Last Thursday (Feb.26th) many of our readers enjoyed the disclosure webinar produced by The Risk Authority/Stanford University. The panelists for the webinar were Michelle Mello, JD, PhD, Dr. Tom Gallagher, and Leilani Schweitzer. For those of you who were not able to view the webinar live, a taped version is available by contacting Simon Mawer at firstname.lastname@example.org.
Lots of good takeaways from the webinar I want to share with the Sorry Works! audience. First, at the beginning, middle, and towards the end of the webinar, the host asked live survey questions of the audience: 1) How many organizations have disclosure programs? 2) What are your attitudes towards disclosure programs? 3) What are the barriers to implementing disclosure programs? I found the results to be interesting and you will too:
How many organizations have disclosure programs?
30% – Full disclosure program operating
30% – Getting a program started
40% – No program
What are your attitudes towards disclosure programs?
30% – Fully Committed
55% – Explore/open, OR skeptical
12% – Not sure
What are the Barriers to Implementation of Disclosure Programs?
26% – Lack of Leadership
30% – Doctor push back
30% – Lack of know how
14% – Perception that Disclosure Not Needed
Michelle Mello shared data on the success of disclosure programs. In addition to the University of Michigan data that many people know about (cutting lawsuits by half, etc), Mello also provided disclosure program data from the University of Illinois Medical Center in Chicago and Stanford Medical Center. UI’s data showed a 50 percent reduction in new claims, and the time to close claims decreased from 55 months to 12 months, while Stanford has seen a 50 percent reduction in lawsuits, indemnity costs reduced by 40 percent, and defense costs reduced by 20 percent.
From the Sorry Works! perspective, when we speak to risk and claims people, they tell us their early data is beginning to mirror the numbers shared by Michelle Mello above. One risk manager summed it up best when she said, “Our claims reduced dramatically when our hospital started running to problems.”
Then, Mello and Gallagher both discussed how healthcare and insurance organizations say they do disclosure, when often they really don’t….which we have also observed at Sorry Works! Some healthcare organizations will “cherry pick” cases, usually the slam dunk cases, but fall back into bad habits with the “gray” or questionable cases. Mello and Gallagher termed this “selective implementation.” Also, leadership of an organization might embrace disclosure, but the front-line staff has not been trained how to communicate with families post-event….so disclosure is not happening as much as it should.
Gallagher then made an interesting point that resistance to disclosure within any organization will be passive:
“We’re not ready to do disclosure yet”…..”the doctors are still uncomfortable with this idea, we should wait,”…..”Not this case, let’s try with another case,” and so on.
Tom is right….over the last few years of doing disclosure presentations I’ve never had anyone stand up in an audience and say, “We shouldn’t tell the truth to our patients when something goes wrong!”….people would be nuts to utter such words in today’s environment. Yet, after speeches I have had many people say the following: “You know Dr. Smith, the guy on the left hand side with the glasses who was asking all the questions and seemed supportive? Well, he doesn’t think the doctors should be forced to disclose, and doesn’t believe our organization is ready for this…he is our biggest obstacle!”
This issue of passive resistance really speaks to the need for leadership. For disclosure to be successful, you need to have strong leaders who are not afraid to lean on people, change hearts and minds, and, in some instances, remove certain people from the organization. Also, a vibrant, well-thought-out disclosure program will be constantly be sharing information and success stories about disclosure throughout your organization, which, over time, will melt some hardened hearts.
At the end of the webinar, Michelle Mello was asked to give a summary of her feelings and thoughts about disclosure and she had a two word response: “Try it.” People simply need to try disclosure, develop a disclosure program within their organization, and do disclosure with every case. Run to the fire every time!
Again, if you want to see a recording of the webinar, contact The Risk Authority’s Simon Mawer at email@example.com.