Proposal aimed at curbing medical mishaps: Indiana hospitals, surgery centers may have to start submitting data on serious errors by the first of the year

The state health department wants to spotlight serious medical errors in hopes the scrutiny will reduce the likelihood of future mishaps.

The department’s Indiana Hospital Council recommended last month that it start requiring hospitals and ambulatory surgery centers to disclose 27 severe problems-also called “never events”- within 15 days of their discovery.

The list of those events, which was devised a few years ago by the not-forprofit National Quality Forum, includes surgeries performed on the wrong body part or the wrong patient and the abduction or sexual assault of a patient.

The Indiana State Department of Health wants to start the requirement by Jan. 1 and eventually plans to post its findings on the Internet. A few other states have already headed down this road, and hospital representatives say the movement could spur lessons that eventually lower health care costs.

Minnesota published its first error report in January, and hospitals quickly spotted troubling patterns to fix, said Bruce Rueben, president of the Minnesota State Hospital Association.

“In the long run, anytime you’re able to improve safety, you’re saving health care costs,” he said, noting that improvements lessen the need for additional or corrective surgeries.

The Minnesota report listed incidents by type and by hospital. It showed 13 surgeries on the wrong body part from July 1, 2003, to Oct. 6, 2004. Foreign objects, things like sponges or gauze pads, were left in patients on 31 occasions.

Health care providers already have learned from the data, Rueben said.

The report showed, for instance, that six hospitals reported incidents where doctors operated on the incorrect portion of a person’s spine. An analysis found that a patient’s skin often shifted between the time hospital staff marked the spot for surgery and the time the operation started, Rueben said.

The report also found severe pressure ulcers or bedsores were a common problem, which has led the state to beef up education on the topic, said Diane Rydrych, a Minnesota Department of Health representative.

Indiana hopes to provide similar teaching moments.

The Hoosier reporting push stems from an executive order issued in January by Gov. Mitch Daniels requiring the state Department of Health to come up with an error-reporting system.

The idea behind the order was to give the public more information and encourage hospitals to avoid serious problems and share tips on how to do so, said Scott Tittle, Daniels’ policy director on health.

The Indiana Hospital Council approved the list of 27 reportable errors Aug. 24 and sent it to the state Department of Health’s executive board. The board will hold a public hearing before deciding whether to adopt it.

The department has several other things to do before a health care provider files the first bit of data. It has to tell hospitals what it wants collected. That means determining what items to include and what to leave out, according to Terry Whitson, assistant commissioner for health care regulatory services. For instance, some people consider a biopsy a surgical procedure because it’s invasive.

The state also has to build an electronic reporting system that can allow hospitals to log onto a secure Web site to enter data, and it must decide how to present the information to the public.

“This is still pretty primitive,” Whitson said. “It still is in very early stages.”

Indiana also will have to maintain the reporting system once it starts running.

It costs Minnesota $535,000 a year to keep the database and oversee it, Rueben said. His state spreads that cost among the hospitals, which also have to pay to track the data.

Rueben said the total cost for hospitals was “not a significant burden.”