Improving Malpractice Prevention and Compensation Systems (IMPACS) was a national initiative of the Robert Wood Johnson Foundation (RWJF) to support promising new mechanisms to prevent negligent medical occurrences and to compensate patients injured by medical care.

Medical malpractice — how to identify it and compensate patients injured by it — has long been a difficult issue confronting American health care. The tort system, the traditional arena for resolving malpractice complaints, provides relief to relatively few.

IMPACS was intended to translate lessons learned from earlier studies of medical malpractice into demonstration projects that would test alternatives to the tort system and, thus, help move malpractice reform from the drawing board to the real world.

Key Results
In addition to demonstration projects, the national program supported evaluation studies of innovative malpractice reform systems.

The program funded 11 the work of grantee organizations. Five of the projects were demonstration projects and six were evaluation or research projects. Se the Project List for reports on the projects.

• Of the five demonstrations initiated by the national program, only one — an intervention project Vanderbilt University Medical Center — was implemented. The other four did not progress beyond the planning stage.
  
  As a result, the program's objective — to develop a new generation of mechanisms to prevent and compensate for medical malpractice — went largely unmet.
• Improving Malpractice Prevention and Compensation Systems produced solid research by respected scholars that may benefit policymakers and researchers when the next malpractice crisis or other development sparks a deeper interest in reform.
• A new system developed with national program funding has promise of reducing malpractice complaints and costs. The Vanderbilt demonstration — although still underway and not conclusive — shows significant potential for replication.
• Improving Malpractice Prevention and Compensation Systems-funded analysis was used to estimate the incidence of medical error in the nation's health system.
  
  A 1999 Institute of Medicine report on the quality of care To Err is Human: Building a Safer Health System cited the findings generated by the program as one of two sources for an estimate that medical mistakes kill 44,000 to 98,000 people annually in American hospitals.
• The national program provided a forum for experts in the malpractice field to exchange and explore new ideas.

Program Management
The national program office was established at Georgetown University School of Medicine, Institute for Health Care Research and Policy, Washington, in March 1994. The program's national advisory committee (see Appendix 1 for a list of members) guided the selection of the 11 projects.

Funding
In October 1992, RWJF's Board of Trustees authorized spending up to $5.5 million over four years to support the program.