Should Pts. see ALL information in an Adverse Event?

[UM Review RN, ASN, RN]

this will be on our ballot on election day. what do you think of it?

patients' right to know about adverse medical incidents

ballot summary:

current florida law restricts information available to patients related to investigations of adverse medical incidents, such as medical malpractice. this amendment would give patients the right to review, upon request, records of health care facilities' or providers' adverse medical incidents, including those which could cause injury or death. provides that patients' identities should not be disclosed.

full text:

be it enacted by the people of florida that:

1) statement and purpose:

the legislature has enacted provisions relating to a patients' bill of rights and responsibilities, including provisions relating to information about practitioners' qualifications, treatment and financial aspects of patient care. the legislature has, however, restricted public access to information concerning a particular health care provider's or facility's investigations, incidents or history of acts, neglects, or defaults that have injured patients or had the potential to injure patients. this information may be important to a patient. the purpose of this amendment is to create a constitutional right for a patient or potential patient to know and have access to records of a health care facility's or provider's adverse medical incidents, including medical malpractice and other acts which have caused or have the potential to cause injury or death. this right to know is to be balanced against an individual patient's rights to privacy and dignity, so that the information available relates to the practitioner or facility as opposed to individuals who may have been or are patients.

2) amendment of florida constitution:

art. x, fla. const., is amended by inserting the following new section at the end thereof, to read:

"section 22. patients' right to know about adverse medical incidents.

"(a) in addition to any other similar rights provided herein or by general law, patients have a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident.

"(b) in providing such access, the identity of patients involved in the incidents shall not be disclosed, and any privacy restrictions imposed by federal law shall be maintained.

"© for purposes of this section, the following terms have the following meanings:

"(1) the phrases "health care facility" and "health care provider" have the meaning given in general law related to a patient's rights and responsibilities.

"(2) the term "patient" means an individual who has sought, is seeking, is undergoing, or has undergone care or treatment in a health care facility or by a health care provider.

"(3) the phrase "adverse medical incident" means medical negligence, intentional misconduct, and any other act, neglect, or default of a health care facility or health care provider that caused or could have caused injury to or death of a patient, including, but not limited to, those incidents that are required by state or federal law to be reported to any governmental agency or body, and incidents that are reported to or reviewed by any health care facility peer review, risk management, quality assurance, credentials, or similar committee, or any representative of any such committees.

"(4) the phrase "have access to any records" means, in addition to any other procedure for producing such records provided by general law, making the records available for inspection and copying upon formal or informal request by the patient or a representative of the patient, provided that current records which have been made publicly available by publication or on the internet may be "provided" by reference to the location at which the records are publicly available."

3) effective date and severability:

this amendment shall be effective on the date it is approved by the electorate. if any portion of this measure is held invalid for any reason, the remaining portion of this measure, to the fullest extent possible, shall be severed from the void portion and given the fullest possible force and application.

[Blackcat99]

I hope they won't allow the patients to see all the information in an adverse event. I think it might cause people to file even more medical malpractice suits.

[Monica RN,BSN]

I am also going to vote against this one.. I think that it may cause more problems with legalities and law suits as well. The incident reports are generally used to investigate internally for root cause analysis that would hopefully prevent a reoccurance of a repeat incident. Allowing patients to see such a report may limit substancially the amount of detail or "admitting" to wrong doing that is actually documented...

I think it is a bad plan....

[jnette, ASN, EMT-I]

I am also going to vote against this one.. I think that it may cause more problems with legalities and law suits as well. The incident reports are generally used to investigate internally for root cause analysis that would hopefully prevent a reoccurance of a repeat incident. Allowing patients to see such a report may limit substancially the amount of detail or "admitting" to wrong doing that is actually documented...

I think it is a bad plan....

Well said, Monica, and I agree wholeheartedly.

Unless there is a real NEED to know, I just don't see this as benefitting anyone.. but could certainly stir up a whole lot of uneccessary grief.

