Chairman's Message => Fall 2003

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Fall 2003

Dear Colleagues,

First Do No Harm

With all the rancorous debate surrounding tort reform and the proposed constitutional amendment limiting attorney contingency fees, there is another aspect of the liability problem that everyone (doctors, attorneys, insurance companies and the public) can embrace – the need for improvement in patient safety. Tort reforms limit economic exposure after there is an injury; patient safety measures prevent injuries.

From the initial "wake up call" in the 1999 Institute of Medicine report “To Err is Human”, patient safety initiatives have increased exponentially. Despite my philosophical disagreement with subject specific mandated CME, two hours of patient safety and error reduction CME is now required biennially for medical license renewal.

An often overlooked, but extremely important portion of the tort reform legislation passed in the last special session directed the Florida Department of Health and AHCA "to study the implementation requirements of establishing a statewide Patient Safety Authority." Among the duties for this proposed authority will be: "(1) collect, analyze, and evaluate patient safety data…(2) development of statewide electronic infrastructure... to improve patient care…(3) identify best practices…(4) assess patient safety culture and… (5) develop core competencies in patient safety in Florida’s schools of medicine, nursing and allied health."

Under a Department of Defense grant, the University of Miami School of Medicine and Baptist Hospital of Miami are 2 of only 19 sites across the country participating in team training to reduce errors in labor and delivery. Additionally, University of Miami President Donna Shalala has committed significant financial and intellectual resources to help establish a South Florida Center for Patient Safety.

Using methodology developed by the National Patient Safety Foundation and the Harvard School of Public Policy, we hope to launch the Greater Miami Executive Sessions on Patient Safety soon. These sessions will link high level executives in 25-30 healthcare facilities in a series of self directed, facilitated sessions to educate them and measurably improve patient safety in their facilities.

Nationally, the Executive Committee of the American College of Obstetricians and Gynecologists has identified patient safety as one of our highest priorities second only to tort reform. As chair of the Quality Improvement and Patient Safety (QUIPS) Committee, I facilitated a strategic planning session on patient safety at the Executive Committee’s last meeting. Members of QUIPS are revising the current ACOG Quality Improvement Manual with a major focus on patient safety under the title "Quality and Safety in Women’s Health Care." In a Committee Opinion, "Patient Safety in Obstetrics and Gynecology", published in the October issue of Obstetrics and Gynecology, our committee urged all ACOG members to embrace 7 principles of patient safety and "to make safety a priority in every aspect of practice." Finally, I have joined the faculty of the ACOG postgraduate course on general OB/GYN to discuss medical errors and safety solutions.

In Congress, HB 663, sponsored by Representative Mike Bilirakis (FL) has passed the House and the companion Senate Bill 720 passed out of committee 20-0. Among its several safety initiatives, this legislation will create a confidential, voluntary reporting system for healthcare errors with analysis by HHS. Information generated will be invaluable in system redesign for patient safety.

The patient safety movement is gathering momentum. It is important that each of us get on board. Educate yourself about the system causes for medical error. Implement system solutions in your office, in your daily practice and in the hospitals to "first do no harm."