Hospital safety bills eyed in session

By David McGrath Schwartz

Saturday, June 4, 2011 | 2 a.m.

Perhaps the most significant sign that opinion has shifted on whether patients can be trusted with information about Nevada hospitals’ safety records: The Nevada Hospital Association and Nevada State Medical Association supported bills requiring such disclosure during the 2011 Legislature.

Nevada’s health care community “knows it’s a national trend. They know that it was coming,” said Bill Welch, CEO of the Hospital Association.

Indeed, bills that have passed or are likely to pass the 2011 Legislature will give consumers better information to use in selecting hospitals by giving them access to the facilities’ rates of preventable infections and other harm, safety advocates say.

Once consumers begin to choose hospitals based on safety performance, it will create competition to improve their safety records, state Sen. Sheila Leslie, D-Reno, said.

“We feel like we are making significant progress with health care transparency,” said Bobbette Bond, executive director of the Nevada Health Care Policy Group. “These will provide better information for consumers to make choices.”

Sentinel events — unexpected incidents in hospitals that cause injury or the risk thereof — are currently reported to the public as a statewide total, rendering the information useless for consumers seeking to compare facilities’ records. Legislation would require the incidents be reported by facility and hospital, and made available for public review on a state website.

Not everything was a victory. Some bills would have required nursing homes to publicly report incidents. They were taken out of the legislation after the state said it would require more staff time. “It’s something to work on next session,” Leslie said.

The bills were prompted by the Las Vegas Sun’s series “Do No Harm,” which analyzed hospital billing records on file with the state, finding that in 2008 and 2009 patients suffered preventable injuries, life-threatening infections or other harm 969 times in Las Vegas hospitals. In that time, patients also became infected with two types of lethal, drug-resistant “superbugs” in area hospitals 2,010 times.

The series received numerous awards, including being named a finalist for a Pulitzer Prize, journalism’s highest honor.

Here is the status of four bills aimed at increasing health care transparency:

• Senate Bill 209: Requires the state Health Division to publish annual reports on its website comparing “sentinel events” in hospitals in Clark and Washoe counties. The bill defines a sentinel event as an “unexpected occurrence involving facility-acquired infection, death or serious physical or psychological injury.” Status: signed by the governor.

• Senate Bill 264: Would also require the state to report sentinel events by facility. But it would require reporting of the readmissions of patients if the readmission was potentially preventable and related to the initial admission. Money raised through administrative penalties could be used for training to improve the quality of care. Status: in conference committee between Assembly and Senate.

• Senate Bill 338: Requires each medical facility and nursing home that provided care to 25 or more patients to report sentinel events to a Centers for Disease Control and Prevention program. The state Health Division would be required to access and publish that information on all medical facilities after Oct. 15, and by nursing homes on Jan. 1. The reports would allow comparisons among facilities. Status: being considered by the Senate; would have to pass the Assembly.

• Senate Bill 339: Requires doctors to inform patients about infections acquired in hospitals. The law mandates that patients, or their families or guardians, be told within five days. There are exceptions, such as when a patient is comatose or suicidal. Status: waiting for the governor’s signature.

• Senate Bill 340: Hospitals and ambulatory surgical centers would be required to report the names of physicians performing surgical procedures and information about those procedures. It would be a step toward linking doctors to potentially adverse medical events. Status: passed Senate; needs approval in the Assembly.