| If your hospital is like many across the nation, | | | | those hospitals that can demonstrate the absolute |
| you're facing a crisis in being able to manage your | | | | best practices when it comes to quality |
| professional liability costs in the face of rising | | | | management. |
| lawsuits and rapidly increasing premiums. What's | | | | We talk to hundreds of hospitals across the |
| the root cause of this problem? Well obviously it's | | | | country every week. In our dealings with them |
| lawsuits coming from patients who have | | | | we've come to realize that liability insurance |
| experienced sentinel events or negative outcomes | | | | carriers who are protecting hospitals are |
| such as deaths, hospital readmissions, etc. While | | | | increasingly either requiring or strongly |
| these patients and their families are entitled to | | | | recommending that their risk management |
| relief in certain circumstances when medical | | | | professionals insist upon sending all sentinel events |
| treatments go bad, the fact is that most hospital | | | | out for external peer review. Why is this? The |
| administrators are being crushed by the rise in | | | | fact is that hospital peer review is rapidly |
| liability costs. | | | | becoming a best practice for insuring rapid case |
| If you are a hospital administrator or CEO and | | | | resolution, root cause analysis of sentinel events, |
| looking for remedies in this regard there are a | | | | and illuminating conflicts of interest when it comes |
| number of things that you can be doing. First and | | | | to insuring quality and patient safety. |
| foremost is taking a holistic look at your quality of | | | | It's no secret that all insurance companies expend |
| care delivery system and in particular, look at | | | | a certain percentage of their revenues on helping |
| your quality management system. Taking an | | | | their clients to improve their practices in order to |
| outside assessment of your quality management | | | | reduce costs when it comes to risk management. |
| system can provide insight to where your | | | | Professional liability insurers who operate in the |
| potential root causes are that are leading to | | | | hospital group space are using peer review as |
| sentinel events and in turn produce the kind of | | | | another strategy to help their clients lower their |
| litigation and lawsuits that drive insurance | | | | experience ratio and improve the root cause |
| premiums up. | | | | analysis that leads to a reduction in sentinel |
| These premiums don't get driven up only by | | | | events. |
| actions in your own hospital but by actions across | | | | The external medical peer review process when |
| the board in all hospitals. In our litigious society | | | | integrated into a hospital quality management |
| today it's no secret that when people feel that a | | | | system provides an outstanding remedy to the |
| service provider (particularly in the medical | | | | professional liability insurance premium escalations |
| environment) has wronged them, their first | | | | that have now turned into a crisis in so many |
| impulse is to find a litigious, fee hungry attorney | | | | states across America. If you're a CEO or hospital |
| who is willing to take on a malpractice suit or a | | | | administrator looking for ways to reduce your risk |
| suit against the hospital on contingency. Since it | | | | and reduce your liability premiums so that you can |
| doesn't cost them anything to sue, it's very easy | | | | reduce the costs of providing services to your |
| for them to get started. | | | | patients and your local population, consider an |
| Who bares the brunt on these costs? In general, | | | | investment in an external review process every |
| ultimately consumers do as well as health plans, | | | | time you have a sentinel event that has a |
| hospital providers - everybody suffers under an | | | | potential for litigation. Often times by sending |
| overly litigious system which rewards people for | | | | cases out for external peer review, you can |
| bringing suits against others. If you are a hospital | | | | prevent any potential lawsuit by insuring that |
| in today's environment there is no question that | | | | nothing was done wrong by your medical |
| liability insurance premiums are on the rise and are | | | | professionals and hospital staff that lead to a |
| going to continue to escalate. The exception is | | | | particular sentinel event. |