PEARL - Program for Early Assessment and Resolution of Loss
What is PEARL?
The Process for Early Assessment and Resolution of Loss (PEARL) is the leading disclosure and offer process in the nation. PEARL is a signature solution developed by Stanford Risk Consulting for Stanford University Medical Center.
Why PEARL?
A fundamental reality health care providers must grapple with is that patient outcomes are not always ideal. Undesirable outcomes may be anticipated (a known complication) or unanticipated.
The question for providers is: how do you deal with adverse outcomes and unhappy patients or families? This question will become increasingly acute with greater technology and complexity of health care and an aging population.
- Stanford Medical Center believes that a proactive approach is key to
- Improving patient safety and the quality of care
- Treating patients with dignity and respect
- Ensuring staff learns and corrects
For these reasons, Stanford created the Process for the Early Assessment and Resolution of Loss (PEARL) process. Stanford Risk Consulting (SRC) is pleased to work with other institutions to implement PEARL processes.
How does PEARL work?
PEARL distinguishes between anticipated or unpreventable adverse outcomes (known complications) and preventable unanticipated outcomes. In both cases, the policy is full disclosure to patients. However, if the adverse outcome was preventable, PEARL recognizes that the patient is entitled to "full disclosure, apology, compensation, and conversation about the lessons learned—what will be different so that others are not similarly harmed."
The underlying philosophy is that the benefits to patients and caregivers from full disclosure and prompt remedial action outweigh the possibility of creating additional risk or claims.
PEARL works by:
- Providing around-the-clock telephone consultation for "concerning outcomes"
- Training "PEARL Risk & Claims Advisors" to provide consultation within approved insurance company protocol
- Embracing and building upon existing hospital disclosure policy
- Instituting a rapid initial assessment to determine if the medical outcome is a preventable unanticipated outcome (PUO)
Providers are cautioned to:
- Communicate only known facts until a PUO determination is made
- Not jump to conclusions
- Not blame or accuse others
- Never make promises, offer to waive bills, or make offers of compensation without express approval of a PEARL Risk & Claim Advisors
With these safeguards, when a preventable unanticipated outcome is identified, a conversation with the patient is initiated to provide full disclosure, apologize, and explain remedial measures. Compensation offers are based on a needs assessment. Patient use of counsel is encouraged and a settlement agreement is required.
What can PEARL do for me?
The benefits of the PEARL process include:
- Promoting transparency, integrity, fairness, and healing
- Proactively increasing patient safety and reducing risk
- Improving patient and physician satisfaction
- More expeditiously and economically resolving claims
The PEARL process is a win-win solution for all parties: improving care and reducing cost. And it is the right thing to do.
For More Information:
Contact Ed Hall, Senior Director, Risk Management Controls & Education
(650) 736-8502
ehall@stanfordmed.org
