resolution," or "Candor," aims to save hospitals from expensive malpractice litigation fees while encouraging higher scrutiny of medical errors. It is also designed to support patients, families and clinicians after a medical error occurs, which can be traumatic for all parties. Candor was developed with a $23 million federal research grant and was tested at 14 hospitals in three health systems, according to the report.

Here are seven things to know about Candor, according to Bloomberg.

1. When a case involving patient harm is identified, trained hospital staff tell the affected patient or their families what happened within one hour. The hospital stays in communication with patients and relatives as the event is investigated and conducts interviews with them about what happened.

2. While the investigation is ongoing, the billing process is put on hold to relieve patients and families of the emotionally disturbing experience of paying for "care" that may have injured or killed a loved one.

3. Hospitals should complete the investigation within about two months and disclose the findings to the patients and their families. If the hospital finds the harm resulted from negligence, or a breach in the standard of care, the hospital and patient will negotiate financial compensation. At this time, hospital officials will also discuss how to prevent similar future incidents.

4. Attorneys representing the patient should be present during the conversation to ensure he or she gets a fair deal.

5. The Candor process doesn't restrict patients' power to sue if they think the hospital's offer for compensation is unfair.

6. While the Candor process helps shed light on a previously opaque internal process, some people have pointed out potential areas of concern. For example, some worry hospitals might only adopt Candor when it will benefit them, such as in a case they expect to lose. Others say the process could make it easier for hospitals to be held to a higher degree of accountability that cold come from an external investigation.

7. But beyond the obvious financial incentives for hospitals, Candor gives patients who are the victims of medical errors something very simple and very important: the acknowledgement that something went wrong. "[Families'] No. 1 complain is, 'I wish they had just said they felt bad or they're sorry," said Laura Sharp, a partner at the Sharp Firm in Austin.

 

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