In response to a devastating report by the Institute of Medicine (IOM) on medical errors, which claimed that such errors kill between 44 000 and 98 000 people each year, President Clinton proposed steps to reduce such mistakes.
The plan, which is designed to cut the number of errors in half by the year 2005, requires the Defense Department to set up a mandatory system for reporting medical mistakes, new rules to make drug packages easier to read and understand, and a research fund of $20 million to study errors and how to prevent them.
Clinton also planned to ask states to require that healthcare institutions be required to report preventable errors that caused serious injuries or deaths, as well as the voluntary reporting of other mistakes and “close calls.” In doing so, he avoided a politically costly battle over a mandatory national reporting requirement.
Data collected by the states would be analyzed and made public without naming the patients or healthcare professionals to educate people about the safety of healthcare systems across the country. Such reporting raises the issue of whether the data will be used to buttress malpractice claims. The White House called for legislation to protect the names of providers and patients as long it does not undermine the rights of individual patients to receive compensation for malpractice.
The Clinton Administration is expected to take several specific steps. Within 1 year, the Food and Drug Administration must develop standards to help prevent errors caused by healthcare providers who confuse medications because of drug names that sound similar or packaging that looks similar, and it must write rules requiring the 3000 US blood banks and other institutions that handle blood to report serious errors. Clinton is also expected to ask the Federal Health Care Financing Administration to publish rules requiring the 6000 hospitals that take part in the federal Medicare program to create error reduction programs.
The issue of medical errors has received considerable attention from healthcare organizations such as the American Medical Association, although that group opposes mandatory reporting rules because it fears malpractice fallout. US Senator Edward Kennedy (D-Massachusetts) said he will make acting on a bill to help reduce errors a priority this year.
However, the issue of medical mistakes is not a new one, and the numbers cited in the IOM’s study merely mirror those of others that have gone before. However, concerns about legal liability and a lack of government support has kept legislative activity in the area to a minimum.
The IOM’s highly publicized report, however, made officials and the public more aware of the problem and gave concrete suggestions on how to reduce the rate of errors. The IOM recommended the following:
Establishing a National Center for Patient Safety to set safety goals, track progress, fund research on error rates and prevention strategies, and serve as a clearinghouse for educational information and best practices.
Creating a mandatory, nationwide public reporting system that would hold institutions accountable for the rate of errors found within their walls. Currently, only about a third of states require such reporting.
Voluntarily reporting near-misses and errors that did not have serious consequences and extending the cover of peer review to keep such reports out of the hands of malpractice attorneys and their clients.
Increasing attention by licensing organizations to the issue of medical errors.
- Copyright © 2000 by American Heart Association