On Several Fronts, President Targeting Major Medical Errors

WASHINGTON —  President Clinton plans to announce steps today to curb dangerous medical errors, including a requirement that all 300 health plans insuring federal workers adopt safeguards to avoid accidents that can injure or kill patients.

Clinton also will direct every agency that runs government health programs--including those for children, veterans, the military and people who are elderly or poor--to explore additional ways to improve patients’ safety. And, for the budget that the administration is preparing to send to Congress early next year, he will ask advisors to include initiatives to reduce medical mistakes.

The president also plans to laud the nation’s hospital industry, which is also planning to unveil a campaign today to begin spreading among all 5,000 of the nation’s hospitals information about how to avoid mistakes involving medication.

The White House is swinging into action just a week after the release of a major independent report that documents the alarming frequency of fatal mistakes--44,000 to 98,000 Americans a year are killed--by a health care system that has been regarded for decades as the finest in the world.

Judging by the swift response from the administration, lawmakers and various health care constituencies, the cause of “patient safety” could blossom into a prime political issue, emerging alongside the bitter debate over how much to regulate HMOs.

Already, the issue of medical errors appears certain to spill into Congress shortly after lawmakers return to work in January.

Monday, Sen. Edward M. Kennedy (D-Mass.) said he intends to introduce legislation that would for the first time require every hospital to notify state governments of all mistakes that cause serious injuries or deaths. Kennedy told reporters that his bill would encourage health care organizations to report errors with less drastic consequences confidentially and on a voluntary basis. And it would create a new federal Center for Patient Safety within the Department of Health and Human Services.

The ideas in Kennedy’s legislation, which he said appear likely to attract bipartisan support, were proposed in last week’s report, sponsored by the respected Institute of Medicine, a branch of the National Academy of Sciences.

Drug Mistakes Called Most Frequent

The report estimates that preventable deaths and injuries in hospitals and other health care settings cost the United States as much as $29 billion a year. The most common kinds of mistakes, it says, involve drugs that are given at the wrong time, in the wrong dose, in hazardous combinations or to the wrong patients.

The IOM study concludes that the nation’s health care system lags behind airlines, the nuclear industry and other parts of the country that have long collected information about accidents--and gleaned from that information ideas about how to operate more safely.

Today, Clinton is expected to stop short of endorsing the report. Instead, he will assign a relatively new federal task force on medical quality to spend the next two months studying the “feasibility and advisability” of its recommendations. In draft remarks prepared for a White House event today, the president notes that efforts to ferret out medical mistakes must be balanced against another goal of the administration: protecting the privacy of patient records.

Republicans, sensitive to any efforts to add to federal bureaucracy, could prove cool to the idea of a national reporting system for medical mistakes. Sen. James M. Jeffords (R-Vt.) chairman of the Senate health committee, has said he plans to convene a hearing on errors early next year. But a committee spokesman said Monday that Jeffords was not inclined to support a federal law requiring all errors to be reported to the government.