Standardized care improves outcomes, reduces medical liability

According to a recent review of clinical guideline development, the obstetric and gynecologic literature increasingly provides evidence that standardization of care not only improves patient outcomes but also has a positive effect on malpractice litigation. Clinical practice guidelines have been developed by specialty organizations such as the American College of Obstetricians and Gynecologists, government-supported groups, hospitals or group practices, and authors of review articles.

The review cites the experience of the Hospital Corporation of America as an example of these positive effects. After an analysis of its obstetric malpractice experience showed that obstetric claims were especially high for particular drugs and procedures, the hospital network developed checklist-driven protocols (eg, for oxytocin administration) and procedure-documentation templates, coupled with mandatory online education modules. The corporation found that patient outcomes improved and that during the past 8 years, obstetric professional liability claims dropped by about half and costs for defending claims decreased fivefold.

In another example, an investigation by the RAND Institute for Civil Justice showed that in California hospitals, a decrease of 10 patient-safety-indicator adverse events in a given year was associated with a decrease of 3.7 malpractice claims. This analysis was valid for surgeons, nonsurgical physicians, and ob/gyns.