While the national debate about how to improve healthcare continues, hospitals and healthcare providers are under increasing pressure to improve patient safety and communicate more effectively with patients and families.They are also being asked to disclose adverse events and medical errors in the hopes that this will reduce the number of malpractice claims. For example, the University of Michigan Health System has a medical error disclosure program that includes a series of timely conversations with the patient after an adverse event or medical error, an apology, and an offer of fair compensation.This program has substantially reduced the number of claims against the university and its liability costs. The University of Illinois Medical Center at Chicago has a similar program through which it has been able to identify and im plement system improvements and increase the reporting of adverse incidents.
Mediation is another vehicle for exchanging information about adverse events, giving an apology, and paying compensation. For the past nine years, my colleague, Carol Liebman, and I have been studying ways in which mediation and mediation skills can resolve healthcare disputes and at the same time improve patient safety and the quality of care. The benefits of using mediation are well known to lawyers: a prompt, less expensive resolution; party control over decision making; and settlement agreements that are more nuanced than court decisions and can include nonmonetary remedies in addition to monetary compensation, such as a promise to make health system improvements. In addition, because mediation communications are protected by confidentiality, the process encourages more candid and less strategic communications.
In the healthcare setting, the exchange of communications in mediation, as in error disclosure programs, provides additional benefits. Hospital representatives and healthcare providers may learn about missed or ignored information that contributed to the harm or about ways that established procedures were ignored, and then make improvements to the system.