In an effort to improve the state’s malpractice system, seven Massachusetts hospitals are participating in a pilot program designed to offer patients harmed by medical errors prompt apologies and financial settlements, reports the Boston Globe.

The alliance of hospitals taking part in the new initiative include Massachusetts General Hospital, Beth Israel Deaconess Medical Center in Boston, Beth Israel Deaconess Hospital-Needham, Beth Israel Deaconess Hospital-Milton, Baystate Medical Center in Springfield, Baystate Franklin Medical Center in Greenfield, and Baystate Mary Lane Hospital in Ware.

Striving for an environment of openness
Championed by the Massachusetts Medical Society (MMS) and patterned after a plan successfully implemented by the University of Michigan Health System 10 years ago, the initiative, called “Roadmap to Reform,” proposes a process of disclosure, apology and offer (DA&O). The new system is meant as an alternative to the current system of litigation, considered by many health professionals as inefficient and responsible in part for driving health costs higher, stated the MMS in a news release.

“The current approach to medical liability is onerous for both patients and physicians,” said Alan Woodward, MD, chair of the MMS Committee on Professional Liability and past president of the organization.

“It discourages transparency, inhibits communication between caregivers and patients, burdens physicians with excessive premiums, leads to unwarranted lawsuits, and motivates physicians to practice defensive medicine,” added Woodward.

The new model, he said, would stop driving up unnecessary costs and “promote honesty and transparency.”

DA&O has been successfully implemented in other states as a viable approach to medical liability reform and patient safety. The model is gaining support around the country, including from the Joint Commission, a non-profit organization that accredits and certifies more than 19,000 health care organizations and programs in the U.S.

How DA&O works
Under the proposed system, physicians, nurses, and hospitals would be required to swiftly disclose any unanticipated negative outcomes, quickly investigate and explain what happened, and take steps to prevent a recurrence of the problem. If the hospital determines it is at fault, it would issue an apology and work with hospital and physician malpractice insurers to determine the amount of compensation to offer the patient for injuries and follow-up care.

The new initiative is designed to provide compensation within 3-6 months, according to MMS’ Woodward, rather than the average of more than five years it takes to move a malpractice suit through the courts.

Patients have the right to reject an offer and pursue litigation. Patients choosing to settle, however, waive their right to sue in the future.

Dr. Kenneth Sands, senior vice president for healthcare quality at Beth Israel, told the Associated Press that patients would also be allowed legal representation as they consider the compensation offer.

“This isn’t ‘You’re not allowed to get a lawyer, here’s a dollar figure, take it or leave it,’ ” he said.

Concerns about the initiative
Some proponents of the plan fear that doctors might resist settlements because Massachusetts state law allows consumers to view any malpractice findings against physicians. Sands worries it might induce some doctors to remain quiet and hope a patient doesn’t sue rather than acknowledging an error that would show up on their records.

Coming from a different perspective, Andrew Meyer, Jr., a Boston malpractice attorney, told the Boston Globe, “For the most part, malpractice insurers are looking for a discount from fair compensation” by making an early offer.

But even Meyer agreed that, “if a patient’s rights are not limited in any way, I have no issue with an attempt at early resolution. Cases just drag on for years.”