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AHRQ ’ s Patient Safety and Medical Liability Initiative. James B. Battles, Ph.D. Agency for Healthcare Research and Quality Center for Quality Improvement and Patient Safety. Presidential Action .
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AHRQ’sPatient Safety and MedicalLiability Initiative James B. Battles, Ph.D. Agency for Healthcare Research and Quality Center for Quality Improvement and Patient Safety
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.
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
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)
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
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
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
Demonstration Grants • States and/or health care systems • 3 year grants • Up to $3 million/grant • 7 demonstration grants • Total $19.7 million
Planning Grants • States and/or health care systems • 1 year grants • Up to $300,000 • 13 grants awarded • Total $3.5 million
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
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
Featured Projects Demonstration 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
Hold Your Questions? We will take questions at the end of the three presentations