Welcome to Scribd. Sign in or start your free trial to enjoy unlimited e-books, audiobooks & documents.Find out more
Download
Standard view
Full view
of .
Look up keyword
Like this
13Activity
0 of .
Results for:
No results containing your search query
P. 1
Promoting Patient Safety: An Ethical Basis for Policy Deliberation

Promoting Patient Safety: An Ethical Basis for Policy Deliberation

Ratings:
(0)
|Views: 1,046|Likes:
Published by The Hastings Center
In 2000, the Institute of Medicine reported that as many as 98,000 Americans die each year as the result of medical error. This special report on patient safety seeks to foster clearer and better informed discussion of the ethical concerns that are integral to the development and implementation of effective policies that would address the problem of medical error.
In 2000, the Institute of Medicine reported that as many as 98,000 Americans die each year as the result of medical error. This special report on patient safety seeks to foster clearer and better informed discussion of the ethical concerns that are integral to the development and implementation of effective policies that would address the problem of medical error.

More info:

Published by: The Hastings Center on Feb 27, 2010
Copyright:Traditional Copyright: All rights reserved

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF or read online from Scribd
See more
See less

12/14/2012

 
A S
PECIAL
S
UPPLEMENTTOTHE
H
ASTINGS
C
ENTER
R
EPORT
 Promoting 
PATIENT SAFETY
 V 
IRGINIA 
 A. S
HARPE
T H E
. . . . . . . . . . . . . . .
HASTINGS
. . . . . . . . . . . . . . .
CENTER 
A
N
E
THICAL
B
ASIS FOR
P
OLICY
D
ELIBERATION
 
T
his is the final report of a two-year Hastings Center researchproject that was launched in responseto the landmark 1999 report from theInstitute of Medicine,
To Err Is Human
, and the extraordinary atten-tion that policymakers at the federal,state, regulatory, and institutional lev-els are devoting to patient safety. Itseeks to foster clearer and better dis-cussion of the ethical concerns thatare integral to the development andimplementation of sound and effec-tive policies to address the problem of medical error. It is intended for poli-cymakers, patient safety advocates,health care administrators, clinicians,lawyers, ethicists, educators, and oth-ers involved in designing and main-taining safety policies and practices within health care institutions. Among the topics discussed in thereport:
n
the values, principles, and per-ceived obligations underlying pa-tient safety efforts;
n
the historical and continuingtensions between “individual” and“system” accountability, betweenerror “reporting” to oversight agen-cies and error “disclosure” to pa-tients and families, and betweenaggregate safety improvement andthe rights and welfare of individualpatients;
n
the practical implications forpatient safety of defining “respon-sibility” retrospectively, as praise orblame for past events, or prospec-tively, as it relates to professionalobligations and goals for the fu-ture;
n
the shortcomings of tort liabili-ty as a means of building institu-tional cultures of safety, learningfrom error, supporting truth tellingas a professional obligation, or ad-equately compensating patientsand families, contrasted with alter-native models of dispute resolu-tion, including mediation and no-fault liability;
n
the needs of patients, families,and clinicians affected by harmfulerrors and how these needs may beaddressed within systems ap-proaches to patient safety; and
n
the potential conflicts betweenthe protection of patient privacy required by the Health InsurancePortability and Accountability Actand efforts to use patient data forthe purposes of safety improve-ment, and how these conflicts may be resolved.
 Although this report is the work of the project’s principal investigator,not a statement of consensus, it drawsfrom the insights of the interdiscipli-nary group of experts convened by The Hastings Center to make sense of the complex phenomenon of patientsafety reform. Working group mem-bers brought their experience as peo-ple who had suffered from devastat-ing medical harms and as institution-al leaders galvanized to reform by tragic events in their own health careinstitutions. They brought expertiseas clinicians, chaplains, and risk man-agers working to deliver health care,confront its problems, and make itsafer for patients. They brought fa-miliarity with the systems thinkingdeployed in air traffic control and inthe military. And they brought criticalinsight from medical history and soci-ology, economics, health care pur-chasing, health policy, law, philoso-phy, and religious studies.The research project was madepossible through a major grant fromthe Patrick and Catherine WeldonDonaghue Medical Research Founda-tion.
S2
 July-August 2003 / HASTINGSCENTERREPORT
 AN OVERVIEW OF THE PROJECT
On the cover:
Hospital 
, by Frank Moore,1992. Oil on wood with frame and attach-ments. 49” x 58” overall. Private Collection,Italy. Courtesy Sperone Westwater, New York.
 
T
he Institute of Medicine report is a publicpolicy document. That is, it proposes theneed for government intervention to addressa problem of serious concern to public health andhealth care financing. Although there was an imme-diate flurry of resistance to the report’s statistics onthe number of deaths associated with preventablemedical error—a key premise in the argument es-tablishing the scope and significance of the prob-lem—these challenges have been effectively silencedby the preponderance of evidence that the rate of harmful medical error, with its enormous humanand financial consequences in death, disability, lostincome, lost household production, and health carecosts, is unacceptable.
S3
SPECIAL SUPPLEMENT / Promoting Patient Safety: An Ethical Basis for Policy Deliberation
by Virginia A. Sharpe
PROMOTING PATIENT SAFETY
Virginia A. Sharpe, “Promoting Patient Safety: An Ethical Basis forPolicy Deliberation,”
Hastings Center Report Special Supplement 
33,No. 5 (2003), S1-S20.
O
ver the last three years, patient safety andthe reduction of medical error have cometo the fore as significant and pressing mat-ters for policy reform in U.S. health care. In 2000,the Institute of Medicine’s report,
To Err Is Human:Building a Safer Health System
presented the mostcomprehensive set of public policy recommendationson medical error and patient safety ever to have beenproposed in the United States.
1
Prompted by threelarge insurance industry-sponsored studies on thefrequency and severity of preventable adverse events,as well as by a host of media reports on harmful med-ical errors, the report offered an array of proposals toaddress
at the policy level 
 what is being identified as anew “vital statistic,” namely that as many as 98,000 Americans die each year as a result of medicalerror—a figure higher than deaths due to motor ve-hicle accidents, breast cancer, or AIDS. And this fig-ure does not include those medical harms that are se-rious but non-fatal.The IOM recommendations resulted in a surge of media attention on the issue of medical error andswift bipartisan action by President Clinton and the106th and then the 107th Congress. Shortly after thereport was issued, President Clinton lent his full sup-port to efforts aimed at reducing medical error by 50percent over five years. In Congress, the reportprompted hearings and the introduction of a host of bills including the SAFE (Stop All Frequent Errors) Act of 2000 (S. 2378), the “Medication Errors Re-duction Act of 2001” (S. 824 and H.R. 3292), and,recently, the “Patient Safety and Quality Improve-ment Act of 2002” (S. 2590) and the “Patient Safety Improvement Act of 2002” (H.R. 4889). Althoughnone of these bills has made it into law, each repre-sents ongoing debate about the recommendations inthe IOM report.Since the IOM recommendations have been ei-ther a catalyst or a touchstone for all subsequent pa-tient safety reform proposals—whether by regulationor by institutions hoping to escape regulatory man-dates—they must be part of the context of any poli-cy-relevant discussion of the ethical basis of patientsafety.
The Institute of Medicine Report

Activity (13)

You've already reviewed this. Edit your review.
1 hundred reads
1 thousand reads
nuqrisi liked this
banarisali liked this
ujangketul62 liked this
narsee liked this

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->