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Alternative Dispute Resolution (ADR) in Healthcare: Analytical Essay
Abstract
Alternative Dispute Resolution (ADR) is a method of resolving disputes without any type of litigation. The purpose behind ADR is to allow parties to a dispute and settle their differences by agreement and discussion. Letting individuals/parties actively participate in and have control over the process of the solution helps in the method of ADR. I am a social worker and we have major responsibilities in managing conflict in a productive manner. Every day social workers are involved in conflict resolutions. If it is advocating for clients, delivering services to clients, resolving conflicts in the work setting, or dealing with conflict within an organization. When social workers have to go to court they serve as fact witnesses, expert witnesses, or parties involved in lawsuits. When litigations are involved social workers seek other ways to resolve disputes. If not, litigations can be costly and time-consuming.
Alternative Dispute Resolution (ADR) in Healthcare
Patient safety and the prevention of any medical errors is sought out to be the main goal by all in the healthcare profession. Often times there are however, bad outcomes that may occur causing; there to be disputes over “how” and “why” and this can be resolved through litigation. Physicians want to avoid letting the patient or patients family know the exact harming effects that may have happened. This then leads to patients using malpractice claims in order to obtain the information that may help explain what the outcome was. There has been one method introduced in health care to avoid litigious approaches and that is Alternative Dispute Resolution (ADR). Healthcare systems that are already using the ADR approach say that it meets the needs of both patients and the providers along with additional benefits such as; reduced costs, encouraging disclosure, and improving patient safety (Balcerzak & Leonhardt, 2009).
The public now has views of increasing the awareness of patient safety. This would include; the demands for transparency of medical errors, significant costs, complexity, and the volume or malpractice cases. This has made a way for utilizing different methods for conflict resolution. Using ADR is a way to provide a more effective, timely, and less costly approach for providers and patients in order to deal with unfavorable events. ADR makes reference to any means of settling disputes outside of the classroom. This usually includes; arbitration, mediation, early neutral evaluation, and conciliation. Mediators are used to act as neutrals to help reconcile each party’s differences before they proceed to arbitration or litigation. Arbitrators are used to act as a neutral third party to hear the evidence and decide the case. Many healthcare systems have stated to use ADR programs to help with the increased court cases, the rising costs of litigation, and the litigation time delays (Balcerzak & Leonhardt, 2009). The bible says in 1 Peter 5:7 (King James Version) “Casting all your care upon him; for he careth for you” (BibleGateway, 2019).
ADR growth can be measured by many different indicators. One of the most telling indicators is the substantial escalation of ADR use in various industries. Out of all the industries where ADR use has increased, the healthcare industry has seen one of the most escalations of use. Even if we think of claims lodged by patients against medical providers or disputes among increasingly complex healthcare organizations, the trend is indeed pronounced. Many events serve as a testament to the increasing interest in ADR within the healthcare community. A few of these are the creation of the American Bar Association Section of Dispute Resolution’s Healthcare and ADR Committee which is; a medical ADR dispute resolution protocol that was adopted by the ABA, the American Medical Association, and the American Arbitration Association; and there is a discussion of ADR in the Handbook on Managing Conflict in Healthcare Organizations that was published by the American Hospital Association and the CPR Institute for Dispute Resolution. A panel of Connecticut Bar Association healthcare and ADR experts have reviewed the causes and suggestions of this occurrence at a joint meeting of the Dispute Resolution and Health Law sections (Mazadoorian, 2016). The bible says in 3 John 2 (King James Version) “Beloved, I wish above all things that thou mayest prosper and be in health, even as thy soul prospereth” (BibleGateway, 2019).
It is helpful and also useful to recognize that healthcare, as a social system, has a number of characteristics that make it less easy in using dispute resolution and conflict management (DR/CM) approaches in order to help solve problems. Healthcare has been described as a complex adaptive system. It is also largely characterized by fluid linkages, flexible rules heavily reliant on system history, constant change, a huge volume of data, and multiple feedback loops but limited access to others information. Normally this kind of system is susceptible in generating more errors then being more innovative than other types of social structure. This system is harder to understand due to the complexity of the system (Morrison & Robson, 2019).
The characteristic of healthcare is very widespread inequalities and imbalances of power, knowledge and control. There are a few other social systems that have many imbalances. The inequalities are obvious between healthcare providers and patients, but they are also present between groups of providers such as; doctors and nurses, types of providers (primary care versus specialist care or curative versus preventive orientation), between payers and management as well as between management and providers (Morrison & Robson, 2019).
There is also a feature of healthcare which are widely divergent “cultures” and value systems of the various professional and non-professional groups working within the system. It is relatively easy to see that patients and their families look at the clinical problem through very different eyes than their healthcare providers do. The orientation of physicians differs so much between most nurses. If we were to look at a healthcare error and ask how it could be understood by a physician, a nurse, a social worker, a pharmacist, a risk manager, a CEO, a lawyer, and a patient, we would get different perspectives from each of these individuals (Morrison & Robson, 2019). The bible says in Chronicles 15:7 (King James Version) “Be ye strong therefore, and let not your hands be weak: for your work shall be rewarded” (BibleGateway, 2019).
