title: Case Outcomes in a Communication-and-Resolution Program in New York Hospitals.
abstract: OBJECTIVE
  To determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery.
  
  
  METHODS
  Five acute-care hospitals in New York City.
  
  
  METHODS
  Following CRP implementation, hospitals recorded information about each CRP event for 22 months.
  
  
  METHODS
  Risk managers prospectively collected data in collaboration with representatives from the hospital's insurer. External researchers administered an online satisfaction survey to clinicians involved in CRP events.
  
  
  RESULTS
  Among 125 CRP cases, disclosure conversations were carried out in 92 percent, explanations were conveyed in 88 percent, and apologies were offered in 72.8 percent. Three quarters of events did not involve substandard care. Compensation offers beyond bill waivers were deemed appropriate in 9 of 30 of cases in which substandard care caused harm and communicated in six such cases. In 44 percent of cases, hospitals identified steps that could be taken to improve safety. Clinicians had low awareness of the workings of the CRP, but high satisfaction with their experiences.
  
  
  CONCLUSIONS
  The bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care.
authors: Stanford Law School, Stanford, CA.
authors: Michelle M
authors: MM
authors: Mello
authors: Boston University Law School, Boston, MA.
authors: Yelena
authors: Y
authors: Greenberg
authors: St. Peters Health Partners, Rexford, NY.
authors: Susan K
authors: SK
authors: Senecal
authors: New York State Department of Health, Albany, NY.
authors: Janet S
authors: JS
authors: Cohn
mesh_terms: D003142:Communication; D005260:Female; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D016365:Liability, Legal; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D017008:Negotiating / Q000379:methods*; D009518:New York; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000331:legislation & jurisprudence
keywords: Medical liability; malpractice; medical error; patient safety