Doppler and Newton

WSJ: New ADR Services For Healthcare Field (7/26/10)
Jeff Thompson
To cut medical-malpractice costs, five New York City hospitals have agreed to a pilot program to divulge medical mistakes early, offer settlements quickly and use special state "health courts,' where judges will help negotiate agreements before cases go to trial.

Foundation Relies on Mediation to Improve Patient Access to Care (7/12/10)
Keith Seat

A national non-profit, the Patient Advocate Foundation, is holding its 11th Annual Patient Congress in Washington, DC, urging members of Congress to support legislation that would improve patient access to care, which is needed even by those fully covered by insurance. The Foundation relies on mediation to ensure that patients with life threatening or debilitating diseases have adequate access to care or receive other needed assistance. The Foundation successfully resolved over 55,000 cases for patients last year using mediation or arbitration. Over 80% of the patients aided by the Foundation were fully insured, but still needed help to access medical care.

PR Newswire.com (June 29, 2010)

How To Disclose Adverse Events To Patients (6/28/10)
Holly Hayes
The May/June edition of the Physician Executive Journal (PEJ) provides a step-by-step approach for reporting adverse events to patients. The seven-step approach is based on principles used in the Program for Health Care Negotiation and Conflict Resolution at the Harvard School of Public Health.

AHRQ Awards $23.2m In Grants For Medical Liability Reform And Patient Safety (6/21/10)
Holly Hayes
The Agency for Healthcare Research and Quality (AHRQ) announced that seven demonstration grants for the Medical Liability Reform and Patient Safety initiative have been funded for a total amount of $19.7 million. Thirteen planning grants have also been funded for a total amount of $3.5 million. The grants support the implementation and evaluation of evidence-based patient safety and medical liability projects.

Where Does Mediation Fit In The Spectrum Of Healthcare Conflict Resolution? (6/07/10)
Holly Hayes
The need to manage conflict in the healthcare setting is not new. Much has been written about disruptive behaviors creating breakdowns in the teamwork, collaboration and communication needed to deliver high quality patient care. A study by The Institute for Safe Medication Practices (ISMP) found that forty percent of clinicians have remained passive or kept quiet during patient care events rather than confront a known intimidator.

Conflict Management in The Joint Commission’s Medical Staff Standard 01.01.01 (5/31/10)
Holly Hayes
Last March The Joint Commission announced its long awaited, revised medical staff standard (MS) 01.01.01, which will replace MS 1.20. The new MS 01.01.01 becomes effective March 31, 2011, to allow facilities and medical staffs to prepare for implementation. The intent of the MS 01.01.01 is, inter alia, to establish a conflict management process in the event of a conflict between/among the medical staff, medical executive committee, and the governing body of a facility. The goal is to enhance patient safety and the quality of care by creating a positive working relationship between a facility and its medical staff.

Jazz Improves Physician-Patient Communication (5/24/10)
Holly Hayes
The American Medical News published this week Jazz offers lessons for doctor-patient interaction. This article discusses the use of jazz music to help physicians hone their patient communication skills. Dr. Paul Haidet, president-elect of the American Academy on Communication in Healthcare says”Jazz is all about harmony in communication. When jazz musicians play, they play in a way that goes along with [how] the rest of the band is playing.”

Bad Behavior In Health Care (5/17/10)
Holly Hayes
After hearing Dan O’Connell speak earlier this month, I found this on-line presentation by Dan titled, Bad behavior — preparing for and dealing with disruptive behavior by providers. Dan is a clinical psychologist who works as an educator, consultant, clinician, department chair and executive director in medical and behavioral health settings.

Operations Management Approach To Conflict in Organizations (5/10/10)
Holly Hayes
Last week, I had the opportunity to attend the University of Texas “Innovation in Health Care Delivery Systems: Maintaining Quality and Reducing Costs Through Management and Information Technology”. One breakout session featured Donde Plowman, Ph.d., Business Professor and Department Head from the University of Tennessee. She has recently undertaken a study to increase the relevance of health services research to leaders in the health field.

Contracting For The Unknown Using ADR (5/03/10)
Richard J. Webb
Healthcare providers and insurers sign contracts every day that extend well beyond the horizon of the world in which they operate. The unknown dimensions of the future healthcare marketplace became even more uncertain with the recent passage of federal healthcare reform legislation. Many of the concepts contained in that law are subject to interpretation and political implementation, not to mention the possibility of repeal or modification by a future Congress.

Patients Engage In Their Own Care More Often When Encouraged By Providers (5/03/10)
Holly Hayes
An article in the March/April 2010 Patient Safety and Quality Healthcare Magazine by Andrea C. Scobie and D. David Persaud titled, “Patient Engagement in Patient Safety:Barriers and Facilitators” examines the impact of patient engagement in their own care on patient safety. One barrier to patient engagement, of interest to the field of conflict resolution, is:

Study Captures Nurses Experiences With Disruptive Behavior (4/19/10)
Holly Hayes
The Journal of Nursing Care Quality published this month the results of a qualitative study titled “Hospital RNs’ Experiences with Disruptive Behavior”. The study describes the different types of disruptive behavior the study group of registered nurses had experienced on the front lines of patient care, identifies the triggers of this behavior, learns how nurses respond to disruptive behavior and identifies the impact of this behavior on the individual and the organization.

