Brief Description: Improving patient safety practices.

Sponsors: Representatives Cody, Campbell, Morrell, Schual-Berke, Lantz, Clibborn, Simpson, G., Moeller, Upthegrove and Kagi.

Hearing Date: 1/27/04

Staff: Chris Blake (786-7392).

Background:

Hospitals are required to maintain coordinated quality improvement programs designed to improve the quality of health care services and prevent medical malpractice. Other health institutions and medical facilities, and health provider groups consisting of at least 10 providers, are authorized to maintain coordinated quality improvement programs. Coordinated quality improvement programs maintained by these other entities must be approved by the Department of Health and must comply, or substantially comply, with the statutorily required components of the hospital coordinated quality improvement programs.

The programs must include: a medical staff privileges sanction procedure; periodic review of employee credentials and competency in the delivery of health care services; a procedure for prompt resolution of patient grievances; collection of information relating to negative outcomes, patient grievances, settlements and awards, and safety improvement activities; and quality improvement education programs. Components of the education programs include quality improvement, patient safety, injury prevention, improved communication with patients, and causes of malpractice claims.

With some limited exceptions, information and documents created for or collected and maintained by a quality improvement committee are not subject to discovery, not admissible into evidence in any civil action, and are confidential and not subject to public disclosure. A person participating in a meeting of the committee or in the creation or collection of information for the committee may not testify in any civil action regarding the content of the committee proceedings or information created or collected by the committee.

A provision of law immunizes a health care provider who, in good faith, files charges or presents evidence against another provider before a regularly constituted review committee or board of a professional society or hospital on grounds of incompetency or misconduct. The proceedings and records of a review committee or board are not discoverable except in actions relating to the recommendation of the review committee or board involving restriction or revocation of the provider's privileges.

Summary of Bill:

Coordinated Quality Improvement Programs

Coordinated quality improvement programs may share information and documents created specifically for a quality improvement committee or peer review committee with other coordinated quality improvement programs for the purpose of improving health care services and identifying and preventing medical malpractice. The information shared is confidential and is neither subject to discovery nor admissible in civil proceedings. Participants in a coordinated quality improvement program that shares information with other programs in good faith and in accordance with confidentiality and disclosure requirements are not liable for any damages resulting from sharing the information.

Health care provider groups that consist of five or more providers may maintain a coordinated quality improvement program.

Patient Safety Account

The "Patient Safety Account" (account) is created. The account is to be funded in two ways. First, a $2 surcharge is placed on licenses for 16 health professions and $2 per licensed bed is charged to hospitals and psychiatric hospitals. Second, one percent of the value of any settlement or judgment in an action for injuries resulting from health care must be provided to the Department of Health (Department) for transfer into the account.

The account is to be used for grants, loans, and other arrangements that support efforts to reduce medical errors and enhance patient safety. The Department must establish criteria for the types of programs to receive funds. The criteria must emphasize evidence-based practices recommended by governmental and private organizations including the Agency for Health Care Quality and Research, the Institute of Medicine, the Joint Commission on Accreditation of Health Care Organizations, and the National Quality Forum. At least two of the projects must implement recommendations of the Institute of Medicine's report Keeping Patients Safe: Transforming the Work Environment of Nurses. Funding priority is given to projects that are proven to enhance patient safety and reduce medical errors as opposed to those that only have a substantial likelihood of doing so. Project proposals must have performance measures.

By December 1, 2007, the Department must report to the Legislature about the funds raised, criteria developed, and projects funded. The account provisions expire December 31, 2010.

The account is a non-appropriated account and the Secretary of Health may authorize expenditures.

Appropriation: None.

Fiscal Note: Requested on January 20, 2004.

Effective Date: The bill takes effect 90 days after adjournment of session in which bill is passed, except for section 203, relating to a surcharge on licenses for health care providers and facilities, which takes effect July 1, 2004.