Profession

New Jersey law expands reporting of medical errors

The law shields both actual and near mistakes from legal discovery.

By Andis Robeznieks — Posted May 17, 2004

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

A conversation about medical liability reform between the head of the New Jersey Dept. of Health and Senior Services and a state senator reportedly led to a new state law that shields analysis and discussions of medical errors from legal discovery.

"They were talking about the medical malpractice insurance crisis and how they can help doctors, when someone said 'Why don't we get to the meat of the problem: Reducing medical errors?' " said Laurie Cancialosi, chief of staff for state Sen. Joseph Vitale, sponsor of the New Jersey Patient Safety Act. "So that conversation was the impetus for this."

The new law allows for more open discussion of why medical errors occurred and how to prevent them from happening again. Some experts, however, are saying that the impact of medical-error reporting laws is unknown and underreporting remains a serious issue in many states.

The New Jersey law, enacted April 27, calls for reporting "serious, preventable adverse events" to the state and to patients or family/guardians.

It also allows for confidential, anonymous reporting of near misses, and shields analysis of the errors and near misses from being used as evidence. Although private medical practices are excluded, the law extends beyond the traditional hospital setting to include outpatient clinics, nursing homes and diagnostic centers.

Except for private practice physician offices, New Jersey "health care facilities" must create patient-safety plans and assemble patient-safety committees. It will be the committees' job to analyze errors and near misses, look for ways to apply evidence-based patient-safety practices and conduct staff patient-safety training.

Medical Society of New Jersey spokesman John Shaffer said the law's requirements will create a burden for doctors, but came with a compromise that shielded error analysis and discussion from discovery.

"We acknowledge that it creates more responsibility for physicians, but we accept that for two reasons: One, it's the right thing to do to work on the systems to prevent future medical errors; and two, in the fight for medical liability and tort reform, there has to be some acknowledgment that you have to meet in the middle," Shaffer explained. "When you look at the flipside, that they almost made this discoverable, we'll take the extra reporting burden."

New Jersey becomes the 18th state to enact such a shield. According to the New Jersey Hospital Assn., before the passage of the law, New Jersey and Kentucky shared the distinction of having the weakest legal protection for quality-improvement reporting, leading to an environment where there was little willingness to engage in candid discussions about errors.

National Conference of State Legislatures Program Manager Kala Ladenheim said the New Jersey law signals a swinging of the patient-safety pendulum, which had moved toward a blameless environment that looked at aggregate data and systems. She said the pendulum is now swinging slightly back to analyzing individual events, but with a different style.

"When I first got in this field in the '70s and '80s, it was totally shame and blame," she said. "You'd have to stand up and say 'This is what I did wrong.' "

While 21 states have some type of mandatory reporting system for medical errors, a report issued last fall by the National Academy of State Health Policy concluded: "There is no evidence to show what level of data disclosure advances the patient safety agenda," and underreporting of errors limits the accuracy of the data.

"The data is not as good as it needs to be, and that's a real concern," said Jill Rosenthal, one of the study's authors and a NASHP project manager. "A couple of states are really having budget crises, and they don't have the resources to do anything but collect the data. Collecting the data, but not using it, is not very useful."

Back to top


ADDITIONAL INFORMATION

Protecting patients, protecting doctors

New Jersey's new patient-safety law:

  • Requires health care facilities* to report every serious adverse event to the Dept. of Health and Senior Services and to the affected patient or his or her family or guardian.
  • Creates a system for anonymous, confidential reporting of near misses.
  • Shields error reports from legal discovery and their use as evidence.
  • Requires health care facilities to implement a patient-safety plan and maintain a patient-safety committee to analyze errors, apply evidence-based safety practices and conduct staff training.
  • Extends "Good Samaritan" protection to health care professionals who respond to emergency situations when not required to do so.
  • Calls for fines of $5,000 for not reporting incidents and $5,000 for every day a report is late.

* Hospitals, outpatient clinics, diagnostic centers and nursing homes, but not offices where physicians operate a private practice.

Sources: Text of N.J. Senate bill 557, N.J. Hospital Assn. and N.J. Dept. of Health and Senior Services

Back to top


External links

New Jersey Patient Safety Act text (link)

New Jersey Hospital Assn. testimony supporting state Patient Safety Act, in pdf (link)

New Jersey Gov. James E. McGreevey news release regarding Patient Safety Act (link)

Summary of National Academy for State Health Policy report, "How States Report Medical Errors to the Public: Issues and Barriers" (link)

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn