Congress must finish work on patient safety

Lawmakers must embrace this historic opportunity to end the culture of blame that inhibits medical error reporting.

Posted Sept. 13, 2004.

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As lawmakers arrive back in Washington, D.C., this month after Congress' summer break, they face a host of enormously weighty issues, from the ongoing war in Iraq to the work of setting next year's federal budget. This being a congressional election year, time is short.

In the coming frenzy, lawmakers must not forget a piece of legislation that has the power to impact every American at some point in their lives. Congress cannot let slip a golden opportunity to pass a patient safety bill. It is imperative that lawmakers approve a final version of this legislation and that President Bush sign it into law this year.

The House passed its patient safety bill last year, and the Senate approved its measure in July. But work still remains. Lawmakers must iron out differences between the two in a conference committee so that final passage can occur.

The overriding vision laid out in the measures, both called the Patient Safety and Quality Improvement Act, is on the mark. The effort to pass a final measure has the strong backing of not only the American Medical Association, but also dozens of state and specialty medical societies, hospital and other health care groups, and accreditation organizations.

The bills strike the proper balance between confidentiality and the need for accountability. The legislation accomplishes this by making medical error reporting voluntary and confidential, but at the same time maintaining injured patients' ability to hold the responsible parties accountable for their mistakes.

Today's litigious culture focuses exclusively on fault. A fear of lawsuits discourages doctors and other health professionals from reporting medical errors. The "aha moment" when the root cause of a problem becomes clear never happens, and as a result, errors are repeated instead of being snuffed out.

This culture of blame must change to a culture of safety, and it would if this legislation were to be enacted.

The bills, which have bipartisan support, would allow physicians and others to report medical mistakes in a confidential manner to patient safety organizations. This information would be legally protected, giving doctors and other health professionals the assurances they need to feel comfortable disclosing errors.

The patient safety organizations would analyze the data to identify patterns and report their findings. This feedback would give doctors and others an invaluable tool for preventing future mistakes. Faulty systems are often the origin of errors, and only by shedding light on these problems can they be fixed.

This new way of doing things would not come at the expense of accountability. Aggrieved patients would still be able to collect evidence for litigation from sources that are available now, such as medical and billing records, and discharge forms. In addition, state error reporting and peer review laws would not be preempted.

This approach has a strong precedent in the Aviation Safety Reporting System, under which accidents are reported quickly in a confidential and voluntary way and then addressed.

The overwhelming support for this legislation in the health care community speaks volumes. Doctors want to change the culture, but they can't do it alone. They need Congress' help. The time is now for lawmakers to finish the job. Their constituents -- the nation's patients and doctors -- deserve nothing less.

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