A recent New Jersey Supreme Court ruling has concluded that hospitals’ internal review reports written after adverse events occur should remain private. But, that doesn’t mean hospitals should not be tracking and reporting adverse events.
Under the ruling, the Valley Hospital of Ridgewood, New Jersey is allowed to keep secret a memo that was written after a roundtable discussion, following events that led to a 2007 malpractice suit alleging a newborn suffered brain damage as a result of negligent care during birth.
In the 4-3 majority ruling, the court said, “[t]he Legislature included in the Patient Safety Act a provision creating an absolute privilege. It reasoned that healthcare professionals and other facility staff are more likely to effectively assess adverse events in a confidential setting, in which an employee need not fear recrimination for disclosing his or her own medical error, or that of a colleague.”
The 2004 Patient safety Act, the Supreme Court was referring to, ensures the confidentiality of healthcare workers in order for them to be more forthcoming when a hospital error is made. Without this provision, hospital staff are less likely to report an adverse event for fear of being held liable. Doctors and nurses should feel they are protected, without the threat of reprisal, to share all information surrounding a bad outcome — allowing for timely and accurate incident reporting.
Timely and accurate incident reporting is essential to improving patient care by identifying adverse event trends due to bad practices, poor planning, or insufficient training. A study from the Journal of Patient Safety calculated the annual toll of preventable deaths due to medical errors in hospitals at as many as 440,000. The finding did not include tens of thousands more who die outside of hospitals from medical mistakes such as drug or diagnostic errors.
It can easily be argued that, in a hospital environment conducive to efficient incident reporting — where all staff feel secure to participate in a culture of quality — and with a robust, integrated Risk, Quality and Performance Improvement program, a large number of those 1,000 deaths per day are preventable.