Medical Malpractice: The Role of Patient Safety Initiatives (CRS Report for Congress)
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| Release Date |
Revised July 14, 2006 |
| Report Number |
RL32092 |
| Report Type |
Report |
| Authors |
Bernadette Fernandez and Amanda Kay Sarata, Domestic Social Policy Division |
| Source Agency |
Congressional Research Service |
| Older Revisions |
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Summary:
Medical malpractice and malpractice insurance continue to be issues of great concern to
physicians,
consumers, legislators, and others. Most of the discussion about rising malpractice insurance
premiums has centered on limiting the damage awards in malpractice suits, though some attention
also has been given to insurance reforms. A third, related area that has received less consideration
in malpractice discussions is patient safety. Patient safety refers to the panoply of rules, practices,
and systems related to the prevention of medical injury. Intrinsic to patient safety efforts are
strategies to prevent medical errors.
While patient safety and medical errors have generated a great deal of discussion in legislatures
in the past several years, such discussion typically has taken place separately from the debates
concerning malpractice. For example, S. 544 , the Patient Safety and Quality
Improvement Act of 2005, encouraged the voluntary reporting and analysis of medical error data.
S. 544 became P.L. 109-41 on July 29, 2005. However, medical liability issues are
addressed in other legislation -- specifically, H.R. 5 / S. 354 , the Help
Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH) Act of 2005, S. 22 , the
Medical Care Access Protection Act of 2006, and S. 23 , the Healthy Mothers and
Healthy Babies Access to Care Act.
The separation of patient safety concerns from medical malpractice issues has not always been
the case. Several states have passed legislation that included provisions that addressed both
malpractice and patient safety issues. Research studies have explored the links between the two
issues, and a few bills introduced during the 109th Congress, such as S. 1337 and
S. 1784 , address those links. Therefore, it is appropriate and timely to reconsider these
issues collectively, and revisit the role patient safety initiatives could play in the prevention of both
medical errors and medical malpractice.
Strategies to enhance patient safety differ according to the specific provider type targeted. For
instance, physician education includes providing clinical guidelines about appropriate treatments for
specific medical conditions, while hospital education involves performance feedback from an
external organization. At the same time, general approaches may apply to both physicians and
hospitals. For example, medical error reporting is a key component for patient safety enhancement,
regardless of the provider focus.
The impact of patient safety initiatives on the quality of care provided continues to be an open
question. Individual initiatives have resulted in promising outcomes, but the overall impact of these
efforts has been mixed. To some degree, this is the case because implementation has not been as
pervasive as initial intentions suggested, and also because not enough research has been done to
identify, enumerate, and assess patient safety efforts.
This report will be updated periodically.