Disputes that go on between parents and school personnel are an unfortunate and often costly reality in special education. Congress has set forth formal procedures and mechanisms for dispute resolution. This initially happened in 1975 with the Education for All Handicapped Children, then again in 1990 with the Individuals with Disabilities Education Act (IDEA), and most recently with the 1997 and 2004 versions of IDEA. Interest has grown particularly in how dispute resolution processes contribute to parent–school relationships that effectively support student-centered educational service planning. A broad outlook of appropriate dispute resolution (ADR) procedures has come out, adding a range of less formal preventative processes to the required formal legalistic procedures. Many states and school districts have tried new strategies to prevent conflict from escalating and to manage disputes as they arise (Reiman, Beck, Peter, Zeller, Moses & Engiles, 2009).
New processes have expanded and older processes have been reconsidered, questions have appeared about “what works” and about the research base that informs the policy, system design, practice, practitioner training, and consumer choice. There are websites, brochures, monographs, conference proceedings, essays, and opinion papers that describe the formal and informal processes. This article best describes the literature search process to identify research in ADR and special education. It organizes some initial search results, summarizes them, and raises important questions for the purpose of future research. The authors wanted this literature of special education and ADR to provide a starting point for the future investigations in service of children with disabilities, their families, and the professionals who work with them (Reiman, Beck, Peter, Zeller, Moses & Engiles, 2009). The bible says in Hebrews 11:1 (King James Version) “Now faith is the substance of things hoped for, the evidence of things not seen” (BibleGateway, 2019).
Alternative dispute resolution is a modern approach to cost effective dispute resolution which has been gradually spreading from its traditional realm in commercial law to other private law areas. Many of its traits have including confidentiality and emphasis on mutually acceptable solutions which seem to be suitable for medical negligence disputes. ADR represents a wide variety of techniques towards finding solutions to the disputes between parties without costly and long court procedure. The term ADR has no consensually agreed definition. We have considered the following components of the ADR definition as; the existence of dispute between two or more parties, related to civil legal rights and/or duties, which might be resolved in litigation before the court, based on the choice of parties, is resolved through a different process, which is essentially confidential, and involves independent individuals who bring a certain level of objectivity to the process. ADR techniques are diverse and many, varying among different jurisdictions. They generally include negotiation, mediation, conciliation, or arbitration. It also includes complaints and grievance procedures, ombudsman procedures, dispute-resolution board procedures, expert intervention and others (Sustek & Holcapek, 2018).
ADR has represented a variety of techniques aiming to find solutions to the disputes between parties without costly and long court procedure. The term ADR may be identified by several features which interconnect with techniques and may serve as a kind of complex definition of the concept. We may consider the following components of the ADR put in to several different definitions: 1) the existence of dispute between two or more parties, 2) related to civil legal rights and/or duties, 3) which might be resolved in litigation before the court, 4) but, based on the choice of parties, is resolved through a different process, 5) which is essentially confidential and 6) involves independent individuals who bring a certain level of objectivity to the process. ADR techniques are diverse and different among jurisdictions. They generally include negotiation, mediation, conciliation, or arbitration, but also complaints and grievance procedures, ombudsman procedures, dispute resolution board procedures, expert intervention and others. In the United States, pretrial screening panels are a popular aim to determine the chances of the parties in litigation in medical malpractice cases (Sustek & Holcapek, 2018). The bible says in Galatians 6:10 (King James Version) “As we have therefore opportunity, let us do good unto all men, especially unto them who are of the household of faith” (BibleGateway, 2019).
Analysis
I have learned several things about ADR not only within the healthcare system but also within my profession of social work. Alternative dispute resolution is about resolving disputes which can happen in many different ways. After reviewing the literature about ADR I have come to the conclusion that disputes are happening everywhere; in healthcare, social work, any job or company, with individuals who have arguments, anywhere. The rest of my research paper is going to lean towards the direction of where ADR leads social workers and healthcare providers and how it helps and how it does not.
References
- Balcerzak, G. A., & Leonhardt, K. K. (2009). Alternative dispute resolution in healthcare. Retrieved from https://www.psqh.com/julaug08/resolution.html
- BibleGateway. (2019). Retrieved from https://www.biblegateway.com/passage/?search=KJV.
- Mazadoorian, H. (2016). A discussion about alternative dispute resolution in the healthcare field. Retrieved from http://rc.com/documents/April06_ADR in Healthcare.pdf
- Morrison, G., & Robson, R. (2019). ADR in healthcare: The last big ADR frontier? Retrieved from https://www.mediate.com/articles/robmorr1.cfm
- Reiman, J., Beck, L., Peter, M., Zeller, D., Moses, P., & Engiles, A. (2009, April). Initial review of research literature on appropriate dispute resolution (ADR) in special education. Retrieved from https://files.eric.ed.gov/fulltext/ED498823.pdf
- Sustek, P., & Holcapek, T. (2018, August 6). Alternative dispute resolution in medical malpractice disputes. Retrieved from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3213596
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