The purpose of the present paper is to examine measures, available to hospital managers to control the frequency of clinical negligence claims and their ultimate cost. Moreover, the extent to which hospital managers can transfer that risk to others is inv
Table of Contents
1 Introduction
2 The Need for Clinical Risk Management
3 Clinical Risk Management
3.1 Financial Control
3.2 Claim Management
3.3 Claim Prevention
4 The Transference of Risk
5 Conclusion
Objectives and Topics
The primary objective of this paper is to examine available measures for hospital managers to control the frequency and cost of clinical negligence claims, while investigating the extent to which this risk can be transferred to external parties.
- Clinical risk management strategies and financial control
- Mechanisms for active claim management and litigation reduction
- Approaches to claim prevention and the creation of a 'culture of safety'
- Analysis of risk transference through liability insurance and mutual funds
- Comparative insights into US and UK healthcare sectors
Excerpt from the Book
Adjudication of Medical Disputes: Arbitration
Arbitration is a well-used voluntary procedure whereby patients and health care providers may enter into written agreements for the submission of any disputes or claims to a third party. The third party is neutral, selected by the parties or through some agreed selection procedure, hears and determines the issues, and makes a binding decision. The quality of the arbitrator's approach can be judicial, but the procedures and rules of evidence may be simplified from the traditional court process, and special rules may be applied (Warren, 1980; Danzon, 1985; Brown and Simanowitz, 1995) In some cases, for example, the arbitrator may be assisted by an expert medical assessor. In the UK arbitration services are available for medical claim. For instance, the Chartered Institute of Arbitrators has developed an arbitration scheme for medical negligence claims within the NHS (Brown and Simanowitz, 1995). However, there are also concerns about arbitration, especially in the case where a medical provider has sufficient monopoly power to force arbitration on patients as a precondition of providing services, or if patients are uninformed. Suppliers of arbitration services would then have incentives to design procedures in favour of doctors. Consequently, many patients' groups do not consider arbitration being an attractive proposition (Brown and Simanowitz, 1995; Danzon, 1985). This is consistent with US NAIC data on claims in the period 1975-1978, which reports that only one-third of one per cent were closed by arbitration. However, the data also shows a higher plaintiff win rate and lower award in arbitration than in court (Danzon, 1985).
Summary of Chapters
1 Introduction: Outlines the purpose of the paper, focusing on medical negligence claims, cost control, and the scope of risk transference in healthcare.
2 The Need for Clinical Risk Management: Analyzes the sharp rise in negligence claims and their financial and personal impact on practitioners and patients.
3 Clinical Risk Management: Defines clinical risk management and explores its three main pillars: financial control, claim management, and claim prevention.
3.1 Financial Control: Discusses the difficulties of projecting negligence costs and the potential for financial fluctuation within hospital units.
3.2 Claim Management: Examines strategies for handling litigation, including alternative dispute resolutions like arbitration and pre-trial screening panels.
3.3 Claim Prevention: Focuses on how claims data can be utilized to improve quality and implement a 'culture of safety' within medical institutions.
4 The Transference of Risk: Investigates the role of liability insurance and risk pooling as methods for managing the financial consequences of medical malpractice.
5 Conclusion: Synthesizes the core aims of clinical risk management and the trade-offs involved in transferring risk to external parties.
Keywords
Clinical Risk Management, Medical Negligence, Malpractice Insurance, Claim Prevention, Financial Control, Litigation, Arbitration, Risk Transference, Patient Safety, Healthcare Management, Liability, Adverse Events, Dispute Resolution, NHS, Trust.
Frequently Asked Questions
What is the core focus of this work?
The work addresses the challenges hospital managers face regarding the frequency and cost of clinical negligence claims and evaluates methods for controlling these risks.
What are the central themes discussed in the paper?
The central themes include financial control, active claim management, the implementation of safety cultures, and the mechanics of transferring liability risk.
What is the primary objective or research question?
The research explores which measures are available to hospital managers to control the frequency and cost of negligence claims and to what extent these risks can be effectively transferred.
Which scientific methods are applied?
The paper employs a comprehensive literature review and qualitative analysis, incorporating data and studies from both the UK and US healthcare systems.
What topics are covered in the main body?
The main body covers the necessity of risk management, specific techniques for financial and claim management, and the comparative efficacy of insurance and mutual risk-sharing models.
Which keywords characterize this paper?
Key terms include Clinical Risk Management, Medical Negligence, Litigation, Insurance, Arbitration, and Patient Safety.
How does the 'culture of safety' impact clinical negligence?
The culture of safety moves away from blaming individuals and instead uses incident data to identify poor performance and systemic weaknesses, thereby preventing future claims.
What are the limitations of arbitration as a dispute resolution tool?
Limitations include the potential for power imbalances where providers might force arbitration on uninformed patients, and the general preference of patients' groups for more traditional legal routes.
- Quote paper
- Dr. Klaus Schöfer (Author), 1998, Clinical Risk Management: What measures are available to hospital managers in order to control the frequency of clinical negligence claims and their ultimate cost? To what extent can they transfer that risk to others?, Munich, GRIN Verlag, https://www.grin.com/document/185877
