SEATTLE -- A report released late last month by the Washington
State Medical - Education and Research Foundation (WSM-ERF) finds that while much action is being taken on patient safety initiatives in Washington state, there are several barriers for improving patient safety and reducing medical errors.
"This report has a lot of good information on what we are doing right, in
terms of patient safety, and what we can do better," said Dr. Jeff Collins,
president of the Washington State Medical Association (WSMA) and a practicing
internist in Spokane. "To stop errors, we must replace the current culture of
blame and sue with improved systems of safety."
The report, titled Patient Safety and Error Reduction Initiatives in the
State of Washington and Avenues and Recommendations for Action, highlights
current patient safety efforts underway in Washington, identifies impediments
to reducing errors and provides potential avenues to improved safety in the
future. The report notes numerous patient safety initiatives currently
underway in Washington. Some of the activities highlighted in the report
-- The Washington State Medical Association's (WSMA) Patient Safety/Error
Reduction Initiative, which encourages physicians and health systems
statewide to look carefully at practices that enhance the safe care of
-- The WSMA is working closely with the Washington State Patient Safety
Coalition, which includes the Washington State Hospital Association,
Department of Health, Group Health Cooperative, Swedish Medical Center
and the Washington Health Foundation. The coalition has worked to
prevent wrong-site surgery, and this year is focusing on medication
-- Physicians Insurance A Mutual Company, the state's largest malpractice
insurance company holds regular seminars to help physicians practice
safer medicine. Current and upcoming seminars include Ruling Out
Misdiagnosis: Evaluation and Management of Chest Pain, Pulling
Together: Managing Handoffs, Conflicts, and Coordination of Care:
Medication Mistakes, Missteps and Malpractice.
-- The Everett Clinic is attempting to change its culture to emphasize
safety. Physicians are encouraged to report problems, through an
intra-net system, in order to make care safer -- without fear of
penalty or backlash.
-- The Wenatchee Valley Medical Center will soon begin using an electronic
prescription-writing system that will allow physicians to
electronically prescribe and send the order to the pharmacy which
automatically updating the patient's computerized medical record.
Added Collins, "While there were many successful patient safety
efforts mentioned in the report, it also cited five impediments to improving
patient safety and reducing errors." Those impediments include:
-- The current tort system and fear of a malpractice suit and punishment
-- Lack of resources
-- Lack of time
-- Complexity of the healthcare system
-- Rigid clinical boundaries
"We agree with the report that meaningful tort reform would go a long way
in creating a culture of safety," said Collins. "The current culture of
blame -- and the fear of being sued -- is hindering efforts to correct
problems and avoid errors."
The report cited specific recommendations for improving patient safety and
reducing errors in Washington state, including:
-- Passing patient safety legislation at the state and federal levels;
-- Encouraging the WSMA to offer examples of innovative approaches and
techniques to physicians practices to help them enhance patient safety;
-- Collaboration between the WSMA and other willing organizations to
provide strong leadership for the patient safety movement in the state.
"We were pleased that the state legislature passed a bill last session,
which the WSMA supported, that allows hospital and medical practice Quality
Improvement Programs to share information among themselves to improve patient
safety practices without that information being discoverable in a lawsuit,"
said Collins. "We will continue to work hard in the next session to pass
additional patient safety legislation on both the state and federal levels."
The WSMA supports a bill that would establish a patient safety account to
help smaller hospitals and medical practices, through grants, implement
patient safety programs. The grant program would be funded from contributions
of up to 1 percent from malpractice settlements and awards plus an assessment
on professional licensing fees and a per-bed charge from hospitals.
Source: Washington State Medical Association