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Objective
This study was undertaken to assess the impact of a multimodality risk management (RM) program on reducing malpractice exposures, claims, and improving patient safety within a multispecialty surgical group.
Design
The study was a prospective evaluation of a comprehensive RM program introduced in 2006. The program provided education and practice change initiatives. Monitoring of performance included claims data, premium history, program evaluations, self assessments and pre and post testing. Practice change involved process improvement in the ambulatory environment with audits for compliance
Setting
A multispecialty surgical group of 45 physicians practicing in eight specialties.
Patients or Other Participants
242 surgeons, mid-levels, and managers were involved.
Interventions
The RM program included case presentations, web-based modules, e-learning, and periodic practice auditing. An RM Work Group was created that governed curriculum development and practice process changes, including approaches to after-hours call documentation, test results tracking, and informed consent.
Main Outcome Measures
Periodic surveys of participants assessed knowledge of RM fundamentals, attitudinal measures, behavior modification and practice change. Process improvement compliance was assessed with audits- reduction of claims was measured with insurance data.
Results
Since inception, there has been an 86% reduction in claims frequency and a 36% reduction in insurance premium payment per year. Program compliance has improved to 100%. The group has experienced significant improvements in audit performance. Attitudinal and behavior modification measures consistently score >90%.
Conclusions
The program has been successful in providing participants with a stronger knowledge base in RM which has been associated with sustained practice changes and attitudinal and behavioral changes. The group has experienced a reduced number of malpractice claims and cost of insurance premiums during the course of the study.