Medical Staff Standard Includes Conflict Resolution Requirement (4/12/10)
Holly Hayes

Where Does ADR Fit In Health Care? (4/05/10)
Holly Hayes
Readers have asked us, “where does ADR fit in health care? It’s a good question and one we have contemplated ourselves. To learn more, we are undertaking an informal survey asking leaders in the field to share their thoughts and experiences on this topic. So far, we have learned that ADR techniques can be applied with the following groups:

Disruptive Physician Skit Highlights Healthcare Communication Issues (4/05/10)
Holly Hayes
The American College of Healthcare Executives (ACHE) held their annual national meeting in Chicago the week of March 22, 2010. During the meeting, Joseph Bujak, a physician and vice president of medical affairs at 246-bed Kootenai Medical Center, in Coeur D’Alene, Idaho and co-presenter Kathleen Bartholomew, a registered nurse and well-known author on nursing, acted out a unique role-playing presentation on doctor-nurse communication.

Health Insurance Reform: Giving The Devil His Due the Importance of Back Room Deals, Dirty Politics and Subversive Negotiation (3/29/10)
r.d. benjamin
It’s the morning after and I have a ‘hangover’ from watching the twist and turns leading up to the US Congress’s passage of health care reform. As a negotiator and mediator this theatre of real life easily competes with the staged versions and is my recreational drug of choice. The meandering of this health care legislation climaxing with the vote last night, has been a spectacle that abounds in valuable lessons and teachable moments for those of us engaged in conflict management work.

Can Conflict Resolution Skills Help Risk Managers And Physicians Disclose Medical Errors? (3/29/10)
Holly Hayes
A new study published in the March edition of the Joint Commission Journal on Quality and Patient Safety (the full article is available for purchase here) and reported on American Medical News (available here) found that physicians are less likely than risk managers to tell patients when a medical error occurs. Physicians, however, are more likely to use the word “error” in describing the event and are quicker to say, “I’m sorry” than risk managers.

What's A Doctor Worth To A Hospital? (3/29/10)
Richard J. Webb
In the ongoing symbiotic relationship between hospitals and members of their medical staffs, it is understood that the physicians generate hospital revenue by admitting their patients and ordering tests and procedures. But exactly how much is any doctor "worth" in this sense? Thanks to the HealthLaw Prof Blog, I saw that James A. White recently covered this issue in the Wall Street Journal Health Blog. Citing to a study of 114 U.S.hospitals by physician recruiters Merritt Hawkins, the WSJ produced a chart listing average hospital net inpatient and outpatient dollars derived from referrals, tests and procedures done in the hospital.

Medicaid Cuts Will Strain Hospital - Physician Relations (3/22/10)
Richard J. Webb
Kevin Sack wrote earlier this week in The New York Times about the effect Medicaid cuts are having on patients throughout the country. When Medicaid payment rates sink low enough, and too many physicians want out, something will have to give. This is where mediation can help.

Mediating The Healthcare Reform Debate (3/15/10)
Richard J. Webb
Even before watching the bipartisan healthcare summit on February 25th, I began to think about how I would mediate the divide between the Obama/Reid/Pelosi reform proposal and the position staked out by the Rupublican leadership. Without knowing it, I was not alone in imagining a mediated solution to this conflict. Mediator Christopher Annunziata wrote in his CKA Mediation and Arbitration Blog that If Anyone Needs a Mediator, It's These People:

Applying Conflict Resolution Skills In Health Care PART V : Use Objective Criteria (3/15/10)
Holly Hayes
One month ago, we started our health care conflict resolution series (see Part I, Part II, Part III, and Part IV) focusing on the Roger Fisher, William Ury Getting to YES principled negotiation method involving:

Applying Conflict Resolution Skills In Health Care PART IV: Invent Options For Mutual Gain (3/08/10)
Holly Hayes
Conflict in health care differs from conflict in other arenas because it can result in significant negative outcomes – in some cases, life or death. Part IV in our series on applying conflict resolution skills in the health care setting follows the Principled Negotiation techniques described by Roger Fisher and William Ury in Getting to Yes with a focus on “inventing options for mutual gain”.

Texas Doctor Proposes Physician-Led Solution To Cut Health Care Costs (3/08/10)
Holly Hayes
The New York Times posted last week an interview with Dr. Howard Brody, professor of family medicine and director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston, discussing a proposal for health care reform involving physicians. A physician-led effort to determine guidelines and recommendations against overuse of the “Top Five” procedures or studies could have a tremendous impact on curtailing future medical costs. We suggest that the process outlined by Dr. Brody could benefit from applying conflict resolution techniques.

Applying Conflict Resolution Skills In Health Care PART III: Focus On Interests, Not Positions (3/01/10)
Holly Hayes
Our health care conflict resolution series began with Part I, applying the “principled negotiation” method to health care (post available here) and followed with Part II, examining a case study of “Separating the People from the Problem”.

Changes In Legal Practice And The Use Of ADR (3/01/10)
Richard J. Webb
In case you haven't noticed, the law business - the way law is practiced - has been changing at a rate uncharacteristic of the profession. Financial pressure from the economic downturn is a major contributor to this development. But change was afoot long before the subprime meltdown and stock market nosedive. The viability of the "big law" pyramid model for most purchasers of legal services has been questioned since the starting salaries of newly minted associates crossed into six figures, but only with the disappearance of easy money has awareness of the issue entered the mainstream.