Malpractice prevention, patient safety, and quality of care: a critical linkage.
There is growing evidence of a negative effect of the current American preoccupation with malpractice on efforts to reduce error, enhance safety, and improve other domains of quality. The use by some insurers of systems assessment and risk analysis programs, linked to rewards for performance--which, taken together, we term proactive risk management--offers an opportunity to enhance our focus on systems and to bring patient safety and malpractice risk reduction into close congruence with other quality improvement efforts. Given the increasing burden of malpractice, as well as the emerging concerns about patient safety, managed care organizations and their providers need to work together with malpractice insurers and quality improvement experts to refocus their efforts on creating systems improvement; driving measurement, analysis, and feedback; and developing incentives for performance that will align quality and risk management efforts and drive breakthroughs in quality, including patient safety.
Pawlson
L Gregory
LG
National Committee for Quality Assurance, 2000 I. Street, NW, Suite 500, Washington, DC 20036, USA. pawlson@ncqa.org
O'Kane
Margaret E
ME
D005544:Forecasting; D006291:Health Policy; D006801:Humans; D008318:Malpractice; D019300:Medical Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D018570:Risk Assessment / Q000458:organization & administration; D012308:Risk Management / Q000458:organization & administration; D017751:Safety Management / Q000458:organization & administration*; D013597:Systems Analysis; D017749:Total Quality Management / Q000458:organization & administration; D014481:United States