What does healthcare mean to you?
To Cheryl De Kleine, senior director of claims management and litigation counsel at Ascension, it means having passion and purpose within her career as an attorney. It means protecting and enabling talented healthcare providers to continue their life-saving work. It means stepping into a doctor’s shoes when none are available, as she was forced to do when she delivered her second child by herself.
It means telling hard truths when things inevitably go wrong.
“The bottom line is to do the right thing,” De Kleine says. “I don’t know where ‘tell the truth’ got so convoluted in this world, but if you made a mistake, you should accept responsibility, apologize, and just tell the truth.”
As De Kleine sees it, her clients at Ascension are the patients themselves, not an insurance carrier or even the hospital system. “This means that we are heavily focused on patient safety and the improvement of healthcare,” De Kleine explains. “But it doesn’t mean that we don’t have lawsuits or trials—we do. If we believe that the medicine or care that was provided was within the standard of care, we’re going to aggressively defend the hospital system and healthcare providers involved.”
But if any incident occurs at an Ascension hospital that involved liability on their part, De Kleine says, she and her team do not shy away from their ethical responsibilities to the patient. “We will approach the patient, and their family, and tell them we made a medical mistake,” she explains. “We will answer their questions as best we are able; and if it’s appropriate, we will compensate them. It’s our belief that this will help heal the patient and their family. It also helps heal the healthcare provider, who has to live with having made a mistake, and the system as a whole because we can learn from our mistakes, predict better practices, and improve patient safety.”
This philosophy is at the heart of Ascension’s CORE (Communicate Openly, Resolve Early) program. CORE is similar to the PEARL (Process for Early Assessment, Resolution and Learning) program that De Kleine led at Stanford as vice president of claims and litigation for the Risk Authority medical network and director of claims and litigation for Stanford Healthcare and Stanford Children’s Health.
De Kleine says that her leadership of that communication resolution program, and her overall perspective on communication in the healthcare space, has been fundamentally shaped by her work with Leilani Schweitzer, a PEARL patient liaison for Stanford University Hospital’s Risk Management.
“Leilani’s son died at Stanford from a medical error when he was just twenty months,” De Kleine explains. “She went through early resolution efforts there, which helped her to some extent, and now she is an international advocate for greater disclosure and transparency in healthcare. When I met Leilani, she explained how they put into place appropriate safety measures so it wouldn’t happen again. She, and her son, changed the purpose and direction of my life; she’s just an amazing woman, colleague, and friend.”
“I’ve met so many different people and had so many different experiences. I think that helps me to keep an open mind and gain a new viewpoint on life.”
It is largely because of the sense of purpose provided by her commitment to patient care and transparent communication that De Kleine feels so fulfilled in her work at Ascension. “I love this job more than any other job that I have had,” says De Kleine, whose path to Ascension spanned roles in the professional liability insurance industry and medical liability defense space, a clerkship at the Superior Court of the State of New Jersey, and a thirteen-year career as an adjunct history professor—not to mention her claims and litigation work at Stanford University.
Of course, all of that followed the twelve-year period in which De Kleine earned a bachelor’s degree in history from Fairleigh Dickinson University and attended an additional four years of law school at night while raising her three children.
“I obviously took the long way to get to where I am now,” De Kleine says, laughing. “But I think that journey provided me with a really good perspective on things—I’ve met so many different people and had so many different experiences. I think that helps me to keep an open mind and gain a new viewpoint on life.”
De Kleine’s partners like ProAssurance Healthcare appreciate her fresh perspective to help guide projects. “Cheryl’s claims management experience is invaluable,” says Mike Severyn, regional vice president of claims for the professional liability insurance division at ProAssurance. “Now that Certitude, ProAssurance’s professional liability program with Ascension, has grown to almost four thousand physicians, we appreciate her ability to navigate complex legal issues.”
De Kleine’s determination to remain open to new experiences is what pushed her to move to Stanford, and later to Ascension, despite the concerns she received from those around her. “I think some people thought I was crazy to pack everything up and move across the country,” she chuckles. “I think there is maybe a misperception that if you’re out of your twenties, you shouldn’t just pick up and do some crazy thing like move across the country, where you don’t know anybody, to start a completely new job.
“It was exciting and challenging all at the same time,” De Kleine continues. “But I’ve learned to trust that everything in my life is taking place at the right time and in the right place—whether it’s good or bad, it will get me where I’m supposed to be. I just have to continue pushing myself and challenging myself so that I stay passionate about what I do.”
Committing to Transparency
Outside of Ascension, De Kleine encourages medical communities and professionals around the world to confront the truths of patient care. But sometimes, she points out, confronting the truth isn’t as simple as it seems.
“We always talk about medical errors and misdiagnoses,” De Kleine says. “Some studies actually note that medical errors are the third leading cause of death in the United States. It just depends which study you’re looking at.”
It can be difficult to find the truth, De Kleine knows, but everyone in the healthcare industry can do something to help get closer to it. De Kleine believes her part is to use her platform as senior director of claims management and litigation at Ascension and as president of the Collaborative for Accountability and Improvement to help spread communication resolution programs throughout the United States and the world.