Patient safety, medical liability focus of government grants

The Dept. of Health and Human Services has awarded $25 million in grants to test and evaluate innovative approaches to improve patient safety and reduce medical liability claims.

Twenty grants were issued in June to states and health systems through the Agency for Healthcare Research and Quality as part of its patient safety and medical liability initiative.

The funded projects include programs to identify and reduce common medical errors, foster better communication between doctors and patients, and ensure that patients are informed of medical errors and offered early compensation.

The initiative was first announced by President Obama during a speech in September 2009 to a joint session of Congress. AHRQ began accepting grant proposals in December 2009.

"We wanted to respond as quickly as possible," said Carolyn Clancy, MD, director of AHRQ.

The projects will test new patient safety programs and produce data to study the link between such programs and medical liability claims. "This new research is the largest government investment connecting medical liability to quality and aims to improve the overall quality of health care," HHS Secretary Kathleen Sebelius said in a statement.

The American Medical Association favors caps on noneconomic damages but also supports testing alternative solutions to the medical liability problem.

"Liability reform will help doctors implement best practices in patient care and reduce unnecessary health costs," AMA Immediate Past President J. James Rohack, MD, said in a statement. "The nonpartisan Congressional Budget Office found that medical liability reforms that include a quarter-million-dollar cap on noneconomic damages would reduce the federal budget deficit by about $54 billion over 10 years."

Medical liability solutions

New York received a nearly $3 million grant to expand and test an existing judge-directed negotiation program in its court system for obstetrical and surgery patients. The state also will develop an early disclosure and settlement model for hospitals.

The University of Washington in Seattle got a $2.97 million grant for a training program to help nurses, doctors and pharmacists become better communicators. The goal is to offer patients "fast and fair compensation" for medical errors, said Thomas Gallagher, MD, associate professor of medicine at the University of Washington School of Medicine. "It's exciting, because we see communication as the missing link in improving patient safety and medical liability."

The Office for Oregon Health Policy and Research in Portland received a $299,458 grant to develop a legislative proposal for safe harbors for doctors who provide state-approved, evidence-based care.

The Ohio State University College of Medicine got a $186,214 grant to develop a statewide database of pregnancy-related deaths that will allow for comprehensive research and work toward establishing interventions.

Cynthia Shellhaas, MD, MPH, associate professor with the university's division of maternal and fetal medicine, said about a dozen states have such surveillance systems. "It's a quality-improvement initiative," said Dr. Shellhaas, also medical director of the state health department's Child and Family Health Services Program.

Sanford Research of Sioux Falls, S.D., a nonprofit research venture between Sanford Health and the University of South Dakota, is developing a method for collecting data on medical errors. The multistate health system received a $299,995 grant to design a patient advocacy reporting system for patient complaints.

It's modeled after a system that has led to safety improvements and reductions in medical liability claims at Vanderbilt University Medical Center in Nashville, Tenn., said Wendell Hoffman, MD, an infectious disease specialist and Sanford Health's patient safety officer.