[TennRN2004]

I can see some of the reasoning behind this legislation. The only example I can think of to compare it to offhand, is that of restaurant reviews (now I know hospitals/restaurants is not a completely equal comparison). But, Both a restaurant and a hospital give public service. If you know a restaurant repeatedly has bad reviews, it does affect your decision of whether or not to patronize that eatery. Same with hospitals, the public has the choice today of many healthcare options, and most of them research and want the best facility. Why should the public not be allowed a way to make a comparison among which hospital/provider to go to? Now, I do think that the way the legislation has it set up will lead to major problems. There should be a better method of ranking hospitals on a list of things-from medication errors, falls/adverse events, to performing the wrong procedures on patients, without actually letting the public review actual documents of occurrences. People forget that even healthcare providers are human and make mistakes- sometimes these mistakes come from things that could be improved in the facility that led to the error, and sometimes, a mistake was just made due to someone working long shifts and being tired or overlooking something. I absolutely believe we should be held accountable for what we do/don't do, but I also think putting this kind of power in the public's hands will put many people on the offensive looking for something to find wrong with a hospital or provider.

[Monica RN,BSN]

Personally I don't think this has to do with ranking or rating a hospital.. It would appear to me to be more of an incentive to lawyers to pursue malpractice suits in the name of $$$$.

[VivaLasViejas, ASN, RN]

No, no, no........this is a TERRIBLE idea!! There's already enough punishment and litigation in health care as it is. I hope this bill will be soundly defeated, not only for Floridians' sake but so that no other state will want to attempt such legislation.

[RN4NICU, LPN, LVN]

This is a bad idea on so many levels, it serves to prove how truly short-sighted people can be. Talk about cutting off your nose to spite your face.

Nurses are leaving the profession due to dissatisfaction (anyone else notice that this problem got many, MANY times worse around the same time this ~customer service~ crap started taking center stage in health care?) and replacements aren't exactly growing on trees. Could it be that the "I want it MY WAY and 30 minutes ago and you better kiss my butt with a smile on your face or I will sue" atmosphere that is ALREADY rampant in health care is causing, or at least contributing to, this career dissatisfaction?? Surely not.

Physicians are leaving specialty practice due to skyrocketing malpractice premiums. Hospitals are cutting costs, as usual (nursing salaries and benefits and adequate staffing levels are a popular target for these cuts) and individual medical insurance premiums are soaring.

So lets make it all better by inviting more lawsuits!!!

:uhoh3:

It's like trying to put out a fire with gasoline.

I am all for accountability - but it seems that people enter the hospital with dollar signs in their eyes, waiting for something to happen so they can sue and retire on easy street. I recently attended a risk-management seminar and our hospital's attorney told us about some of the types of frivilous lawsuits that get filed against the hospital EVERY DAY. Most of them are thrown out of court right on the spot. They are thrown out of court because the patient must have suffered an injury - NOT AN INCONVENIENCE - an injury. That is criteria #1 for proving a malpractice/medical negligence lawsuit - the patient must have suffered an injury. What happens, more often than I ever would have dreamed, is that the patient was either informed that something unplanned happened (and instantly saw dollar signs), or talked to one of their friends/family members who told them "that wasn't supposed to happen - you should sue". They are all for it because they think that the hospital will settle in order to save face (or legal costs).

I also agree with those who have pointed out that this could decrease reporting of incidents and actually decrease the quality of care because root cause analysis cannot be done. Kind of defeats the purpose, IF the purpose were patient safety. Instead, the purpose seems to be keeping ambulance chasing lawyers from even having to chase the ambulance.

this is only part of it - but I can only rant for so long in one post :)

[mattsmom81]

These kinds of laws are no win for nurses. If we're against it we're hiding something. If we're for it, it's gonna make our job even more frustrating.

IMO malpractice attorneys have been having a field day for too long and tort reform and caps are necessary; something the current administration has supported. :)

The general public does NOT understand what we do and frequently misinterprets...they also don't understand 'no promises'; complications happen...medicine is not a perfect science. But the shister attorneys have been able to convince juries of otherwise. We don't need to give them any more ammo.