Washington State Medical Association Makes Reducing Barriers to Patient Safety a Top Priority


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



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