COMMENTARY

A System for Patients to Report Doctors' Errors; Vague e-Discovery Rules; More...

Wayne J. Guglielmo, MA

Disclosures

October 11, 2012

In This Article

A System for Patients to Report Physicians' Medical Mistakes Is in the Works

Federal healthcare experts have long viewed patients as an untapped resource in the effort to improve patient safety. Patients have potentially vital information that could help to more fully answer questions such as why medical errors -- including drug mix-ups and wrong-body-part surgeries -- occur, these officials say.

But if collecting accurate data on medical errors generally has proven difficult, collecting such data from patients in particular has proven even harder. For one thing, no formal mechanism has been put in place for patients to report safety events -- until now, that is, according to a report on nytimes.com.[1]

A pilot program proposed by the Agency for Healthcare Research and Quality, part of the US Department of Health & Human Services, would supplement safety reports now forwarded by providers, including doctors and hospitals, with those from patients and their relatives. In the proposed reporting system, these patients and family members "would report medical errors and near misses through a Web site and in telephone interviews." For each incident, the government would seek to learn the basic facts, including details of the event, whether there was harm and what type, and whether the patient reported the incident and to whom.

The government also wants to glean why a medical mistake occurred -- or, more accurately, why patients think it occurred. To help them along, a draft online questionnaire offers some possible reasons, including:

  • "A doctor, nurse, or other healthcare provider did not communicate well with the patient or the patient's family."

  • "A healthcare provider didn't spend enough time with the patient."

  • "Healthcare providers failed to work together."

  • "Healthcare providers were not aware of care received someplace else."

The draft questionnaire also asks patients for the name and address of the doctor or healthcare worker involved in the mistake and for permission to share the report with that provider so that he or she "can learn about what went wrong and improve safety." Federal officials have said they will keep reported information strictly confidential.

Patient safety advocates have praised the proposed reporting system. "Patients and their families are a potential goldmine of information," said Martin J. Hatlie, Chief Executive of Project Patient Care. "They see things that busy healthcare workers don't see. Doctors are in and out. Nurses are in and out. But relatives are there continuously with the patient. They often know how to fix errors that cause errors."

For the most part, provider groups have also been supportive of the idea. "It's a great concept," said Nancy E. Foster, Vice President of the American Hospital Association. "The idea is welcome."

But Kevin J. Bozic, Chairman of the Council on Research and Quality at the American Academy of Orthopedic Surgeons, has stressed the importance of matching information in patients' reports with that in the medical record. Said Bozic, "Patients' perceptions and experience of care are very important in assessing the overall success of medical treatments. However, patients may mischaracterize an outcome as an adverse event or complication because they lack specific medical knowledge."

The American Medical Association is still studying the proposal, which must receive White House approval in order to move forward.

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