A network of organizations that will collect and analyze data on medical errors and “near-misses” while protecting physician and patient confidentiality may be in place by the end of this year.
Federal agencies are in the midst of finalizing regulations to create Patient Safety Organizations (PSOs), whose data would be protected from discovery by malpractice attorneys.
“We’re pretty far along in the process,” reports Bill Munier, MD, director of the Center for Quality Improvement and Safety at the Agency for Healthcare Research and Quality (AHRQ). A final round of revisions could be completed in a matter of months.
In a recent survey of physicians, 95% said they need to know about errors to learn from others’ mistakes, but 88% feared that acknowledging incidents could make them vulnerable to malpractice claims, according to a report in Health Affairs (2008;27:256-255). The PSO system addresses that concern.
Once an organization gets PSO status, it will be able to gather information and share it freely with others in the PSO for the purpose of learning from the case and identifying ways to reduce or avoid similar safety issues in the future.
PSOs are designed to encourage voluntary, provider-driven initiatives to improve the safety and quality of patient care.
Under most state laws, in-house hospital reviews “usually have confidentiality within the hospital, but it’s lost if the information goes beyond. If multiple hospitals want to aggregate information, they can lose protection,” Dr. Munier explains.
That risk can apply to facilities even within an individual health system, especially if it crosses state lines. “So, if you have a hospital system with 60 member hospitals in 14 states—which is reasonable—those hospitals can’t share information without risking legal discovery,” he continues. “The PSO designation will set up uniform national protection.”
In addition to encouraging the aggregation of data for PSO-wide studies, PSOs should have an impact on safety at the most local level by encouraging frank discussions during peer review of specific cases within hospital departments. “That can only be done if the doctors feel safe,” Dr. Munier notes. “If they feel that a colleague needs more education, they may be less likely to say so.”