Medical Mutual Insurance Company of Maine

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Patient Safety Programs and The Decline in Claims Frequency: Can Statistical Analysis Provide Insight on Correlation vs. Cause?

By Terrance J. Sheehan, MD
President & CEO

The Institute of Medicine released a controversial report in the year 1999 titled To Err Is Human. The report stated that thousands of deaths each year are due to medical error. And while most in the medical community believe that faulty methodology in the study misstated the error-related mortality statistics, it nevertheless served as a wake-up call that shook the industry. One of the key recommendations of the report called for healthcare organizations to implement meaningful patient safety programs.

When I first became President of Medical Mutual, I wrote in my first annual report message in the spring of 2006 that, "I firmly believe one of our most valuable resources to improving the care environment lies in the experience that comes from evaluating and handling claims for the past 28 years. By analyzing that experience and leveraging the insights gained from it, our Risk Management and Claims Department professionals have implemented changes to improve care… Our whole focus has always been on system analysis and improvement, using evidencebased quality improvement and patient safety concepts."

Since then, the Company has used such concepts to enhance its already industry-leading risk management services through case-based seminars, practice manager workshops, office practice surveys and hospital education programs. Coincidentally — or not — both the healthcare industry at large and Medical Mutual have experienced a sustained reduction in claims frequency.

There certainly appears to be a correlation between the drop in claims frequency and implementation of concerted patient safety initiatives. But while the correlation is interesting and encouraging, no one could argue convincingly at this moment in time that the collective patient safety initiatives implemented since the Institute's 1999 report have actually caused the reduction in claims frequency.

Wouldn't it be great, though, if we had statistically-analyzed data to make that argument in a more convincing fashion? That would mean that, as I have hypothesized previously, we have indeed reached a new, lower set point for claims frequency. It would prove the value of quality improvement efforts in patient care and encourage additional efforts, not to mention the positive effects it would have on medical professional liability rates going forward.

All of which is why I have asked our chief actuary, Kevin Atinsky, FCAS, MAAA, to embark on the tall task of conducting a statistical analysis that begins testing the hypothesis. I say tall task because any such analysis, at least at this point, is subject to caveats. (See the reprint of Kevin's article on the subject on page four of this publication, which recently appeared in the Second Quarter 2009 issue of Physician Insurer.) Nevertheless, any new insight into the question will be valuable insight.

In the meantime, let us all continue our vigilant focus on patient safety and quality improvement in the everyday practice of our profession.