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THIS WEEK'S EDITION:
- Sorry Works! Audio Conference a Great Success/CDs for Sale
- Sorry Works! visits Advocate Health Care in Chicago
- Question & Answer
- What Sorry Works! is not...clearing up myths and mis- understandings
- Past newsletters now on the Sorry Works! website
- Employers & Insurers want "sorry" and rebate
SORRY WORKS! AUDIO CONFERENCE A GREAT SUCCESS/CDs for sale....
The first-ever Sorry Works! audio conference - a joint project between The Sorry Works! Coalition and the Risk Management & Patient Safety Coalition (RM&PSI) - was a great success. We had a fantastic audience with reach into 34 States, the District of Columbia, and two provinces in Canada: Alabama, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Iowa, Idaho, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maryland, Michigan, Minnesota, Missouri, North Carolina, North Dakota, Nebraska, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Vermont, Washington, Wisconsin, and the provinces of Alberta and Ontario in Canada.
Many thanks to our great panel which included Dr. Steve Kraman, Joe Johnson of Triad Hospitals, Bruce Klores (Washington D.C. Plaintiff's attorney), and Doug Wojcieszak, (founder/spokesperson, The Sorry Works! Coalition). Dr. Geri Amori of RM&PSI did a wonderful job of hosting the conference and leading the discussion. Thanks to all.
CDs of the audio conference are now on sale. Medical and insurance professionals can purchase the CD and use it to provide CME credits and nursing contact hours for their staff. Purchasers of the CD have six (6) months from the date of the audio conference (November 14, 2006) to play the CD for their staff, complete the necessary paperwork, and mail back to RM&PSI in order to qualify for the credits. This CD qualifies for 1.5 AMA PRA Category I CreditsTM. It is also approved for 1.8 nursing contact hours by the Michigan Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. For more information or to purchase the CD, please contact Melanie Gober at mgober@rmpsi.com or call 517-886-8226. Thank you!
Additional Sorry Works! audio conferences are being planned for next year – stay tuned!
SORRY WORKS! VISITS ADVOCATE HEALTH CARE IN CHICAGO
The week before Thanksgiving Sorry Works! paid a visit to Advocate Health Care in Chicago. Dr. John Banja and Doug Wojcieszak spoke at three different sessions over two days, and enjoyed a fantastic response. After the talks Advocate personnel spoke with Banja and Wojcieszak and said the talks cleared up misconceptions and confusion about Sorry Works! and disclosure (more below). However, Advocate personnel also talked among themselves - for a long time. And they weren't talking about the Da Bears or the cold weather...no, they were talking about disclosure!
Advocate corporate personnel and Advocate employees within their individual hospitals learned that they were all pretty much on the same page when it came to disclosure - which surprised a lot of people. Several times it was heard, "Oh, I never thought you guys in corporate would go for this disclosure stuff."
We also heard, "Well, we at corporate have thought disclosure is a good and important thing to do for awhile, but we never thought the staff in the individual hospitals would go for the program."
The Sorry Works! talks brought people out of their silos and opened up communication and dialogue about disclosure - which means Advocate is one step closer to implementing successful disclosure programs. This is a theme we have continually harped on over the last two months....for disclosure to happen doctors need to communicate with their insurers, insurers need to communicate with their insureds, hospitals administrators need to be speaking with their medical staff and insurer(s), and so on. Most people are for disclosure (the arguments against disclosure are indeed coming to a close), but, surprisingly, people think they are alone in their support of disclosure – which is not true.
The true value of Sorry Works! talks is that they bring medical, legal, and insurance people from an institution or organization together and get them talking and sharing ideas about disclosure. Powerful stuff. If you are interested in a Sorry Works! presentation for your hospital, healthcare organization, or insurer/insureds to get people talking, please contact doug@sorryworks.net or call 618- 559-8168.
Advocate's Lutheran General Hospital has a very good disclosure policy in place which can be viewed on the Sorry Works! website at: http:/www.sorryworks.net/article22.phtml.
Many thanks to our host Reverend Clint Moore, head ethicist at Advocate Lutheran General in Park Ridge, IL. Also special thanks to Sorry Works! supporter and friend Bruce Campbell, CEO of Advocate Lutheran General Hospital.
QUESTION & ANSWER
Welcome to this week's Q&A with Dr. Geri Amori, RM&PSI Senior Director (www.rmpsi.com) and experienced risk manager, educator, and counselor and Doug Wojcieszak, Founder and Spokesperson of The Sorry Works! Coalition (www.sorryworks.net). This week's question comes from the recently completed Sorry Works! audio conference. Over the next few weeks will be sharing some of the questions we received from the audio conference.
Question: How do we get more provider C-Suite executives, attorneys, and insurance companies to embrace the philosophies/approaches practiced by the Sorry Works! speakers on the audio conference? How do we accelerate these positive changes?
