Mediation

Early Intervention Mediation: A Web-Based CME/CNE Program

Presented by the Colorado Foundation for Medical Care

Fred Abrams, MD has been a physician member of CFMC since 1974 and a physician reviewer since 1987. He currently serves CFMC as Associate Medical Director.
Holly Muyskens, RN, BSN is Project Coordinator for the CFMC Early Intervention Mediation Pilot Project and has been with CFMC for over 15 years.

Presenters have no commercial interests or relationships to disclose.

Overview

This program is designed for physicians, nurses, administrators, risk managers, patient representatives and directors/managers of clinical services and other interested health care professionals. It will address conflict in healthcare and how to effectively engage in minimizing escalation of patient issues and concerns that could ultimately lead to attorney involvement and litigation.

Objectives

Attendees will enhance their ability to:

Describe the results of CFMC’s Early Intervention Mediation Pilot Project
Describe and discuss barriers to EIM in the hospital setting
Describe the role of the health care mediator and the benefits of mediation for health care personnel, patients and their families

CME Credit

The Colorado Foundation for Medical Care (CFMC) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing education for physicians.

CFMC designates this educational activity for a maximum of 1 category 1 credits toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity. There is no charge for this program.

NURSING CREDIT

The Colorado Foundation for Medical Care is an approved provider of continuing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This activity provides 1.2 contact hours.
There is no charge for this program.
Release date: September, 2005.
Expiration date: September, 2006.

For more information:

Lorraine Pickrell
303-695-3300 x 3372
lpickrell@cfmc.org

Introduction

As any health care provider who has personally been involved in litigation or knows someone who has, litigation or any attorney-involved issues concerning their patients can be personally damaging and costly from many perspectives. It is critical for patients and healthcare professionals to participate in taking steps toward improving patient safety, patient satisfaction, and participating in efforts to decrease the incidence of attorney involved patient concerns (frivolous) and ultimately litigation. We are fortunate in Colorado to have tort reform, organizations supportive of early intervention and dispute resolution.

In September 2004, CFMC received special funding from CMS for a pilot program designed to explore alternatives to traditional Medicare beneficiary complaint medical record review. The pilot program is called Early Intervention Mediation (EIM). This proactive plan focuses on early conflict resolution, using QIO facilitation and mediation, to assist with mitigating beneficiaries’ complaints before the complaints worsen or become lawsuits.

Communication

What patients want from YOU…

Early acknowledgement and recognition that there has been a misunderstanding, problem or some level of dissatisfaction with care or the system
A compassionate explanation of the issue
An apology
Assurance that steps are being taken to prevent this from happening to anyone else

The process of achieving the mutual goal of conflict resolution can be achieved by moving from self-interest or individual needs to a shared view of issues or enlarged interests to creating options-enlightened interests and finally to agreement or aligned interests. (Marcus, Dorn-Harvard School of Public Health). Taking time to engage in and manage patient concerns as early and directly as possible will help preserve or restore the patient/provider relationship and minimize or prevent an issue from escalating. Effective communication is worth every minute. How much time do you want to spend with attorneys, in depositions or in court?

Definitions

Facilitation involves discussion about solving a conflict or concern with the assistance of an impartial third party. Facilitation is voluntary, can be done telephonically by shuttling information between involved parties.

Mediation typically is a scheduled face-to-face meeting including the patient and any members of the health care team. Mediation is lead by an impartial, third party, is voluntary, the information exchanged during mediation is confidential

Conclusion

Most patients would rather have immediate solutions to problems than an “after-the fact” review of the medical record. CFMC’s pilot project stands on the premise that QIOs can be supportive of the existing systems that hospitals have in place to ameliorate complaints. This service directed and funded by the Centers for Medicare and Medicaid Services.

CME/CNE Components

After downloading and viewing the presentation, please complete the registration form and test, as well as the program evaluation. If you do not have PowerPoint or a ZIP utility, you can download viewers free of charge (above, left column).

Presentation (MS PowerPoint Document, compressed into a ZIP file)
Program Evaluation, Registration for Credit, and Post-Presentation Test [GRADED SAMPLE]
Program Evaluation, Registration for Credit, and Post-Presentation Review [SAMPLE THAT PROMPTS FOR THE CORRECT ANSWER]

The Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS Policy. The contents of this CME/CNE program may not be reproduced or distributed in any form without the written consent of CFMC. This program does not attempt to define a standard of care nor does it dictate an exclusive course of action.