Senate OKs medical error reporting bill

The Senate unanimously approved a measure that would establish a confidential and voluntary system for reporting medical errors. The Patient Safety and Quality Improvement Act, sponsored by Sen. James Jeffords (I-Vt.) and Sen. Judd Gregg (R-N.H.), would encourage healthcare providers to report medical errors, incidents of "near misses" and best healthcare quality practices to patient safety organizations. These groups would then use that data to develop recommendations and promote standards to improve patient safety.

The Senate bill (S. 720), passed in July, now must be reconciled with a similar bill (H.R. 663) the House passed in March 2003. Both versions of the bill include strong whistleblower protections for healthcare workers who report errors. The measure establishes confidentiality protections to promote the reporting of medical errors, and includes protections for patient confidentiality.

"Under this bill, doctors and other healthcare providers will be able to report their mistakes without the threat of punishment, and their patients will be much better off for it," says Jeffords.

President Bush going after overtime again

Just a few weeks before his administration's changes to the Fair Labor Standards Act (FLSA) stripped millions of their right to overtime pay, President George W. Bush took another jab at workers. Bush called on Congress to pass legislation that would amend the FLSA to include flex-time and compensatory time as alternatives to overtime pay.
Under the Bush proposal, an employee could accrue 160 hours of comp time in a year. If the time were not used, the employer would not have to pay the employee until the end of the year. Under existing law, employers already have the ability to set up comp time and flex-time arrangements without workers losing pay or the choice of when to take their comp time.

Last year, Republican sponsors of the Family Time Flexibility Act (H.R. 1119) couldn't gain enough support for the measure, which would have given private sector employers the right to pay for overtime in comp time instead of cash. Bush is pushing for a similar proposal this year. There is a hook: The employer, not the employee, decides when or if the employee gets to use comp time.

GAO report finds JCAHO accreditation inadequate

The government accountability office (GAO) has released a report that raises serious questions about the ability of the hospital accreditation process to assure compliance with Medicare standards. These standards are used to identify any problems that would jeopardize quality care and patient safety. The report found that surveyors for the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a private group that accredits 82 percent of the nation's Medicare-participating hospitals, failed to detect deficiencies found by state survey agencies.

"The GAO report reaffirms what healthcare professionals have long knownÑthere is no adequate system in place to ensure that patients receive high-quality care in hospitals," says Edward J. McElroy, president of AFT Healthcare. "For years, nurses and other healthcare workers have complained that JCAHO inspections are ineffective and called for substantive changes to improve patient safety and health."

The AFT and other unions have been calling on JCAHO officials to adopt a more stringent accreditation process by enacting unannounced inspections, whistleblower protections, public disclosure of findings and off-site confidential hearings between inspectors and healthcare workers.

The GAO called on Congress to give the Centers for Medicare & Medicaid Services (CMS) the same authority over JCAHO's hospital accreditation program that it has over other accreditation programs. CMS establishes conditions that hospitals must meet to receive Medicare payments. Hospitals accredited by JCAHO are considered compliant with these requirements.

Following the release of the report in August, Rep. Pete Stark (D-Calif.) and Sen. Charles Grassley (R-Iowa) introduced legislation that would give CMS additional authority over JCAHO's accreditation process.

"While more may need to be done, the legislation will improve accountability," said Stark. "It establishes a clear chain of command within the hospital oversight process to improve patient safety."

The measure "is a step in the right direction to ensure that hospitals are held to the highest standard," says McElroy. In the meantime, "AFT Healthcare will continue its efforts to improve the quality of patient care and workplace conditions by pushing for more rigorous inspections. Patients deserve no less."