Doug: Keep talking, educating and spreading the message. Healthcare and insurance executives are saying that they are "crisis mode" with malpractice, and Sorry Works!/disclosure programs answer these problems. There is a lot of data coming in showing that disclosure programs reduce litigation costs, while there is not a shred of evidence that traditional deny and defend practices work. Furthermore - and most compelling – disclosure programs can be implemented right now without any legislative or judicial actions, and they can never be taken away. Very empowering message to share and move people.
Geri: We've got to address the "WIIFM" (What's in it for me?). Executives, attorneys and insurance companies are at least one step removed from the patient at the point of immediate pain. Although they can theoretically empathize and understand, they tend to take a more financially strategic view of risk reduction. It comes with the territory. It isn't because they don't care; it's because they haven't thought through the psychology of anger, blame, and its relationship to punishment via money. They see the patient/family when the anger has become objectified into wanting retribution. They rarely if ever SEE the patient/family when the pain is so palpable that what is needed is to know that someone is listening, cares, takes responsibility, and will make things right.
Now that we can have empathy for them, we need to undertake re- educating them. Most of the doctors, lawyers, c-suite and insurance people I know need facts. Fear and lack of knowledge prevents all people from changing behavior. We know what we know. SO, find those articles that show the financial benefits of early resolution. Send them those articles. Send them the articles about patients/families that have used their experience to improve care. Get people in the field to speak with them.
If you persist, slowly but surely, your efforts to re-educate will win. They need to know it will be easier for them ultimately; less stressful ultimately, financially better ultimately; and that intangible called more satisfying.....
Got a question? E-mail it to doug@sorryworks.net or gamori@rmpsi.com. Your identity will remain confidential. Thanks!
WHAT SORRY WORKS! IS NOT....clearing up myths and mis-understandings
As noted above, the Sorry Works! talk at Advocate Hospitals cleared up some confusion for folks. In this section we address some of most common misconceptions, and we hope you, our readers, will forward this section onto your friends and colleagues who might need some more information about Sorry Works!
Myth: Sorry Works! is just about sorry....the Sorry Works! people don't understand there is so much more to disclosure than "sorry." But they are so wed to "sorry" and just don't understand.
Response: Not true....sorry does work, but there is much more to Sorry Works! than just "sorry." Sorry Works! is a program....a disclosure program. In the Sorry Works! program, you have a team from your hospital and/or insurer trained on the program. When an adverse event happens, the team swings into action to establish initial contact with the patient and/or family:
"We are sorry this happened, we are investigating the situation, and we will be back to you in XX weeks with our findings. Here is my business card if you have any questions or need assistance. Also, as relatives come to the hospital please have them call me if they any questions or concerns...I will be happy to speak with them. Is there anything we can do for you or your family at this point?".
The investigation will determine if the professional standard of care was breached or not.
If there was an error, the program says a meeting will be scheduled with the patient, family, and their attorney. In the meeting four things will given to the family: 1) an apology; 2) an admission of fault; 3) explanation of what happened and how the mistake will be fixed so it is not likely to happen in the future again; 4) offer of fair, upfront compensation. In most instances, the cases can be settled in a matter of weeks.
If, however, there was no error, the program dictates a meeting with the patient, family, and their attorney still should be held. In that meeting, an explanation of the investigation will occur, records will be opened and shared, and all questions will be answered. The disclosure team will empathize with the patient and family ("we are sorry this happened") but no settlement will be offered and all lawsuits will be contested to jury verdict (no settlements, ever), if necessary.
As you see, Sorry Works! is much more than "sorry." Sorry Works! is a great marketing tool to describe disclosure programs, but people shouldn't get hung up on the name.
Myth: Well, those Sorry Works! people want doctors and nurses to say "sorry" for every bad thing that happens in our hospital. That's just not practical....often adverse events are not our fault.
Response: Look at the program described above. No one is saying that doctors have to come running out the operating room apologizing all over themselves and whipping out the checkbook. No. You communicate and empathize with patients and families all the time, but you only admit fault after an investigation has shown that an actual mistake/breach of professional standard of care occurred.
Myth: Sorry Works! is just another no-fault scheme...my docs will never go for it!
Response: Not true. Again, read the program description above. The beauty of Sorry Works! is physicians and nurses are never sold out when they did their job no matter what it costs to defend them all the way to jury verdict if necessary. In fact, to get docs and nurses to admit fault after legitimate errors they have to know they will be defended all the way if they did their job (i.e, did not breach professional standard of care). Sorry Works! is definitely not a no-fault scheme.
Past newsletters now on Sorry Works! website
Past Sorry Works! newsletters are now available on the Sorry Works! website. If you want to review a newsletter or if you are new to our e-list go to the following link: http://www.sorryworks.net/newsletter.phtml.
Newsletters run about a month behind and they go back as far as April 2006. Check it out!
EMPLOYERS WANT "SORRY" AND COMPENSATION/REBATE FOR MEDICAL ERRORS.
