Patients at the University of Michigan Health System who have experienced a bad outcome are likely to receive another visit from their physician. They are told the reason for the outcome and whether it was preventable or not, and the physician apologizes. If the physician or hospital was at fault, the patient is offered compensation.
Explore this issue:July 2015
This course of action is the basis of what is being called a “Michigan Model” for malpractice reform—an innovative approach to medical errors, mishaps, and near misses, implemented by the University of Michigan Health System in Ann Arbor. Physicians and administrators at the University of Michigan say the program, which began in 2001, has achieved resounding success by a number of measures, including reduced malpractice claims and improved hospital-patient relations.
All that, and yet none of those measures is the primary overarching goal of the communication and resolution program at the university. It’s safety.
“The main goal is to get better,” said attorney Rick Boothman, chief risk officer at the University of Michigan Health System and architect of the Michigan Model. “We will never improve if we can’t admit our mistakes to ourselves. And we are brutally honest.”
Boothman teamed up with some University of Michigan physicians to study the impact of the Michigan Model. They compared data from the six years before the program’s implementation with numbers from the six years after the model debuted. Post-implementation data revealed fewer claims and fewer compensated claims (See “Comparison of Claims before and after Implementation of the Michigan Model for Medical Errors,” below). Time to claim resolution was shorter, and claims-related costs were down as well (Ann Intern Med. 2010; 153:213-221).
“Doing the right thing paid off,” said Sanjay Saint, MD, MPH, a co-author of the study. Dr. Saint is chief of medicine at the VA Ann Arbor Healthcare System, professor of internal medicine at the University of Michigan and director of the university’s patient safety enhancement program. “If we’re at fault, we disclose and try to make the patient and the family whole. They can still hire an attorney if they want to, but otherwise things get resolved faster. Our openness helps us.”
More academic medical centers are following Michigan’s lead in providing full disclosure to patients. Stanford University’s program, called PEARL (Process for Early Assessment and Resolution of Loss), began on a limited basis in 2005 and launched as a full-fledged program in 2007. In its first three and a half years, the university reported a 36% decrease in claim frequency and a 32% average reduction in annual insurance premiums.