Avoiding litigation

When the incident is inappropriately managed and the communication is poor, it worsens the patient recovery, also increasing the likely of litigation processes. 

The literature₁ refers four main reasons for litigation: 

• Explanation – the desire to find out how it happened but feeling ignored or neglected afterwards.
• Accountability – wish to see the professionals involved called to account.
• Standards of care – wish to prevent similar incidents in the future.
• Compensation – to receive a financial compensation.

However, the fear of litigation could lead to the practice of defensive medicine and to avoid disclosing incidents to patients.₁ To break the cycle healthcare workers should be aware that open disclosure prevents litigation issues.

In the field of litigation, a study₂ found that the relationship between malpractice litigation risk and the healthcare workers behaviours could be affected by many factors: 

• the complexity of care provided – as it increases, the risk of an adverse increases and consequently the calls for accountability.
• the discussion of the incidents among the colleagues – it might encourage incident reporting and disclosure to patients.
• the personalized responsibility (in contrast with team responsibility where it is shared by team members) – is more likely to increase the impact of litigation risk on the behaviour of the individual who is responsible.
• the response of the organization to the staff after an incident – a non-punitive response to errors leads to an increase of the number of reports. 

These factors are related with the organizational patient safety culture and psychological safety, which will be addressed in the next sections.

1. Vincent C, Young M, Phillips A. Why do people sue doctors? a study of patients and relatives taking legal action. Obstet Gynecol Surv. 1995;50(2):103–5. 
2. Renkema E, Broekhuis M, Ahaus K. Conditions that influence the impact of malpractice litigation risk on physicians’ behavior regarding patient safety. BMC Health Serv Res. 2014;14(1):1–6.