The document discusses the victim compensation program implemented at the Lexington VA Medical Center since 1987. Under the program, when medical errors are identified that cause patient harm, the hospital fully discloses the facts to patients, accepts responsibility, and offers compensation through negotiated settlements. Over 13 years, the hospital settled over 170 cases through this approach, with an average settlement of $16,000, avoiding costly litigation. Studies found this approach improved patient satisfaction and reduced costs compared to traditional denial and litigation practices.

1. Victim Compensation Without Litigation - the Lexington Experience. *Former chief of staff, VA Medical Center, Lexington KY Steve Kraman, MD* Professor, Pulmonary and Critical Care Medicine and Vice Chairman, Department of Internal Medicine University Of Kentucky Kentucky Clinic J-515 Lexington, KY 40536 [email_address]

3. How do hospitals usually respond to financial threats?

14. Financial Consequences - 7 Yrs. Lexington VA and 35 other similar VA hospitals. Total payments (7 years) Total claims (7 years) Workload (Lexington)

16. National VA Malpractice Payments (2000)* The mean malpractice judgment $413,000. The mean settlement pre-trial $ 98,000 The mean settlement at trial $ 248,165 Mean time from incident to trial date ~ 48 months. Recovery Frequency 31%. Lexington mean payment (2000) $36,000 *From office of VA General Counsel

19. Other Opinions…

22. National Patient Safety Foundation Talking to Patients About Health Care Injury: Statement of Principle When a health care injury occurs, the patient and the family or representative are entitled to a prompt explanation of how the injury occurred and its short- and long-term effects. When an error contributed to the injury, the patient and the family or representative should receive a truthful and compassionate explanation about the error and the remedies available to the patient. They should be informed that the factors involved in the injury will be investigated so that steps can be taken to reduce the likelihood of similar injury to other patients…. ------------------approved by the National Patient Safety Foundation Board of Directors on November 14, 2000.

23. "A long habit of not thinking a thing wrong gives it a superficial appearance of being right." Thomas Paine (1737–1809)