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What Should Hospitals Do When They Make Mistakes?

Advocates suggest increased candor will reduce medical errors and improve care

By Heidi Raschke

Helen Haskell's son Lewis went in for routine elective surgery in 2000. He didn't come home. The reason? A medication error.

“We took our child in for elective surgery," Haskell, of Columbia, S.C., says in a recent story from Bloomberg  News. "He just died through utter negligence.”

What did the hospital do? It sent her bills. And then it sent her to collections for nonpayment.

Eventually there was a settlement, but an already terribly painful situation was made worse by the widespread approach hospitals take to handling medical errors: denial, secrecy and settlements.

In the story, titled Hospitals That Mess Up Are Urged to Confess, writer Jon Tozzi uses Haskell's story to illustrate the problem and lay out in detail what she and other advocates for reform say is a less expensive and kinder approach to handling medical errors: honesty, apologies and improved safety.

A Call for Candor

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"The new approach promoted by the federal Agency for Healthcare Research and Quality (AHRQ) is explicitly aimed at saving hospitals money on malpractice litigation while encouraging more robust scrutiny of what went wrong. It also aims to support patients, families, and clinicians after an event that can be traumatic for all involved," Tozzi writes. "It's called Communication and Optimal Resolution, or Candor for short, and was developed with a $23 million federal research grant and tested at 14 hospitals in three health systems."

This is how it works, Tozzi writes: "When a case involving patient harm is identified, trained hospital staff tell victims or their families what happened within one hour. At the same time, they reach out to caregivers. The hospital stays in touch with patients and relatives as the event is investigated and interviews them about what happened. It also pauses its billing process so injured patients or grieving families aren’t dealing with the cost of care received, an emotionally fraught experience when that 'care' injured or killed a loved one."

An investigation must be completed quickly and the findings shared with patients and/or their families. A financial settlement is negotiated in cases of negligence.

Read more about Candor here.

Heidi Raschke is a longtime journalist and editor who previously was the Executive Editor of Mpls-St. Paul Magazine and Living and Learning Editor at Next Avenue. Currently, she runs her own content strategy and development consultancy. Read More
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