Evidence on improvements in medical liability outcomes after the introduction of a communication-and-resolution program at a hospital in Tennessee

Background In 2009, the Erlanger Hospital System (EHS) in Tennessee introduced a Communications-and-Resolution Program (CRP) for addressing adverse medical outcomes. The program requires transparency from their medical staff whenever a patient suffers an unexpected outcome. Healthcare professionals often fear that such transparency could lead to worse liability outcomes, especially increased litigation and reporting to the National Practitioner Data Bank (NPDB). Methods Using a difference-in-difference model, we compared the liability outcomes of EHS to all healthcare entities in the state of Tennessee from 2005 to 2015. We reviewed charts after CRP was implemented to determine whether there was a written request for compensation or only a verbal request for compensation. Results After introducing the CRP, EHS defense costs fell by 58% ( p < 0.001) and the number of claims filed fell by 42% ( p = 0.01), compared to that in Tennessee. We found a statistically insignificant impact on compensation at EHS after CRP was implemented compared to compensation in Tennessee. We find weak evidence of relative reductions in Total Liability Costs ( p = 0.34; 95% CI = −81% to +31%). Under the CRP, 40% of paid compensations resulted from only a verbal request for money, not a written request. Conclusion Our results provide the first evidence using a comparison group to demonstrate that CRP can lower defense costs and claims filed in court while not significantly increasing other compensation or total liability costs. The large fraction of cases with only a verbal request for compensation suggests that there could be less reporting to the NPDB when a hospital implements CRP.