Common Factors | Fall 2022

How Reporting Harm Events Early Brings Faster Resolution and Can Promote Healing

New research from Constellation and Candello shows early reporting leads to shorter case life cycle and decreased expenses.

In this era of clinician shortage and transactional care—leading to burnout, poor experience for all involved, as well as increasing costs—the practice of early reporting and prompt event investigation is critical to the future of care itself.

Being a witness to, a part of, or the cause of an unexpected outcome that results in harm to a patient or resident—even if all standards of care were met—can be a devastating and heartwrenching experience for physicians and care team members. Exacerbating the pain, malpractice claims may arise years later, and unresolved grief and sadness can return with full force for both the patient’s family and the care team.
To the leaders, risk mitigation and claim consultants at Constellation, these scenarios are all too frequent. Case after case, early experience demonstrated that if health care teams would report harm events earlier, the unintended painful consequences—for patients and residents, care teams and the organization—could be mitigated, creating a path to healing for everyone involved. Upon deeper review and study of early intervention work, leaders in risk mitigation and claims hypothesized that when cases that can be reported early are reported early, the outcomes will be better. They observed that when cases continued for a longer time period, emotional suffering was prolonged for all involved, and expenses tended to be higher. When harm events were reported sooner, the process of investigating claims and, if appropriate, determining fair compensation, was a much more efficient and less costly process.

To validate and further explore these observations, Constellation and Candello, a division of CRICO, joined forces to evaluate the magnitude of potential benefits of early reporting. By applying careful research questions and statistical models to Candello, a large national database of coded claim data, they wanted to determine whether early reporting of harm events would have a significant impact on the “life cycle”—the time from assertion to closing of a case—and if it would impact expenses.
To answer these questions, the team analyzed data from Candello, formerly called CRICO Strategies’ Comparative Benchmarking System— of which Constellation is a data-contributing member—including over 31,000 malpractice claims, to better understand the impact of early reporting of harm events. When a harm event that became a claim or suit was reported early, the research found a statistically significant reduction in both expenses and the life cycle of a case.
Recognizing and accounting for the variability of region, analysis year, case type and clinical severity of the patient’s injuries, a 25% decrease in average expenses and a 3.4% decrease in average time to closure was observed when a case was reported early. There was no statistically significant difference in indemnity payments between cases that were resolved early and those that were not. In other words, early reporting was not found to consistently affect the payments made to a patient, resident and family member to compensate fairly for the harm incurred.
For Constellation, these findings correlate with prior observations and have the added, and important, benefit of decreasing the time of intense emotional suffering, allowing the healing process to begin sooner for all involved.
These findings are of interest, as many believed that open communication with patients and residents and families around harm events would lead to an increase in demands for compensation. This research found that expenses and life cycle were reduced, and indemnity payments were neither increased nor decreased, reinforcing that programs such as Constellation’s early intervention program, called HEAL, convey significant emotional and business benefits.