title: Decreasing Malpractice Claims by Reducing Preventable Perinatal Harm.
abstract: OBJECTIVE
  To evaluate the association of improved patient safety practices with medical malpractice claims and costs in the perinatal units of acute care hospitals.
  
  
  METHODS
  Malpractice and harm data from participating hospitals; litigation records and medical malpractice claims data from American Excess Insurance Exchange, RRG, whose data are managed by Premier Insurance Management Services, Inc. (owned by Premier Inc., a health care improvement company).
  
  
  METHODS
  A quasi-experimental prospective design to compare baseline and postintervention data. Statistical significance tests for differences were performed using chi-square, Wilcoxon signed-rank test, and t-test.
  
  
  METHODS
  Claims data were collected and evaluated by experienced senior claims managers through on-site claim audits to evaluate claim frequency, severity, and financial information. Data were provided to the analyzing institution through confidentiality contracts.
  
  
  RESULTS
  There is a significant reduction in the number of perinatal malpractice claims paid, losses paid, and indemnity payments (43.9 percent, 77.6 percent, and 84.6 percent, respectively) following interventions to improve perinatal patient safety and reduce perinatal harm. This compares with no significant reductions in the nonperinatal claims in the same hospitals during the same time period.
  
  
  CONCLUSIONS
  The number of perinatal malpractice claims and dollar amount of claims payments decreased significantly in the participating hospitals, while there was no significant decrease in nonperinatal malpractice claims activity in the same hospitals.
authors.affiliation: Arizona State University, Phoenix, AZ.
authors.forename: William
authors.identifier: http://orcid.org/0000-0002-0968-4395
authors.initials: W
authors.lastname: Riley
authors.affiliation: Premier Insurance Management Services, San Diego, CA.
authors.forename: Les W
authors.initials: LW
authors.lastname: Meredith
authors.affiliation: Premier Insurance Management Services, San Diego, CA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Price
authors.affiliation: Fairview Health Services, Minneapolis, MN.
authors.forename: Kristi K
authors.initials: KK
authors.lastname: Miller
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: James W
authors.initials: JW
authors.lastname: Begun
authors.affiliation: Arizona State University, Phoenix, AZ.
authors.forename: Mac
authors.identifier: http://orcid.org/0000-0002-0070-4943
authors.initials: M
authors.lastname: McCullough
authors.affiliation: Independent Perinatal Consultant, Edina, MN.
authors.forename: Stanley
authors.initials: S
authors.lastname: Davis
mesh_terms: D005260:Female; D006801:Humans; D007318:Inservice Training; D008318:Malpractice / Q000191:economics / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000517:prevention & control*; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D061214:Patient Safety; D018743:Perinatal Care / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D011247:Pregnancy; D011446:Prospective Studies; D058996:Quality Improvement
keywords: Perinatal malpractice claims; care bundles; in situ simulation training; patient safety; perinatal outcomes