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。患者希望了解医疗差错，特别是直接伤害他们的差错。虽然向患者披露错误及其后果是困难的，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满足个别患者需求的过程，而且更多地利用患者的经验来帮助医院改变他们的系统，提高后续患者的安全性。为实现这一目标，我们将：1）在德克萨斯大学系统进行为期3年的披露和赔偿研究，在三个时间点测量披露、不当行为和对安全的影响（基线，在初步披露培训之后/在实施利用披露提高安全的最佳做法之前，以及在实施这些最佳做法之后）; 2）在第二年举办一次国家专家会议，以确定利用披露改善医院安全的最佳做法; 3）实施、评估和传播这些最佳实践（重点是将患者和家属纳入努力，以了解错误发生的原因）。这项研究的成果将包括：使用披露和患者的观点来提高患者安全的最佳实践;一项新的调查，以衡量安全文化和错误披露文化;以及评估披露和赔偿如何影响传统的侵权结果，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不仅满足个别患者需求的过程，而且更多地利用患者的经验来帮助医院改变他们的系统，提高后续患者的安全性。为实现这一目标，我们将：1）在德克萨斯大学系统进行为期3年的披露和赔偿研究，在三个时间点测量披露、不当行为和对安全的影响（基线，在初步披露培训之后/在实施利用披露提高安全的最佳做法之前，以及在实施这些最佳做法之后）; 2）在第二年举办一次国家专家会议，以确定利用披露改善医院安全的最佳做法; 3）实施、评估和传播这些最佳实践（重点是将患者和家属纳入努力，以了解错误发生的原因）。 这项研究的成果将包括：使用披露和患者的观点来提高患者安全的最佳实践;一项新的调查，以衡量安全文化和错误披露文化;以及评估披露和赔偿如何影响传统的侵权结果，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.