National health reform legislation includes some quality of care provisions but, as a Hearst newspapers article points out, none of the federal bills requires medical error reporting and only one (the House bill) requires public reporting of healthcare-associated infections. This is despite the fact that 10 years ago the Institute of Medicine (IOM), in a seminal report titled “To Err is Human,” recommended national medical error reporting and then systemic changes based on those reports. All of the bills do require public reporting of hospital readmissions and financial incentives to reduce them, but they should go further. While Congress focuses on access to health care, the bills miss an opportunity to improve quality and reduce costs by reducing medical errors and infections. Proper patient safety measures are important to ensure that as more people have health insurance, the health care they access will do more good than harm!

Massachusetts is being looked to as a model for national reform. Massachusetts has also been a leader on quality initiatives. Chapter 305, signed into law in 2008, requires public reporting of Serious Reportable Events and infections. Chapter 305 also prohibits reimbursement to hospitals for costs related to Serious Reportable Events. Congress should consider all of these options as legislation moves ahead.

Health Care for All and the Consumer Health Quality Council are also moving on to pursuing additional quality improvement initiatives that could be considered for national legislation. These include requiring the use of check-lists to reduce infections and other complications and requiring hospitals to screen high-risk patients for MRSA. Learn more about these initiatives on the HCFA website. As the nation looks to reform health care, Massachusetts continues to lead with innovative health care quality initiatives.

Deb Wachenheim