A number of hospitals and health systems around the country are adopting safety programs to reduce harm to both mother and infant in the delivery room, according to a story in the WSJ’s special report on health-care innovation. But in at least one case, innovation has drawn some unexpected–and apparently unwanted–attention. In  last month’s issue of the American Journal of Obstetrics and Gynecology , New York Weill Cornell Medical Center and New York-Presbyterian Hospital reported impressive results from an obstetrics safety program, which trained teams in standard protocols to reduce the risk of  birth injury. Now the hospital and the study authors are protesting the fact that a  bill being introduced in the state assembly would mandate its use for all hospitals in the state. According to the study, the program not only reduced the risk of possible neurological damage during childbirth, but reduced payments the hospital had to make to settle malpractice claims. Average annual payments decreased from $27.6 million between 2003 and 2006 to $2.5 million between 2007 and 2009, and the number of sentinel events – defined as death or serious physical or psychological injury –decreased from five in 200 to none in 2008 and 2009. But Herbert Pardes, president and CEO of New York-Presbyterian, says that imposing the findings on all

hospitals as a way of lowering malpractice costs “would be a serious mistake.” In a statement sent to the Health Blog, Dr. Pardes says his hospital instead stands behind a program of medical malpractice reform being undertaken by New York Gov. Andrew Cuomo that would include capping malpractice payments. Dr. Pardes said in his statement that broad conclusions can never be reached on the basis of one study alone, and “more work has to be done to adapt clinical methods over a period of years, and only then might a body of knowledge-based scientific methods be able to inform public policy.” The authors of the obstetrics study weighed in with their own statement, saying they have no way of knowing yet whether their findings are transferable to other hospitals and “strongly object to the use of our work to propose sweeping new legal mandates.” The twin goals of patient safety and compensation for injury will only be achieved, the statement went on to say, “when physicians focus on medical safety and attorneys focus on reforms to the legal system to make it fairer, less costly and less burdensome. Then, when catastrophic medical injury, preventable or not, does occur, patients, rather than trial lawyers, receive the compensation they need quickly.”

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Legislating Obstetrics Safety?