This article first appeared in the St. Louis Beacon, March 5, 2009 - The Missouri Legislature is considering bills to change the way hospitals report serious medical errors.
The bills deal with so-called "never events," which are mishaps considered unacceptable at health-care facilities. They include having a foreign object left inside a patient during surgery or surgery performed on the wrong body part or receiving care from somebody impersonating a health care professional.
Health care groups are monitoring two bills this session that would set up a process for hospitals to report such incidents. One bill, HB497
"I believe that people have a right to know what's going on in those hospitals," Ervin said. "This bill puts forth a process for adverse event reporting in Missouri so we can get some idea of what's taking place."
Another bill sponsored by state Sen. Kurt Schaefer, R-Columbia, SB382 , also requires hospitals to report the events to the patient safety organizations. But Ervin's legislation goes further in directing hospitals to report never events on a quarterly basis to the Department of Health and Senior Services. It also requires the department to make public a report showing the number of serious adverse events for the previous year by region and category.
Hospitals would have to alert patients when an adverse event occurs and they could not charge patients or insurers for health care costs.
Health Coalition Supports
The St. Louis Area Business Health Coalition strongly supports consolidating information about never events. The group -- which counts companies such as Monsanto, Energizer and Anheuser-Busch as members -- is an advocate for employers who want to enhance the value of the dollars they spend on health care benefits.
Mary Jo Feldstein, a spokeswoman for the group, said the legislation would achieve a longstanding goal to standardize the reporting process for never events.
"These are sorts of things that never need to happen," Feldstein said. "When one of those never events happens, the hospitals should have to tell the patient. They should have to tell the [Department of Health and Senior Services]; they have to tell ... a patient safety organization."
Hospital and Medical Groups Have Questions
But some elements of Ervin's bill are drawing criticism from both the Missouri Hospital Association and the Missouri State Medical Association. Dave Dillon, a spokesman for the MHA, said his group is opposed to transmitting information about never events to the Department of Health and Senior Services.
He said such a move would place a federally designated patient safety organization in legal jeopardy.
Tom Holloway, a lobbyist for the Missouri State Health Association, is also concerned, explaining that "under federal law those federally designated organizations cannot have any affiliation with [an agency] like a Department of Health that licenses that hospital."
Ervin said a newer version of his bill contains language seeking to address those concerns.
Feldstein said experts familiar with the law told her group that having hospitals report to the department and the patient safety organization separately would not put the designation in jeopardy.
"Also, most states in the nation already have required reporting so it would not make sense that all of those programs would be all of a sudden deemed invalid," Feldstein said.
Ervin added that requiring hospitals to report the incidents only to patient safety organizations could be akin to "the fox guarding the hen house." Feldstein noted that current statutes allow hospitals to create their own patient safety organizations.
"So, an error could happen, and the only entity that they would have to tell would be themselves," Feldstein said. "So, we're basically back where we started."
When asked about that contention, Dillon said patient safety organizations are better equipped to handle and compile information about medical errors.
"The endgame for us is development of best practices," Dillon said. "So, we want people to report. And we want to create an environment where they feel comfortable reporting."
Ervin's legislation received a hearing before the House Special Committee on Health Insurance. Schaefer's bill has been referred to the Senate Health, Mental Health, Seniors and Families Committee.
Jason Rosenbaum, a fomer state government reporter for the Columbia Daily Tribune, contributes to Missouri Lawyers Weekly and KBIA radio in Columbia.
