For

Providers - Administrators

"Studies show that the most important factor in people's decisions to file lawsuits is not negligence, but ineffective communication between patients and providers." Clinton & Obama, NEJM 2006

"Malpractice suits often result when an unexpected adverse outcome is met with lack of empathy from physicians and a perceived or actual withholding of essential information." Vincent C, The Lancet 1993

The above quotes exemplify what is wrong with the current medical liability system, in which litigation is the main pathway for harmed patients to seek compensation. For patients, the current system breeds distrust of our healthcare system and blocks efforts to improve patient safety due to fear and secrecy that often surround bad outcomes. For physicians, it results in unaffordable premiums, and for all clinicians and staff a loss of trust in the justice system. It also causes them to view patients as potential litigants, and encourages the practice of defensive medicine. For the health care system as a whole, the current system stalls patient safety efforts, drives up the overall cost of health care, and compromises access to care when liabilty concerns lead physicians to avoid high risk patients.

Communication, Apology, and Resolution (CARe) is an alternative process designed to make tort the last resort. Built upon a culture of safety that relies on solid root cause analysis, it includes full disclosure and explanation, apology when appropriate, and timely and fair injury compensation. Visit our About section for background on the CARe approach in Massachusetts and on MACRMI.

Institutional Goals of CARe

The overall goals of CARe are to create an environment in which patient injuries are addressed rapidly and appropriately, and patient safety improves through learning from adverse events. Specific goals within the CARe initiative include:

Ensuring that all adverse events are reported and analyzed for "root causes;"
Ensuring that whenever there is signficant patient harm, there is an effort to assess preventability and implement changes to prevent recurrence;
Ensuring that patients receive communication regarding the adverse event and what is being done to prevent it from happening again;
Ensuring that there is an attempt for early resolution with the patient and/or family through a full explanation, an apology, and compensation when appropriate.

Download an article on malpractice reform and opportunities for leadership by health care institutions and liability insurers in the New England Journal of Medicine, 2010.

Testimonials

“Compassion, honesty, and transparency are at the core of healing relationships. CARe speaks to our need to treat patients and families with respect and dignity when a preventable medical error occurs. Because 1/3 of physicians have experienced a medical error occurring to themselves or a loved one as a patient, CARe also speaks to what clinicians want for themselves and family members.”

Randolph Peto, MD, MPH, Medical Director for Quality and Patient Safety, Baystate Medical Center

"Blue Cross Blue Shield of Massachusetts is proud to support this collaborative effort. By working together, Massachusetts will continue to be a leader nationally in the continuing drive for affordable and high-quality patient care."

Blue Cross Blue Shield of Massachusetts

"CARe will provide patients and health care providers essential support, guidance and educational tools to communicate regarding unanticipated medical outcomes. This dialogue will help maintain therapeutic relationships and will contribute to improvements in patient safety."

Coverys

"Our work at the Coalition has highlighted the value of the CARe model in preserving healing relationships between patients and their clinicians after an adverse event. We have also seen the potential for deep learning from adverse events as a consequence of the change in the organizational culture related to those events. This can significantly accelerate the pace of improvements in patient safety."

Massachusetts Coalition for the Prevention of Medical Errors

For

Providers - Administrators

Institutional Goals of CARe

Testimonials

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