Improving Patient Safety and Restructuring Medical Liability Using ACEs

描述（由申请人提供）：本项目的最终目标是制定一个全面的计划，为华盛顿州西雅图-塔科马大都市区的主要卫生系统实施综合医疗责任和患者安全计划，以代替当前的侵权制度。新的医疗责任计划将基于避免事件类别（ACE）的发生，道歉和立即的，标准化的赔偿给病人（和家庭，如果合适的话），以及几个相关的辅助支持过程的识别。该计划将用于快速识别错误并尽早提供补偿，从而增加获得补偿的患者数量。作为规划拨款的一部分，将开发并试点测试一项针对减少这些ACE的有针对性的患者安全培训计划。规划赠款将由一个由华盛顿塔科马多保健系统领导的主要区域卫生系统联合会进行。其他卫生系统赠款的参与者包括西雅图的瑞典卫生服务和弗吉尼亚梅森医疗中心，也是西雅图。除了这三个大型的直接医疗保健提供系统，其他参与者在协作规划赠款项目是华盛顿医疗保健论坛，华盛顿州医学协会，华盛顿州医院协会，几个主要的健康保险公司，和首选健康，国家最大的首选提供者组织。为了完成该计划，该联盟将首先召集一个由当地医疗责任从业人员、患者安全领导人和国家专家组成的专家小组，以选择一系列可预防的医疗事件，这些事件将构成ACE计划的核心。然后将为这些ACE制定标准补偿计划，并根据影响的严重程度和预期持续时间对支付金额进行分层。将制定一个逐案赔偿确定方案，以涵盖所有其他可预防的医疗责任案件。综合计划的其他组成部分将包括建立替代性争议解决的仲裁或调解程序，通过焦点小组测试患者参与程序，采用既定的提供者道歉程序，并在地区医院试点测试相关的重点患者安全计划。 公共卫生相关性：拟议项目的相关性是充分探索和充实一个全面的替代方案，以解决目前基于诉讼的侵权制度的方法来解决医疗责任案件-通过创建一个基于证据的，合理的赔偿制度，可预防的不良医疗事件，与医院和医生的病人安全培训计划，重点放在这些可预防的事件。规划补助金将建立这一系统，该系统的实施将开始将目前的医疗责任环境转变为一个提供者接受专门培训以避免不良事件的过程，立即承认确实发生的错误，并迅速道歉和公平赔偿受伤的病人。这一结果不仅可以提高患者的安全性和满意度，而且随着时间的推移，还可以降低护理成本。

DESCRIPTION (provided by applicant): The ultimate goal of this project is to prepare a comprehensive plan for implementing an integrated medical liability and patient safety program for major health systems in the Seattle-Tacoma metropolitan area of Washington State, to be used in lieu of the current tort system. The new medical liability program will be based on identification of the occurrence of Avoidable Classes of Events (ACEs), an apology and immediate, standardized compensation to the patient (and family, as appropriate) when possible, and several related ancillary support processes. This program will be used to quickly identify errors and make early offers of compensation, increasing the number of patients who are compensated. A focused patient safety training program targeting reduction of these same ACEs will be developed and pilot tested as part of the planning grant. The planning grant will be conducted by a consortium of the leading regional health systems, headed by Multicare Health System of Tacoma, Washington. Other health system grant participants include Swedish Health Services of Seattle and Virginia Mason Medical Center, also of Seattle. In addition to these three large direct health care delivery systems, other participants in the collaborative planning grant project are the Washington Healthcare Forum, the Washington State Medical Association, the Washington State Hospital Association, several major health insurers, and First Choice Health, the state's largest preferred provider organization. To complete the plan, the consortium will first convene an expert panel of local medical liability practitioners, patient safety leaders, and national experts to select a broad set of preventable of medical events that will form the core of the ACEs program. Standard compensation schedules will then be developed for these ACEs, with payment amounts stratified by severity and expected duration of the impact. A case-by-case compensation determination program will be developed to cover all other preventable medical liability cases. Other components of the comprehensive program will include establishing an arbitration or mediation process for alternative dispute resolution, testing patient participation processes through focus groups, adopting an established provider apology process, and pilot testing the linked, focused patient safety program at area hospitals. PUBLIC HEALTH RELEVANCE: The relevance of the proposed project is to fully explore and flesh-out a comprehensive alternative to the current litigation-based tort system approach to resolving medical liability cases - by creating an evidence-based, reasonable compensation system for preventable adverse medical events, linked to hospital and physician patient safety training programs focused on these preventable events. The planning grant will create this system, the implementation of which will begin the process of transforming the current medical liability environment to one in which providers are specifically trained on avoiding adverse events, immediately acknowledge those errors which do occur, and rapidly apologize and fairly compensate the injured patient. This outcome will not only improve patient safety and satisfaction but also can, over time, reduce the costs of care.