Patient Safety Commission Leader Opposes Mandatory Hospital Reporting
Bethany Higgins says there’s no evidence that requiring hospitals to report errors leads to increased patient safety
February 17, 2011 -- It seemed paradoxical: the head of the Oregon Patient Safety Commission testifying against two Senate bills intended to increase patient safety.
But that’s just what happened on Wednesday, as Commission Administrator Bethany Higgins stated her opposition to Senate Bills 207 and 236 before the Senate Committee on Health Care, Human Services and Rural Health Policy. She joined the Commission in January, taking over from Jim Dameron, after leaving Kaiser Permanente in Georgia, working with its healthcare facilities as director of quality and patient safety.
Legislators sided with Higgins, whose group collects and analyses voluntary error reports from hospitals around the state. They contended that legislation to change the operations of such a young agency was premature.
Senate Bill 236 would require hospitals and ambulatory surgical centers to participate in the Commission’s reporting program, in the hope that mandated participation would lead to a higher number of reports.
In 2009, written notices of errors sent by hospitals to the Commission declined by 54 percent compared to 62 percent in 2008.
One of the bill’s supporters, Marcia Kelly, policy advocate for the American Association of University Women-Oregon, cited the Commission’s August 2010 report stating that “adverse events are under reported by Oregon hospitals.
“If this is true,” said Kelly, “then it undermines the effectiveness of the program as a whole.” Mandatory reporting, she argued, would increase the transparency and accountability of hospitals to their patients and to legislators.
But Higgins strongly disagreed. “Simply making reporting mandatory will not produce results,” she said. “After researching the other 26 states’ reporting systems with a mandatory requirement, we have not seen sufficient evidence of greater participation or reporting of adverse events in those states.”
Finding ways to effectively use the reports the Commission already receives is the better approach, she said. “We can only make genuine progress when we use what is reported to prioritize and implement programs that actually help reduce the likelihood of adverse events. “
Moreover, Higgins added, the bill only mandates participation from two types of medical centers – hospitals and ambulatory surgical centers -- while the Commission’s ambitions are larger.
“Other segments of the healthcare delivery system, such as pharmacies, nursing homes and renal dialysis centers are just as crucial for understanding opportunities to improve patient safety,” said Higgins.
Legislators -- several of whom were involved in creating the Commission in 2006 -- sided with Higgins.
“This voluntary program has gotten incredible results,” said Sen. Jeff Kruse (R-Roseburg). “My fear is that once we go regulatory, it changes the flavor of what we’re doing,” creating an adversarial environment between hospitals and policymakers.
The Commission, is “still in its infancy,” and needs not legislation, but to “focus on increasing outcomes,” said Sen. Laurie Monnes Anderson (D-Gresham),
Advocates for Senate Bill 207, which aims to create a hotline and web portal for hospital patients to report serious medical errors or events, argued that it would “help with patient safety … and give a voice to victims of hospital errors,” according to Darlene Huntress, the statewide organizer for advocacy group Oregon Action.
The state already has such a system, argued Higgins, and a new hotline would be redundant.
“Hospitals currently refer unresolved patient concerns to the Public Health Division’s Health Care Regulation and Quality Improvement Program for investigation and follow up,” she said.
Moreover, Higgins added, the new hotline would cost the Commission an estimated $60,000 a year – chump change for most state-run programs, but a large sum for a five-year-old, semi-independent agency with no state funding.
Legislators seemed convinced by Higgins’ argument.
“Maybe what’s needed isn’t another hotline but more outreach” about the existing one, offered Sen. Jeff Kruse (R-Roseburg). His colleague, Sen. Alan Bates (D-Ashland), concurred.
“Many people have no idea that the health department hotline is available,” said Bates. Further education to the public could change that, he argued.
Despite legislators’ lauding of the Commission’s efforts, they didn’t let the agency completely off the hook.
Bates said that “under reporting to [the Commission] is a much more serious problem than a lot of people think,” while Monnes Anderson argued that the group needed to “make strides” in bringing more hospitals on board.
After the legislative hearing, Higgins told The Lund Report that she “appreciated the support of the committee,” but acknowledged that more work still needed to be done. She said her focus in the coming months would be on recognizing and validating the work of participating hospitals to create “healthy competition,” and an incentive to participate in the Commission’s reporting system.
Additionally, said Higgins, “There are far more levers than just a hospital environment where patient safety needs to be a real focus,” such as pharmacies and nursing homes. While she didn’t offer any specifics on strategies or programs the Commission has planned, Higgins said that “we need to be clear about the bigger picture of medical care.”
To Learn More
Bookmark/Search this post with
Keywords:
- Login or register to post comments
- Email this page
Printer-friendly version
Comments Welcome
If you'd like to submit a comment on any of the stories that appear in The Lund Report, you'll need to become a subscriber and share your name and email address with us.
You can also send us story tips anonymously.
Where does $20 billion in waste associated with medical errors fit on list of year's big quality stories? http://www.healthcaretownhall.com/?p=3337
Nursing Homes do self report as reqiured. In addition they are routinely visited by representatives of
the State's Ombudsman program who follow up on patient, family, friend & other reports of concern!0
Ms. Robinson's clarification is misleading. Kaiser does NOT operate any inpatient facilities in Georgia. The link she provided is merely a list of facilities they have contracts with at this time (like any health insurer).
There is a profound difference between organizational entities that provide inpatient services and HMOs that merely contracts with the provider of those services. Just because an HMO has a contract with a hospital does not mean in any way that it "operates" said facility.
Anonymous -
Kaiser does indeed operate a number of healthcare facilities in Georgia:
https://members.kaiserpermanente.org/kpweb/fds/list.do?name=fds-geo-brow...
-Rebecca Robinson
So, according to the article Higgins purportedly ran Kaiser's quality and safety for its hospitals in Georgia.
Kaiser doesn't own or operate any hospitals in Georgia.
Perhaps that tidbit of information helps to explain her remarkably ill-informed assertions.