New bill would improve patient safety

Sept. 1, 2002

Washington remains concerned about the high rate of medical errors in the healthcare system. In an effort to improve the situation, a bipartisan group of senators recently introduced the Patient Safety and Quality Improvement Act.

The measure would enhance patient safety by encouraging voluntary reporting of information and raising standards and expectations for continuous quality improvements. The sponsors of the bill include Sens. Jim Jeffords, I-VT; Bill Frist, R-TN; John Breaux, D-LA; and Judd Gregg, R-NH.

In introducing the bill, Jeffords said it will lay the groundwork for preventing unnecessary deaths and unnecessary injuries. Only by providing a framework through which medical errors can be reported and analyzed will we be able to make changes, strengthen and improve our healthcare system, and reduce morbidity and mortality.

Additionally, Frist said, Weve always been taught to learn from our mistakes, which should hold true for our nations medical facilities and personnel. The lives of patients should never be put at risk because we failed to learn from our past mistakes.

The legislation builds on recommendations made in the landmark Institute of Medicine (IOM) study, which found between 44,000 and 98,000 deaths occur each year as a result of preventable adverse events. These events are estimated to cost $37.6 billion to $50 billion a year, representing 4 percent of U.S. national health expenditures.

The IOM study underscored the need for a system analysis of errors and emphasized that improving patient safety requires fixing the system, not fixing blame.

Sponsors of the new bill believe it will encourage a culture of safety by providing legal protections for information submitted voluntary to patient-safety improvement systems.

Under the bill, patient-safety data is privileged and confidential, and therefore cannot be subjected to civil, criminal, or administrative proceedings unless a judge finds the release of the information meets a strong three-pronged test.

The bill has the support of many in the medical community, including physician organizations such as the American Medical Association, the American Academy of Family Physicians, and the American College of Physicians-American Society of Internal Medicine (ACP-ASIM).

Sara Walker, M.D. and ACP-ASIM president, said, Some of the most important information will be derived from reports of near misses, those events that do not result in harm to the patient, but could contribute significantly to the prevention of avoidable injuries or death in the future.

The bill would allow existing mandatory and voluntary reporting systems at the state level to be surveyed to identify the successes and failures of these systems. In addition, it would protect states rights to maintain or create peer-review and confidentiality protections that are stronger than what is required at the federal level.

Under the legislation, the secretary of Health and Human Services would conduct a study to assess the impact of medical technologies and therapies on patient safety, patient benefit, healthcare quality, and cost of care, as well as productivity growth.

If enacted, the measure would direct the Agency for Health Care Quality to coordinate with patient-safety organizations, provide research funding, and disseminate information learned about improving patient safety.

At this early stage, sponsors arent sure if they have the necessary votes to pass the bill. In addition, Sen. Ted Kennedy, D-MA, chairman of the Senate Health, Education, Labor, and Pensions Committee, does not support the measure. He is concerned that it would limit the legal options of injured patients.

Nevertheless, sources say Kennedy might be willing to help fashion a compromise measure. In the meantime, physician groups and the bills sponsors are working hard to gather the congressional support they need for passage.

Joan Szabo is a Washington, DC, freelance writer specializing in healthcare issues. She has been writing the Washington Report column for MLO for five years.

© 2002 Nelson Publishing, Inc. All rights reserved.

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