How early reporting of harm events leads to faster resolution, lower expenses and quicker healing

The traditional practice of denying and defending harm events is stressful and costly for consumers, providers and health organizations; it also undermines the patient-clinician relationship.

A system of early reporting of harm events focused on transparency, communication and fair reparations can mitigate these issues, leading to more positive outcomes for all.

During a featured session sponsored by Constellation at the Becker's Hospital Review 9th Annual CEO + CFO Roundtable, Laurie Drill-Mellum, MD, CMO Emerita at Constellation, and Gretchen Ruoff, senior program director for patient safety services at Candello, discussed the creation, validation and results of Constellation's HEAL early reporting system.

 Four key takeaways:  

1. Denying and defending harm events leads to negative long-term consequences. Patients experience increased anger and depression, which leads to avoiding future medical care. Providers suffer from guilt and burnout, as well as increased chance of a second harm event. "The risk of a subsequent malpractice claim increases by almost threefold immediately after a malpractice claim is filed against a clinician and remains elevated for some time," Dr. Drill-Mellum said. Organizations incur mounting expenses, reputation damage and lawsuits.
2. Constellation established the HEAL Program and encourages early reporting of harm events. "After lots of careful research, interviewing subject matter experts in early intervention and developing a business model that was vetted across our organization, we launched HEAL," Dr. Drill-Mellum said. "The acronym stands for honoring everyone involved; empowering each person to be part of the solution; acting early and decisively to limit harm; and learning from these events to better protect patients and care teams." This voluntary program can be engaged after a harm event occurs and includes early reporting, communication assistance, expert case review, clinician peer support and risk consultation.
3. HEAL provides a better path to resolution than existing reimbursement models. "We offer up-to-policy limits based on the severity of harm and make a prompt offer of fair compensation," Dr. Drill-Mellum said. "This saves patients and families the anguish of a lawsuit and saves care team members and organizations the uncertainty and stress of waiting — sometimes for years — to see how situations develop in terms of subsequent claims or lawsuits. The point is to get to earlier resolution." In addition, HEAL offers a standard-of-care review and peer support for caregivers, which are not available in reimbursement models.
4. Candello partnered with Constellation to validate the early results of HEAL on a broader scale. Candello conducted a study of more than 31,000 adverse event cases, adjusting for case type, jurisdictional regions and clinical severity. "We found that early reporting (fewer than 90 days) decreased the lifecycle of a case anywhere from 3 to 13 percent, which translates to resolution one to four months earlier," Ms. Ruoff said. "Early reporting also reduced average expenses for managing cases by anywhere from 25 to 43 percent. The HEAL program is not designed to impact indemnity because it remains focused on providing fair compensation when a harm event occurs, and, as expected, we did not see a significant effect on indemnity payments."

Constellation prepares its policyholders to be ready for future harm events by providing assessments on the organization's culture, communication and event evaluation tools and caregiver programs. By offering timely event and standard-of-care evaluations, as well as communications support, Constellation helps policyholders decrease expenses and lifecycle, which promotes healing for all involved. 

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