Steve S. Kraman, MD; Ginny Hamm, JD
Kraman SS, Hamm G. Risk Management: Extreme Honesty May Be the Best Policy. Ann Intern Med. 1999;131:963-967. doi: 10.7326/0003-4819-131-12-199912210-00010
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Published: Ann Intern Med. 1999;131(12):963-967.
This paper reviews a humanistic risk management policy that includes early injury review, steadfast maintenance of the relationship between the hospital and the patient, proactive full disclosure to patients who have been injured because of accidents or medical negligence, and fair compensation for injuries. The financial consequences of this type of policy are not yet known; however, one Veterans Affairs medical center, which has been using humanistic risk management since 1987, has had encouragingly moderate liability payments. The Department of Veterans Affairs now requires such a policy for all of its facilities; therefore, comprehensive experience may be only a few years away.
Workload was calculated by the Allocation Resource Center (Budget Office, Department of Veterans Affairs) and is adjusted for sharing, referrals, and patient complexity. In bottom panel, white filler represents payments that resulted from court judgments; left-slanting diagonal lines represent claims settled during litigation before a judgment was made; black filler represents claims settled at the national level by Veterans Affairs general counsel; right-slanting diagonal lines represent claims settled locally by Veterans Affairs district or regional counsel. *Veterans Affairs Medical Center, Lexington, Kentucky.
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