Senators introduce bill to improve patient safety

BMJ 2000; 320 doi: (Published 19 February 2000) Cite this as: BMJ 2000;320:465
  1. Fred Charatan
  1. Florida

    Two US senators are introducing a bill to improve patient safety, following the publication last November of a report from the Institute of Medicine of the National Academy of Sciences, which claimed that medical errors kill from 44000 to 98000 Americans each year.

    Mistakes involving the prescribing and dispensing of drugs were the most common errors, resulting in 7000 deaths a year (4 December 1999, p 1456), the report said.

    President Clinton immediately ordered the Federal Quality Interagency Task Force, which oversees federal health programmes for 85 million Americans, to adopt all feasible techniques for reducing medical errors, and to report back within 60 days. He also included more than $50m (£31.2m) in new funding for government programmes to reduce the nation's rate of medical errors, when he unveiled the federal budget proposal last week.

    Senator Edward Kennedy of Massachusetts, the senior Democrat on the US Senate's health committee, and Democratic senator Joseph Lieberman of Connecticut are introducing the Error Reduction and Improvement of Patient Safety Act. They have bipartisan support from Republican senators James Jefford of Vermont and Dr Bill Frist of Tennessee.

    Among other provisions, the bill creates a national centre for patient safety in the Department of Health and Human Services' Agency for Health Care Policy and Research.

    To reach the Institute of Medicine's goal of a 50% reduction in errors over the next five years, the American Hospital Association is working with the Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania. The institute is a national leader in the safeguards and reporting of drug treatment and founded the US Pharmacopoeia Medication Errors Reporting System.

    Many hospitals now use computerised programs to make safety checks on drugs ordered for patients. At the LDS (formerly, Latter Day Saints) Hospital in Salt Lake City, Utah, the main computer automatically checks each patient's allergies and drug interactions against laboratory results and other data.

    About a third of US hospitals have a system for doctors to enter orders for tests and drugs into a computer, which the Institute of Medicine described as a powerful method for preventing treatment errors. Desktop or mainframe computers can be supplemented by the use of laptop and hand held devices.

    A safety system based on hand held devices for monitoring drug treatment is now being installed at 170 Veterans Affairs hospitals. A bar code is attached to the day's pills. The nurse swipes the code on her badge to identify herself, registers the codes on the drug package and the patient's identity bracelet, then checks a hand held device to make sure the codes match.

    “When we tested the system in Topeka, there was a 57% reduction in errors,” said Dr James Bagian, director of the Veterans Affairs' national centre for patient safety.

    The BMJ Publishing Group is holding a one day conference on reducing error in health care and improving patient safety on 21 March in London. Further details can be obtained from the BMA/BMJ conference unit (tel 44 (0)20 7383 6605; confunit{at}

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