Amy J. Schmitz, Elwood L. Thomas Missouri Endowed Professor of Law at the University of Missouri School of Law, has written “Dangers of Digitizing Due Process,” University of Missouri School of Law Legal Studies Research Paper No. 2020-01 (Draft to be Edited and Included in Published Proceedings with Cyberjustice Laboratory).

Online Dispute Resolution (ODR) is not a new concept and has received significant scholarly attention. Nevertheless, there is still serious confusion over what ODR even means.

A North Carolina federal court has ordered a data breach lawsuit that was filed against Epic Games, the developer of the popular video game Fortnite, to individual arbitration. 

A California federal judge has issued a preliminary injunction against a new state law that would prohibit employers from requiring workers to sign a mandatory arbitration provision as a condition of employment. 

by Holly Hayes In 2009, The Joint Commission established a standard (LD.03.01.01) that addresses disruptive physicians: EP 4: The hospital/organization has a code of conduct that defines acceptable and disruptive and inappropriate behaviors EP 5: Leaders create and implement a process for managing disruptive and inappropriate behavior How prevalent is disruptive behavior among physicians? The American College of Physician Executives and QuantiaMD published a survey of 844 physician executives on this topic: More than 70% of physicians say that disruptive physician behavior occurs at least once a month at their organizations, and more than 10% say that such incidents occur on a daily basis. The physicians surveyed also provided insights into their own ability to deal with disruptive physician behavior, showing a mixed level of confidence about how individual physicians cope with this issue. Over half of respondents (51%) agreed that they were comfortable reporting incidences of disruptive behavior; while slightly less (47%) agreed that they were comfortable directly confronting it. There was little disagreement among respondents that disruptive behavior can affect patient care at least some of the time, with only 1% of respondents saying that patient care is never impacted. In addition, patient-related issues topped the list of consequences from disruptive behavior that respondents had experienced. Survey respondents also weighed in on what topics related to disruptive behavior they wanted more education on, with most physicians (61%) saying they were interested in methods to confront disruptive behavior. Other topics included education on improving culture and disciplining disruptive behavior (both at 55%), as well as improving communication (50%), indicating that healthcare organizations have ample opportunity to address disruptive behavior from a cultural and systematic perspective. How can leaders become more comfortable addressing disruptive behavior? An article on the website Strategies for Nurse Managers.com addreses the topic of disruptive clinicians. Carol S. Cairns, CPMSM, CPCS, president of PRO-CON, suggests asking Human Resources for help and guidance when approaching a disruptive physician. “Sometimes medical staff leaders are not trained to do that type of intervention,” she says. “HR people very often are. Maybe the chief of a department or the credentials chair might be counseled by a vice president of HR who understands how to do that process; someone who does this more commonly with employees and they know how to do it effectively.” How can nursing staff become more comfortable addressing disruptive behavior? The website DoctorsLounge published the results of a study on the impact of communication skills education from the May issue of the AORN Journal. Rebecca Saxton, Ph.D., R.N., from the Research College of Nursing in Kansas City, Mo., conducted a pretest and a posttest of nurses to review the impact of “educational communication skills intervention on the ability of perioperative nurses to address disruptive physician behavior”. A 10-item Self-Efficacy to Address Disruptive Behavior Scale was administered to 17 nurses before and after participation in a two-day communication skills program presented by a certified Crucial Conversations (a VitalSmarts product) trainer. Saxton found that there was a significant increase in total mean self-efficacy scores both immediately after the intervention and at four weeks post-intervention. Four weeks after the intervention, participants reported the ability to address disruptive physician behavior 71 percent of the time. “The results of this study suggest that one intervention strategy to address the serious threat of disruptive physician behavior to patient safety is to educate nurses in communication skills,” Saxton concludes. Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.

by Holly Hayes Grants distributed by the Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) are moving forward with programs to address medical liability according to the Modern Healthcare April 2012 issue. See more here Beth Israel Deaconess Medical Center received a planning grant of almost $274,000 to institute a program they call Disclosure, Apology and Offer. The program “consists of disclosing when adverse events occur, investigating why they happened, sharing information with patients and their families and then offering financial compensation and bypassing the court system”. Dr. Alan Woodward, chairman of the Massachusetts Medical Society Committee on Professional Liability says, “malpractice cases in Massachusetts take five and a half years to resolve. Of the dollars physicians pay for liability premiums, only 30% goes to patients, with the rest covering insurance company overhead, attorney and expert witness fees and other court costs”. He added, “You can do a root-cause analysis at relatively low cost and put the findings on the table.” The University of Illinois at Chicago received a demonstration grant to expand its disclosure, apology and offer program to other area hospitals. Their program, called Seven Pillars, has been in place since 2006 and has resulted in reduction in malpractice claims and premiums. Most importantly, the investigation of adverse events has resulted in fewer incidents of patient harm. The New York State Unified Court System received a grant for a “judge-directed negotiation program” aimed at offering an “opportunity to settle before litigation gets into full swing”. Participating judges attended a three-day education session that included medical legal issues and mediation techniques. These programs are alternatives to tort reforms or special healthcare courts. Dr. Woodward believes it will be a long time before either of those alternatives is adopted in Massachusetts. Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.