Studies have shown that when health-care providers apologize to patients for errors or unfortunate results, patients are less likely to sue and are more likely to have a more positive take on the event. Now, seven healthcare systems in Massachusetts will formally pilot a project that will attempt to resolve medical liability issues without malpractice trials.

Program goals include improving patient safety, increasing transparency and trust, reducing litigation and cutting costs to healthcare systems. One participating hospital — Baystate Medical Center — began a successful disclosure and apology initiative four years ago. The formal pilot, called “Roadmap to Reform,” will include Baystate as well as hospitals from Beth Israel Deaconess Medical Center and the Massachusetts General Hospital. Roadmap to Reform is being led by the Massachusetts Medical Society, which received a federal grant in 2010 to create the program.

The Roadmap to Reform model consists of a policy called Disclosure, Apology and Offer (DA&O). This includes fully disclosing medical errors, detailing why and what will be done to prevent similar errors from happening in the future, issuing a sincere apology for events deemed avoidable and offering timely compensation to resolve the issue.

Continue Reading

The process is relatively simple. Once a suspected error is reported, hospitals conduct a root cause analysis to determine who is at fault. If fault is deemed to be on the part of a clinician or hospital policy, those responsible will be required to apologize to the injured patient. The hospital will then work with its malpractice insurance provider to determine appropriate compensation for the patient to cover injuries and/or follow-up care.

The DA&O process does not prevent patients from taking legal action, but seeks to reduce lawsuits by resolving issues in a faster and less hostile manner. Researchers from the Harvard School of Public Health will evaluate outcomes associated with the pilot program when it wraps.


  1. Guglielmo WJ. “Malpractice Experiment Riles Lawyers; Legal Battle in Ohio.” Medscape Today News. Published: May 11, 2012.
  2. Benjamin E, Woodward A. “Viewpoint: A new approach to medical liability.” Published: May 13, 2012.