If your hospital is like many across the nation, you're facing a crisis in being able to manage your professional liability costs in the face of rising lawsuits and rapidly increasing premiums. What's the root cause of this problem? Well obviously it's lawsuits coming from patients who have experienced sentinel events or negative outcomes such as deaths, hospital readmissions, etc. While these patients and their families are entitled to relief in certain circumstances when medical treatments go bad, the fact is that most hospital administrators are being crushed by the rise in liability costs.
If you are a hospital administrator or CEO and looking for remedies in this regard there are a number of things that you can be doing. First and foremost is taking a holistic look at your quality of care delivery system and in particular, look at your quality management system. Taking an outside assessment of your quality management system can provide insight to where your potential root causes are that are leading to sentinel events and in turn produce the kind of litigation and lawsuits that drive insurance premiums up.
These premiums don't get driven up only by actions in your own hospital but by actions across the board in all hospitals. In our litigious society today it's no secret that when people feel that a service provider (particularly in the medical environment) has wronged them, their first impulse is to find a litigious, fee hungry attorney who is willing to take on a malpractice suit or a suit against the hospital on contingency. Since it doesn't cost them anything to sue, it's very easy for them to get started.
Who bares the brunt on these costs? In general, ultimately consumers do as well as health plans, hospital providers - everybody suffers under an overly litigious system which rewards people for bringing suits against others. If you are a hospital in today's environment there is no question that liability insurance premiums are on the rise and are going to continue to escalate. The exception is those hospitals that can demonstrate the absolute best practices when it comes to quality management.
We talk to hundreds of hospitals across the country every week. In our dealings with them we've come to realize that liability insurance carriers who are protecting hospitals are increasingly either requiring or strongly recommending that their risk management professionals insist upon sending all sentinel events out for external peer review. Why is this? The fact is that hospital peer review is rapidly becoming a best practice for insuring rapid case resolution, root cause analysis of sentinel events, and illuminating conflicts of interest when it comes to insuring quality and patient safety.
It's no secret that all insurance companies expend a certain percentage of their revenues on helping their clients to improve their practices in order to reduce costs when it comes to risk management. Professional liability insurers who operate in the hospital group space are using peer review as another strategy to help their clients lower their experience ratio and improve the root cause analysis that leads to a reduction in sentinel events.
The external medical peer review process when integrated into a hospital quality management system provides an outstanding remedy to the professional liability insurance premium escalations that have now turned into a crisis in so many states across America. If you're a CEO or hospital administrator looking for ways to reduce your risk and reduce your liability premiums so that you can reduce the costs of providing services to your patients and your local population, consider an investment in an external review process every time you have a sentinel event that has a potential for litigation. Often times by sending cases out for external peer review, you can prevent any potential lawsuit by insuring that nothing was done wrong by your medical professionals and hospital staff that lead to a particular sentinel event.
Managing Professional Liability Costs With Peer Review
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