Practice of Medicine

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How an Organization’s Culture Drives Reporting

By: Rebecca Summey-Lowman, MBA, RDN, CPHRM, CPPS, CHPS

MagMutual takes a proactive and collaborative approach to handling reported events. When an incident is disclosed, we have a team of risk and claims professionals who evaluate the information to determine the best approach and strategy to achieve the best possible outcome. This allows our risk and patient safety experts access to real-time issues.

It also gives us the opportunity to evaluate the cases for non-traditional approaches. Early settlement approaches such as modest payouts to cover out-of-pocket expenses and daily loss of time, and sometimes writing off medical bills, can all help preserve the patient-physician relationship and reduce costly litigation expenses.

Early in this process we discovered a trend: many events are reported long after the incident occurred – closing the window of opportunity for an early resolution or non-traditional approach. We would like to see this change. Early reporting is vital to proactive claims management and early resolution opportunities.

Reporting events to us is largely dependent upon the culture of reporting within your organization. When you don’t know about an incident, you lose the opportunity to examine the root causes and take action to prevent it from happening again. Event reporting is a fundamental part of medical error reduction and yet evidence suggests that underreporting of events remains a significant problem.

Barriers to reporting often involve a fear of revealing shortcomings in professional competence, opening the doors to professional sanctions, and increased medical liability premiums. Staff members are often unwilling to report events or unsafe practices because they fear punishment or do not have confidence that reporting will result in any change.

In addition, management attitudes and institutional culture can greatly influence the success or failure of your reporting efforts. Barriers to reporting must be recognized and addressed before an event reporting system can have a substantial impact on patient safety. The ideal system promotes an open and honest reporting environment balanced with professional accountability.

Keep in mind that your malpractice insurance policy with us is a contract. The terms of the contract protect you provided that you comply with your duties and notification provisions specified in the policy. If you are aware of a claim or an incident which could lead to a claim, or if a claim is made against you or anyone for whose acts you are legally responsible, you must promptly notify us.

Failure to report a potentially compensable event early on could seriously impair our ability to appropriately defend your claim and coverage for your claim under this policy may even be denied. Prompt reporting of claims has no adverse effect on your insurability, premiums or discounts.

If you are ever in doubt about reporting, err on the side of caution and contact us. Our claims and risk professionals are available to assist you in determining when an incident triggers your reporting requirements. Additionally, we are equipped to offer you guidance on disclosure and apology strategies.

Keep in mind that early reporting affords us the opportunity to seek resolution opportunities that may not exist down the road. This might just help you preserve your relationship with your patient and avoid the cost and personal toll of litigation. Above all, the most fundamental component to error reduction and early claims resolution is determined by the culture of reporting within your organization.

10/18

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Disclaimer

The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.