For Medical Disclosure and Transparency Presented by: Jessica Scott, MD, JD Foreword by: Dale Micalizzi Founder/Director of Justin s Hope 24 th Annual National Forum on Quality Improvement in Health Care Orlando, Florida December 11, 2012 (Presentation C-25) Session C25 Explain the potential emotional, physical and reputation harm that often results from medical errors both for patients/families and for health care professionals. Describe the potential psychological impact of litigation on patients and health care professionals. Understand the potential outcomes and remedies possible with the IACT Program as opposed to the court system 1
Jessica S. Scott MD, JD has developed and implemented the IACT Program in association with Carolina Dispute Settlement Services (CDSS) and Executive Director, Diann Seigle. Jessica is currently employed by GlaxoSmithKline, a corporation with no affiliation with CDSS or the IACT Program. 2
3
4
5
The Joint Commission Federal/State Legislation Medical Boards National Practitioner Data Bank Apology statutes Lack of disclosure and communication is the most prominent complaint of patients, and their families, who together have become victims of medical error or negligence. Years of expensive and wounding litigation often ensue when families are sometimes only seeking answers. Healthcare at a Crossroads: Strategies for Improving the Medical Liability System and Preventing Patient Injury The Joint Commission (white paper) 2005 6
There is in fact a fundamental dissonance between the medical liability system and the patient safety movement. The latter depends on the transparency of information on which to base improvement; the former drives such information underground. Healthcare at a Crossroads: Strategies for Improving the Medical Liability System and Preventing Patient Injury The Joint Commission (white paper) 2005 7
The goal of any such restructuring should be to reduce litigation by decreasing patient injury, by encouraging open communication and disclosure among patients and providers, and by assuring prompt and fair compensation when safety systems fail. (The Joint Commission) Healthcare at a Crossroads: Strategies for Improving the Medical Liability System and Preventing Patient Injury The Joint Commission (white paper) 2005 8
University of Michigan Disclosure Program University of Michigan Disclosure Program 9
Children s Hospital and Clinics, (Chicago) Disclosure Program COPIC Insurance Company Disclosure Program 10
University of Illinois Medical Center Disclosure Program (Cook County) To provide an alternative to our current tort litigation system that better meets the needs of: patients for full disclosure, understanding, and in appropriate cases, an apology and compensation physicians to proactively address issues and communicate with their patients in a safe and effective way so that both the physician and patient can gain closure healthcare organizations to learn from errors and near misses to improve systems and processes in healthcare delivery and society to simultaneously increase patient safety and reduce costs. 11
MISSION STATEMENT: To provide a safe and supportive resolution process that values transparency and early disclosure of medical errors for patients, doctors, and healthcare organizations so that physical, emotional, and financial stress for all parties will be minimized. 12
Collaborative Law is an established practice area in law for over 25 years 95% Settlement Rate on national level without resort to the court system CDSS brought Collaborative Law to NC in late 1990 s Collaborative Lawyers are settlement experts and cannot litigate the case should it impasse 13
Discuss your thoughts and reactions to the conflict in this scene What was happening in this scene? Was there successful conflict resolution? Why or why not? What is the effect of the interaction on the doctor and on the widower? 14
Write down 3 words that describe how you feel: 1. 2. 3. Write down 3 words that describe how you feel: 1. 2. 3. 15
16
17
18
Jessica Scott, M.D., J.D. Director Healthcare ADR Innovations, C.D.S.S. Diann Seigle Executive Director, C.D.S.S Judge Ralph Walker Recalled Court of Appeal and Superior Court Judge Douglas Holmes, M.D. ENT Surgeon, Rex and Wake Med Robert Maitland, J.D. Past President Orange County Bar, Maitland Law Firm Jeff Seigle, J.D. Co Founder Separating Together Collaborative Law Group Tim McNeill, J.D., M.H.A RTP Law/McNeill Law Offices Joann Sumner, MSN, CS, FNP BC Clinical Psychotherapist, Nurse Practitioner and Nurse Instructor 19
20
OUR VALUES: We value communication and trust in the doctor patient relationship We value the commitment to transparency and honesty We value the patient s right to be informed about their care from initial consent to final outcome, whether good or bad We value efforts to address the needs of the 99% of patients not currently compensated for the medical harms they have incurred We value efforts to inform those patients who may or may not have been harmed but still need information about what happened to them when there is an unexpected bad outcome in their care or treatment We value the commitment to improve patient safety through disclosure of errors and near misses We value the commitment to develop healthcare quality metrics to enhance efforts at improving quality of care in our country We value the dedication of the medical community to give the best care possible to the patients they serve and we seek to provide a process that gives providers an opportunity to repair relationships with patients and their families by reducing the emotional burden these providers carry about their patients bad outcomes http://www.youtube.com/watch?v=sgpf_gaabri www.iactprogram.com 21
Jessica S. Scott MD, JD and Carolina Dispute Settlement Services www.iactprogram.com Raleigh, NC 919 755 4646 22