The Texas Disclosure and Compensation Study: Best Practices for Improving Safety

描述(由申请人提供)：披露和赔偿计划是传统医疗责任的主要替代方案。患者想知道医疗差错，特别是直接伤害他们的差错。尽管向患者披露错误及其后果很困难，但向患者披露错误的好处是多方面的。我们的总体目标是确定如何使披露和赔偿成为一个不仅服务于个别患者的需求，而且更多地利用患者的经验来帮助医院改变他们的系统并提高后续患者的安全性的过程。为了实现这一目标，我们将：1)在德克萨斯大学系统中开展一项为期3年的披露和补偿研究，在三个时间点(基线、初始披露培训之后/实施利用披露来提高安全性的最佳实践之前和实施这些最佳实践之后)对披露、不当行为和对安全的影响进行研究；2)在第二年主办一次全国专家会议，以确定利用披露来改善医院安全的最佳实践；以及3)实施、评估和传播这些最佳实践(重点是让患者和家属参与了解错误发生的原因)。这项研究的成果将包括：使用信息披露和患者视角来改善患者安全的最佳实践；一项衡量安全文化和错误披露文化的新调查；以及关于披露和赔偿如何影响传统侵权结果的评估，如索赔、诉讼、解决时间、付款和总费用。 公共卫生相关性：我们的总体目标是确定如何使披露和赔偿成为一个过程，不仅服务于个别患者的需求，而且更多地利用患者的经验来帮助医院改变他们的系统，并提高后续患者的安全性。为了实现这一目标，我们将：1)在德克萨斯大学系统中开展一项为期3年的披露和补偿研究，在三个时间点(基线、初始披露培训之后/实施利用披露来提高安全性的最佳实践之前和实施这些最佳实践之后)对披露、不当行为和对安全的影响进行研究；2)在第二年主办一次全国专家会议，以确定利用披露来改善医院安全的最佳实践；以及3)实施、评估和传播这些最佳实践(重点是让患者和家属参与了解错误发生的原因)。 这项研究的成果将包括：使用信息披露和患者视角来改善患者安全的最佳实践；一项衡量安全文化和错误披露文化的新调查；以及关于披露和赔偿如何影响传统侵权结果的评估，如索赔、诉讼、解决时间、付款和总费用。

DESCRIPTION (provided by applicant): Disclosure and compensation programs are a leading alternative to traditional medical liability. Patients want to know about medical errors, especially errors that directly harm them. Although disclosing an error and its consequences to a patient is difficult, the benefits of disclosing errors to patients are multiple. Our overall goal is to determine how to make disclosure and compensation a process that will not only serve the needs of individual patients, but take more advantage of the patient's experience to help hospitals change their systems and improve safety for subsequent patients. To meet this goal we will: 1) conduct a 3-year study of disclosure and compensation in the University of Texas System with measures of disclosure, malpractice, and impact on safety at three points in time (baseline, after initial disclosure training/before implementation of best practices for using disclosure to improve safety, and after implementation of these best practices); 2) host a conference of national experts during year two to identify best practices for using disclosure to improve hospital safety; and 3) implement, evaluate, and disseminate these best practices (with a focus on incorporating patients and families into efforts to understand why errors occur). The products of this study will include: best practices for using disclosure and patients' perspectives to improve patient safety; a new survey to measure both safety culture and error disclosure culture; and an assessment of how disclosure and compensation influences traditional tort outcomes such as claims, suits, time to resolution, payments, and overall expense. PUBLIC HEALTH RELEVANCE: Our overall goal is to determine how to make disclosure and compensation a process that will not only serve the needs of individual patients, but take more advantage of the patient's experience to help hospitals change their systems and improve safety for subsequent patients. To meet this goal we will: 1) conduct a 3-year study of disclosure and compensation in the University of Texas System with measures of disclosure, malpractice, and impact on safety at three points in time (baseline, after initial disclosure training/before implementation of best practices for using disclosure to improve safety, and after implementation of these best practices); 2) host a conference of national experts during year two to identify best practices for using disclosure to improve hospital safety; and 3) implement, evaluate, and disseminate these best practices (with a focus on incorporating patients and families into efforts to understand why errors occur). The products of this study will include: best practices for using disclosure and patients' perspectives to improve patient safety; a new survey to measure both safety culture and error disclosure culture; and an assessment of how disclosure and compensation influences traditional tort outcomes such as claims, suits, time to resolution, payments, and overall expense.