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Fom Physician's News Digest Newsletter:November 2, 2006


A coalition of health care purchasers, quality groups and government agencies working with the National Quality Forum (NQF) have agreed for the first time to endorse a single set of 30 safe practices that all hospitals should use to prevent death and injury to patients.

The agreement comes after a two-year effort to harmonize the often conflicting array of safety guidelines that have sprung up since 2000 in response to the landmark Institute of Medicine report, "To Err Is Human," which found that as many as 100,000 patients die each year from medical mistakes, reported the Wall Street Journal. The new practices will replace an outdated set first issued in 2003 and will add several important new protections for patients – such as requirements that hospitals disclose medical errors promptly to patients and families who are affected, adopt evidence-based programs to prevent medical errors during hand-offs of patients between nursing shifts, and evaluate non-nursing staff who care for patients to ensure they are competent to provide safe care, the Wall Street Journal added. When the NQF issues the safe practices guidelines, it will include detailed guidance on how to implement them, including examples of programs hospitals can use to train staff to convey difficult information to patients, discuss end-of-life care, and disclose bad outcomes, the Journal noted. The federal Agency for Healthcare Research and Quality is also unveiling some new tools and training programs for hospitals, including incentives to adopt information technology that can intercept medication errors. Among the groups that advised the committee to create the new measures are the Leapfrog Group – a coalition of large employers that surveys hospitals on safety and quality measures, the federal Centers for Medicare and Medicaid Services, the Joint Commission on Accreditation of Health Care Organizations, and the Institute for Healthcare Improvement – a nonprofit group which leads hospitals in safety collaborative programs, while providers such as managed care giant Kaiser Permanente also participated in the effort, the Journal added. Though voluntary, the NQF practices will likely be incorporated into the growing number of programs that reward those who take steps to improve safety and penalize those who don't, while Medicare and private insurers are expected to use the safety practices in pay-for-performance programs that provide incentives for compliance, the Journal noted. By failing to comply with safety practices, hospitals risk losing credentials they need from the Joint Commission to be reimbursed by Medicare and private insurers, the Journal added.
Wall Street Journal, November 1, 2006 (subscription required)
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