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A Culture Of Openness And Defensive Medicine

2019; Project HOPE; Volume: 38; Issue: 8 Linguagem: Inglês

10.1377/hlthaff.2019.00737

2694-233X

Andrea Cioffi, Fernanda Cioffi,

Healthcare Policy and Management

Letters Health AffairsVol. 38, No. 8: Military Health Systems A Culture Of Openness And Defensive MedicineAndrea Cioffi and Fernanda Cioffi AffiliationsSapienza University Rome, ItalyFertilitas Reproductive Medicine Day Surgery Salerno, ItalyPUBLISHED:August 2019Free Accesshttps://doi.org/10.1377/hlthaff.2019.00737AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSDefensive medicineQuality of careTo improve the quality of health care, it is certainly important to promote a culture of openness in hospital systems. In addition, as was clear from the article by Veronica Toffolutti and David Stuckler (May 2019), that promotion involves better monitoring of the weaknesses of a health facility in medicolegal terms and more careful analysis of clinical situations in which a patient has suffered damage in suspicious circumstances.The fact that governments are paying particular attention to this issue is confirmed by the current Italian reality. In particular, in recent years in Italy there has been a so-called legislative revolution aimed at improving the quality of care offered to patients and reducing malpractice litigation. We refer to the Health Care Security Law of 2017. Among the various innovations in this law, great importance is given to health care risk management, and the law states that the implementation of prevention activities and risk management is a primary interest that, together with other factors, will ensure compliance with the principle of the safety of care.In the article by Toffolutti and Stuckler, it becomes clear that by increasing the openness of health facilities, we could move toward increasing the practice of defensive medicine. This fact has also emerged in many meetings about risk management in Italian health systems. Doctors tend to react with rigidity when they are submitted to the judgment of experts in medicolegal disputes who point out mistakes made during routine activities.This is why, in the process of improving the openness of health care facilities, it is essential to strike the right balance between the need for transparency for the benefit of patients and the need to avoid the possibility that doctors working in health facilities, who are already burdened by considerable stress, feel excessive pressure. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 5 August 2019 Information© 2019 Project HOPE—The People-to-People Health Foundation, Inc.PDF downloadRelated articlesA Culture Of Openness Is Associated With Lower Mortality Rates Among 137 English National Health Service Acute Trusts06 May 2019Health AffairsA Culture Of Openness: The Authors Reply05 Aug 2019Health Affairs