Current federal legislation on patient safety

AORN Journal,  Sept, 2002  by Burke Beu

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Introducing the Patient Safety and Quality Improvement Act (S 2590) to the Senate on June 5, 2002, Sen William Frist (R-Tenn) declared,

   Each year, as many as 98,000 people in the United States die as a result of
   medical errors. More Americans die each year from medical errors than from
   breast cancer, AIDS, or motor vehicle accidents.... the status quo is
   simply unacceptable.... The legislation we are introducing today will go a
   long way toward preventing many of these tragedies. Although a variety of
   patient safety initiatives are underway in the private sector as well as
   within the Depart-ment of Health and Human Services and in the states,
   Congress has an important role to play in reinforcing, encouraging, and
   enhancing these efforts. (1)

Several federal bills concerning patient safety have been introduced during the current session of the US Congress. The two most widely publicized are S 2590 and a complimentary proposal introduced in the House of Representatives (ie, the Patient Safety Improvement Act of 2002, HR 4889). Both the American Hospital Association and the Joint Commission on Accreditation of Healthcare Organizations have expressed support for these bills, (2) which provide legal protection for those who voluntarily submit information to patient safety improvement systems and incentives for creating voluntary, nonpunitive reporting systems that promote learning.

Following are brief descriptions of these and other bills addressing various aspects of patient safety that have been introduced in Congress this session. The bills are listed in numerical order. The official titles of bills mentioned in this article appear in Table 1.

SENATE BILLS

Several bills related to health care safety have been introduced in the US Senate this session. Among the topics they address are care for older adults, health care in rural areas, and improvements in health care technology.

Elder Fall Prevention Act of 2002 (S 1922). Falls are the leading cause of injury death among people 65 years of age or olden Hospitalizations for older adults sustaining hip fractures are increasing and are expected to reach 500,000 by 2040. This bill provides for a three-year national education campaign and support for research aimed at reducing the risk of falls and preventing repeat falls experienced by older adults. (3) An identical bill (ie, HR 3695) has been introduced in the House of Representatives.

Preserving Health Care In Rural America Act of 2002 (S 2390). This bill amends the Medicare provision of the Social Security Act to provide for payment adjustments for low-volume rural hospitals. It also establishes a loan and grant program for improvement projects and technology acquisition to improve health care services in rural areas. (4)

The Patient Safety and Quality Improvement Act (S 2590). Acknowledging that health care systems must identify and learn from medical errors to improve processes, this bill supports fostering a learning environment and providing legal protection regarding voluntary reporting of patient safety data. It also provides for establishment of a national safety database to analyze regional variations and national statistics on health care quality. (5)

Efficiency in Health Care (eHealth) Act of 2002 (S 2638). According to bill sponsor Sen Edward M. Kennedy (D-Mass),

   Health care remains one of the few industries clinging to antiquated 20th
   century technology while the rest of the nation's businesses have moved
   into the 21st century.

This inefficiency results in increased cost as well as increased potential for medical errors. This bill would provide grants to health care facilities, group health plans, and health insurance issuers for the purpose of improving technology related to patient records, billing information, insurance claims, referrals, and medication prescriptions. (6)

HOUSE BILLS

Several bills related to patient safety have been introduced in the House of Representatives this session. These bills address such topics as antitrust laws, new facility construction, and health care liability reform.

Health Care Antitrust Improvements Act of 2002 (HR 3897). An increasing number of Americans participate in managed health care plans. That fact, in addition to increased consolidation of health insurers, is the basis for HR 3897, which clarifies antitrust laws as they apply to health care. Consolidation can result in significant leverage of an insurance company over a health care provider and, therefore, can affect the quality of care a patient receives. This bill aims to encourage competition in health care and protect the consumer. (7)

Veterans' Major Medical Facilities Construction Act of 2002 (HR 4514). This bill authorizes the secretary of Veterans Affairs to carry out specified major medical construction projects in five states. These projects include improvement, renovation, or replacement of Department of Veterans Affairs patient care facilities. Specific improvements may include seismic correction, fire safety improvements, or increased accommodation for people with disabilities. (8)