title: The "Seven Pillars" Response to Patient Safety Incidents: Effects on Medical Liability Processes and Outcomes.
abstract: OBJECTIVE
  To determine whether a communication and resolution approach to patient harm is associated with changes in medical liability processes and outcomes.
  
  
  METHODS
  Administrative, safety, and risk management data from the University of Illinois Hospital and Health Sciences System, from 2002 to 2014.
  
  
  METHODS
  Single health system, interrupted time series design. Using Mann-Whitney U tests and segmented regression models, we compared means and trends in incident reports, claims, event analyses, patient communication consults, legal fees, costs per claim, settlements, and self-insurance expenses before and after the implementation of the "Seven Pillars" communication and resolution intervention.
  
  
  METHODS
  Queried databases maintained by Department of Safety and Risk Management and the Department of Administrative Services at UIH. Extracted data from risk module of the Midas incident reporting system.
  
  
  RESULTS
  The intervention nearly doubled the number of incident reports, halved the number of claims, and reduced legal fees and costs as well as total costs per claim, settlement amounts, and self-insurance costs.
  
  
  CONCLUSIONS
  A communication and optimal resolution (CANDOR) approach to adverse events was associated with long-lasting, clinically and financially significant changes in a large set of core medical liability process and outcome measures.
authors: Department of Communication Studies and Center for Communication and Health, Northwestern University, Chicago, IL.
authors: Bruce L
authors: BL
authors: Lambert
authors: Office of Patient Safety Loyola University Health System, Maywood, IL.
authors: Nichola M
authors: NM
authors: Centomani
authors: MedStar Institute for Quality & Safety, MedStar Health Research Institute, Columbia, MD.
authors: Kelly M
authors: KM
authors: Smith
authors: Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC.
authors: Lorens A
authors: LA
authors: Helmchen
authors: Department of Psychiatry, University of Illinois at Chicago, Chicago, IL.
authors: Dulal K
authors: DK
authors: Bhaumik
authors: Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL.
authors: Yash J
authors: YJ
authors: Jalundhwala
authors: MedStar Institute for Quality & Safety, MedStar Health Research Institute, Columbia, MD.|Beazley Institute for Health Law and Policy, Loyola University Chicago, Chicago, IL.
authors: Timothy B
authors: TB
authors: McDonald
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007351:Insurance, Liability / Q000191:economics; D016365:Liability, Legal; D010043:Outcome and Process Assessment, Health Care; D061214:Patient Safety / Q000706:statistics & numerical data; D058996:Quality Improvement / Q000458:organization & administration; D012308:Risk Management
keywords: Patient safety; communication; disclosure; medical liability; resolution