MEDICAL ERRORS: Clinton to Outline Mandatory Reporting
President Clinton will announce a proposal today to establish a mandatory national error prevention system that would require hospitals to report all preventable medical errors that result in death or serious injury, the Washington Post reports (Kaufman, 2/22). As part of an initiative to improve patient safety, the reporting system would require hospitals to inform state health officials about the errors. White House officials said that the goal of the program is to reduce the number of medical errors by 50% over the next five years (McQuillan, USA Today, 2/22). President Clinton also will ask Congress for $20 million to create a Center for Quality Improvement and Patient Safety within the HHS-directed Agency for Healthcare Research and Quality. To avoid confusion over similarly named and packaged prescription drugs, the president has set aside an additional $33 million for the FDA's medical error and adverse-drug-event reporting systems (Gerlin, Philadelphia Inquirer, 2/22). Under the plan, mandatory error reporting will be required at the 500 Defense Department-operated hospital facilities and all 6,000 hospitals participating in Medicare (Gearan, AP/Nando Times, 2/22). In outlining the proposal, the president has essentially agreed with the recommendations of the National Academy of Sciences' report last year that found medical errors account for upwards of 98,000 deaths annually.
Both the American Medical Association and the American Hospital Association strongly oppose mandatory reporting, arguing that it could "expose doctors and hospitals to more lawsuits," the New York Times reports. Fearing the legal repercussions, the groups assert that health care providers will be hesitant to report any errors. Dr. Nancy Dickey, former AMA president, said: "We are opposed to mandatory reporting. It may well drive underground the very information you need to improve safety. A number of states have mandatory reporting, and there's no evidence that they have greater safety or fewer errors." AHA President Richard Davidson said, "We thought we had an agreement to work with the White House in a public-private partnership, but there has been little or no consultation. That's a serious disappointment." However, White House officials pointed out that only the hospitals reporting the errors would be made public; doctors and health care workers would be kept confidential. Chris Jennings, the health policy coordinator at the White House, said, "These actions will significantly reduce the likelihood of lawsuits and concerns about liability. We will avoid errors and problems that might be subject to litigation" (Pear, 2/22). The Senate today will continue to hold hearings regarding medical errors (Murray, Wall Street Journal, 2/22).