Voluntary Reporting, Confidentiality Seen as Key to Preventing Errors
Blank, Christine, Drug Topics
It's important to maintain the voluntary reporting of drug errors and the confidentiality of the drug-error reporters, emphasized one of the speakers at the 2000 Technical Conference held by the American Health Quality Association (AHQA) in Orlando, Fla., last month.
Judy Smetzer, director of risk management services with the Institute for Safe Medication Practices (ISMP), underscored the importance of a voluntary, nonpunitive program. In a voluntary system, more health-care providers and pharmacists will report problems, she said. This will promote more understanding of factors leading to errors. In addition, a mandatory system will not increase patient safety or the public's trust in the health-care system, "since fear of reprisal will drive errors further underground," she said. At recent Congressional hearings, she added, a mandatory program was criticized by "almost everyone."
While Smetzer was speaking in Orlando, AHQA's president was in Washington, D.C., urging legislators to use Medicare's national Peer Review Organization (PRO) system as a model for reducing medical errors. PROs use a standardized set of national performance indicators, which assures national comparability of data among states. That is critical in order to accurately measure improvement in health quality, William E. Golden, M.D., FACP, told the Ways & Means Subcommittee on Health.
Golden said Congress should hold providers accountable for measurably reducing errors, through a "qualified expert organization, completely independent of hospital providers." The PRO program can serve that purpose, he said. "PROs will be accountable under their federal contracts for measuring and reducing the frequency of missed prescriptions.... If a PRO cannot accomplish sufficient measurable improvement, it may lose its federal contract," he said.
Back at the technical conference, Smetzer said mandatory reporting programs require organizations, not individual practitioners familiar with the situation, to do the reporting, and they may not have the expertise to analyze the data. A voluntary program, on the other hand, "understands the practitioner is exceeding the standards set by the system," she said. …