Below is a recent article from the Chicago Tribune that shows major employers are in tune with Sorry Works! when it comes to medical errors that harm their employees. Good article – read below.
http://www.chicagotribune.com/business/chi- 0611160125nov16,0,4190587.story?coll=chi-business-hed.
Chicago Tribune
November 16, 2006
Backlash at bills for medical mistakes
Firms tired of paying for low-quality care
By Bruce Japsen
Tribune staff reporter
If you go to a restaurant and get a bad meal you probably won't have to pay for it. And lemon laws allow consumers who buy cars that never work right to get their money back.
But in health care there is no tradition of rebates--even when a hospital surgical team leaves a sponge in a patient's chest cavity after open-heart surgery, or when a mix-up of a patient's medication causes a prolonged illness, employers and insurers say.
Tired of paying for botched medical-care procedures and low-quality medical care, some of the nation's largest businesses Wednesday called on U.S. hospitals to agree to apologize and waive costs related to "never" events--medical errors these employers say should never happen.
Both the Leapfrog Group, a national coalition of large health-care purchasers such as Boeing Co., General Motors Corp. and General Electric Co., and the Midwest Business Group on Health, a Chicago- based business coalition representing more than 80 local employers, said hospitals should commit to a new policy on 28 health- care "never" events as a way to make providers of medical care more accountable.
Many of the errors, such as a surgery performed on the wrong body part or mixing up donor sperm for an artificial insemination, would seem obvious fodder for a malpractice suit and a settlement worth more than the bill for the procedure.
But other errors on the list, such as "retention of a foreign object in a patient after surgery" or patient injury associated with "contaminated drugs, devices or biologics provided by the health-care facility," are probably more common and fixing them compounds the soaring cost of health care.
Hospitals are committed to "making it right" with patients when they make mistakes, the industry's Washington-based lobby and trade group said.
"We agree that these 'never' events should never occur and we are working hard to make sure they are not only rare, but more and more rare each day," said Richard Umbdenstock, president-elect of the American Hospital Association, which represents more than 4,800 of the nation's hospitals. "We certainly agree that when they do occur and it can be tragic, we need to reach out and make it right. They are very much doing this already."
But while the hospital group said it believed most hospitals would sign on to the Leapfrog group's policy, they said there would be instances in which "hospitals and patients" would have to work the situation out themselves, citing complexities of cases.
Providers face pressure
It seems obvious to some that most consumers and many companies would support a don't-pay-for-errors approach, and as such the industry is also expected to sign on, given the momentum in Washington and state governments to demand that medical-care providers adhere to basic quality standards. The seriousness of the errors on the group's list could make defending a demand for payment for these errors hard to justify and cause a political firestorm if hospitals did not comply.
One hurdle is that few states require hospitals to report their errors. Although egregious errors such as those on the list are considered rare, there were more than 100 "never" events reported by hospitals in Minnesota in its most recent reporting year.
In Illinois, state health officials are still working through the details on how hospitals will report such incidents under terms of a law signed last year.
There is momentum to go beyond serious errors to consider more routine problems, such as hospital-borne infections and other quality issues, as part of the nationwide debate over paying medical care providers based on performance.
Still, when such serious errors occur, the business community picking up the tab for insurance says patients should get an apology and patients and their insurers or employers should not be billed.
Under Wednesday's proposal, it may be that hospitals would not bill for the original treatment or would absorb the costs for additional treatment needed after the error. According to Leapfrog, details of "what constitutes 'waiving cost' should be handled on a case- by- case basis by the parties involved."
Such errors add to health-care costs that have spiraled upward for years.
At least one study suggests medical errors and low-quality health care account for 30 percent of the more than $2 trillion spent on medical care in the United States.
The push by U.S. businesses comes as Congress and the Bush administration consider imposing financial penalties on providers when such errors occur.
Earlier this year the Centers for Medicare & Medicaid Services, which runs the nation's largest health insurance programs, said it would work with Congress to investigate potential ways to reduce reimbursement to providers that commit "never" events.
Number of events unknown
Although federal officials say the exact number of "never" events is unknown, the Centers for Medicare & Medicaid said they are costly to the system and believe they could number in the tens of thousands annually.
Already, health insurers say they are working clauses into hospital contracts that preclude them from being billed for "never" events and say there is momentum to apply that practice to lesser errors.
On Jan. 1, 2005, Minneapolis-based health insurer HealthPartners Inc. required hospitals in its network to report errors to the state department of health and not bill its health plan members for a "never" event.
"We do see this as an important signal to the health-care system about transparency and an expression of pay-for-performance," said Babette Apland, senior vice president of health-care management for HealthPartners, a health plan with more than 600,000 members.
"To consumers, to people, this makes sense," she added. "I think it gives us the framework to stop payment when there is this type of extremely poor quality. I think there is a lot of interest in the industry about payment reform and how we pay for value."
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