Patient safety bill calls for voluntary error reporting

Medical mistakes that are reported to a "patient safety organization" would be protected from legal action.

By Amy Snow Landa, amednews staff. July 1, 2002.

Washington -- In the latest effort to reduce medical errors in the nation's health care system, a "tripartisan" group of senators recently introduced legislation designed to encourage physicians and others to report mistakes voluntarily.

Under the Patient Safety and Quality Improvement Act, medical professionals would be able to report mistakes confidentially to private groups called "patient safety organizations." To qualify as a PSO, a group would have to certify its ability to collect and analyze patient safety information on a confidential basis, and use the data to provide feedback to health care organizations.

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The National Patient Safety Foundation would "definitely" qualify as a PSO, according to a spokesman.

The information collected by the organizations would be granted certain legal protections that would prevent lawyers from obtaining it through discovery or subpoena, or admitting the data as evidence in any civil, criminal or administrative action.

Removing the fear of lawsuits is key to enticing more physicians and hospitals to come forward voluntarily with information about patient safety, said Sen. James Jeffords (I, Vt.), one of the bill's sponsors. "If you don't get the information, you can't address the problems."

Under the legislation, patient safety organizations would collect information on medical errors and near misses, analyze the data for trends, and recommend to hospitals and others ways to prevent future mistakes.

A judge could order a PSO to release patient safety information but only if it was deemed material to a certain case, its release was in the public interest, and it was not available from another source.

Widespread backing

Health care industry support for the Jeffords legislation appears to be widespread. The AMA and other physician groups quickly endorsed the measure when it was introduced in June.

Then-AMA Chair Timothy T. Flaherty, MD, said the bill would "guide the necessary transformation from the existing culture of blame, which suppresses information about errors, to a 'culture of safety,' which focuses on openness and information sharing in order to prevent future errors."

In addition to physician groups, a number of other health care and insurance organizations support the measure. They include the American Hospital Assn., the Medical Group Management Assn. and the Health Insurance Assn. of America.

But it is unlikely the bill will find smooth sailing in the Senate, where patient safety legislation falls under the jurisdiction of the Health, Education, Labor and Pensions Committee.

Committee members include Jeffords and Sens. Judd Gregg (R, N.H.) and Bill Frist, MD (R, Tenn.), who are sponsors of the bill. But the committee's chair, Sen. Edward Kennedy (D, Mass.), does not support the measure that they have introduced, along with Sen. John Breaux (D, La.).

Kennedy is concerned that the legislation would curtail legal options for injured patients and preempt state medical peer review systems, his spokesman said. "But he still hopes to work out an acceptable compromise."

On the House side, Rep. Nancy Johnson (R, Conn.), who chairs the Ways and Means health subcommittee, has introduced similar legislation.

Kennedy's concerns illustrate ongoing disagreement over how to strike the appropriate balance between encouraging medical error reporting and maintaining legal remedies for injured patients. Lawmakers' inability to find that balance has stymied passage of similar legislation for the past three years.

The effort was prompted in 1999 by the Institute of Medicine report that estimated that between 44,000 and 98,000 Americans die each year as the result of medical mistakes.

The following year, Congress created a center within the Agency for Healthcare Research and Quality to study medical errors. But lawmakers were unable to pass broader patient safety legislation.

ADDITIONAL INFORMATION:

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Thomas, the federal legislative information service, for bill summary, status and full text of the Patient Safety and Quality Improvement Act (S 2590) and the Patient Safety Improvement Act of 2002 (HR 4889). (http://thomas.loc.gov/)