INTERNATIONAL IMPLICATIONS OF OPEN DISCLOSURE OF MEDICAL ERRORS, AND THE SUPERIORITY OF FULL RISK INTEGRATION

• Published in: Journal of global business and technology 2018-10, Vol.14 (2), p.1-14
• Main Authors: Cwiek, Mark, Kikano, George, Novaretti, Marcia, Klaus, Jacob
• Format: Article
• Language: English
• Subjects: Apologies; Communication; Critical incidents; Disclosure; Dominance; Employment; Errors; Health care delivery; Health care industry; Health care policy; Health insurance; Health needs; Health services; Honesty; Hospitals; Injuries; Insurance; Insurance companies; Legislation; Liability insurance; Litigation; Medical errors; Medical malpractice; Medical technology; Medicine; Patient communication; Patient safety; Patients; Personal health; Physicians; Policy making; Political culture; Professional malpractice; Professionals; Profitability; Profits; Public health; Public policy; Quality improvement; Risk; Science and technology; Teams; Transactions; Transparency
• ISSN: 1553-5495; 2616-2733

Worldwide and throughout the ages, people have been dependent on their physicians and healthcare systems to provide them with accurate, timely and complete information related to their personal health needs. Honesty and transparency are core values considered essential in the normal and wide range of human transactions, and this is especially true in healthcare, where patients and their families place their full trust in their providers and the medical systems. Despite significant advances in science and technology, a large percentage of patients still incur preventable adverse events. Intense worldwide efforts have spotlighted the need to improve patient safety and to reduce errors. "Open disclosure" is an approach that ensures swift and honest discussion of adverse events or harm to the affected patient and the patient's family, that can allow for an apology to be extended and, where indicated, permit an expeditious resolution to settle the matter and to avoid the need for litigation. It is advanced in this article that the structure of the medical system and its ability to organize around an optimal set of resources, herein referred to by the authors as possessing "full risk integration," is key to optimizing the opportunities for success in this area. An optimal degree of risk integration for a healthcare system therefore includes: the fewest number of involved malpractice insurance companies, the fewest number of medical employment/independent contractor arrangements, a lessening of fear of financial catastrophe due to a potentially large malpractice payout, an effective and quick incident analysis, a responsive and humane apology management team, and a regulatory and political environment conducive to risk integration. The need for congruent legislation and comprehensive public policy changes to help with the goal of expansion of open disclosure throughout the world is discussed.