AHRQ’sPatient Safety and Medical

Liability Initiative

James B. Battles, Ph.D.Agency for Healthcare Research and Quality

Center for Quality Improvement and Patient Safety

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Presidential Action

On September 9, 2009, President Obama addressed a joint session of Congress to announce his proposals for health insurance reform. One component of such a plan includes investing in new ways to manage medical liability claims. The President stated:

So I'm proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.

I think it's a good idea, and I'm directing my Secretary of Health and Human Services to move forward on this initiative today.

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Goals

Put patient safety first and work to reduce preventable injuries

Foster better communication between doctors and their patients

Ensure that patients are compensated in a fair and timely manner for medical injuries, while also reducing the incidence of frivolous lawsuits

Reduce liability premiums

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Components of the Patient Safety and Medical Liability Initiative

Review of what works

Grants awarded (June 2010)

– Demonstration

– Planning

Evaluation contract

Open funding announcements (November 2010)

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Review of What Works

Document published by AHRQ in December, 2009 “Review of Reforms to Our Medical Liability System” Examined medical liability reforms

– Full Disclosure/early offer programs– Certificate of merit programs– Caps on damage awards– Pre-trial screening panels– Health courts

Studies conflict on impact of reforms on frequency or severity of claims

Little evidence on impact of reforms on patient safety

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Stakeholder Input

AHRQ reached out to a wide range of stakeholders representing different views about the extent and nature of the medical liability problem – health care providers, patients, academicians, insurers,

and lawyers Outreach included an October 26, 2009 all-day public

meeting Unanimous support for reforms that can measurably

improve patient safety and help bring rationality and fairness to the medical liability system

Stakeholder input informed the development of the demonstration and planning grants review criteria

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2010 Grants

RFA published – October 20, 2009 Awards announced – June 11, 2010 Address patient safety and medical liability Four goals of the initiative (patient safety first,

communication, compensation, reduce liability premiums) $23 million 20 grants awarded (7 demonstration, 13 planning) Largest government investment linking medical liability to

quality Variety of models

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Demonstration Grants

States and/or health care systems

3 year grants

Up to $3 million/grant

7 demonstration grants

Total $19.7 million

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Planning Grants

States and/or health care systems

1 year grants

Up to $300,000

13 grants awarded

Total $3.5 million

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Evaluation Contract

An independent program evaluation across all patient safety and medical liability grants

Awarded to JBA/RAND

$2 million dollars/5 years

Assess the impact of the projects and activities

Measure and document how well the projects have contributed to addressing the patient safety and medical liability concern

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Current Program Announcement

AHRQ issued two program announcements (demonstration/planning) that will enable AHRQ to receive grant applications now and make grant awards, contingent on available funding resources (November 2010)

Similar to previous funding announcement – Eligibility was expanded beyond health systems and

States to include non-profit organizations; – Consortiums (States, health systems and risk

management organizations)– Next submission due date is May 25, 2011

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Featured ProjectsDemonstration Grants Judy Kluger, J.D.

New York State Unified Court System, New York, NY

Ann Hendrich, M.S., R.N., F.A.A.N. Ascension Health System, St. Louis, MO

Planning Grants Kenneth Sands, M.D., M.P.H.

Beth Israel Deaconess Medical Center, Boston, MA

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Hold Your Questions?

We will take questions at the end of the three presentations