President Bill Clinton unveiled several initiatives in February to reduce the rate of medical errors by 50 percent in five years.

"We can dramatically reduce incidents when the wrong drug is dispensed, a blood transfusion is mismatched, or a surgery goes awry," said Clinton in announcing his national action plan to the press.

He referred to the findings of a report released last November by the Institute of Medicine (IOM), an arm of the National Academy of Sciences. Studies have shown that anywhere from 44,000 to 98,000 deaths occur annually because of medical mistakes in health care settings.

Clinton responded to the IOM results by directing the national Health Care Quality Task Force to study the IOM report. At a February press briefing he announced the task force recommendations, which were similar to those made by the IOM:

• Establish a new Center for Quality Improvement in Patient Safety to invest in research, translate findings into better practices and policies, and develop national goals.

• Develop federal regulations requiring all 6,000 hospitals participating in Medicare to have patient-safety programs to prevent medical errors.

• Require all 50 states to implement a system of mandatory reporting of deaths and serious injuries and voluntary reporting of other medical mistakes in three years.

"Reporting is vital to holding health care systems accountable for delivering quality care and educating the public about the safety of their own health care system," according to Clinton in the White House press release.

He noted that 21 states already require mandatory reporting systems. A coalition of health care experts from the private and public sectors, the National Quality Forum, will be developing patient safety measures that will lay the foundation for a uniform system of reporting errors, according to the White House.

The President also addressed concerns of the American Medical Association and the American Hospital Association about the confidentiality of patient and provider information contained in mandatory reporting systems available to the public.

"People should have access to information about a preventable medical error, . . .and providers should have protections to encourage reporting and prevent mistakes from happening again," said Clinton.

The President mentioned that he has already directed federal agencies to implement mandatory reporting systems for deaths and serious injuries. "The Department of Veterans Affairs has done this, and beginning this spring, all 500 Department of Defense hospitals and clinics will have a mandatory reporting system."

Clinton also called on the Food and Drug Administration (FDA) to develop new standards to prevent medical errors related to drugs’ having similar names or similar packaging, according to the press release.

"In addition, the FDA will develop new label standards that highlight common drug interactions and dosage errors," said Clinton.

Altha Stewart, M.D., chair of APA’s Council on Psychiatric Services, told Psychiatric News, "In general, we support any initiative that. . . makes it easier for psychiatric patients to take and comply with prescribed medications. The IOM report also reinforces the need for us to educate our patients about their medications, including possible adverse reactions and side effects."

The President noted that the Department of Veterans Affairs already has a computerized system for patient orders including prescriptions. "No more handwritten prescriptions that no one can read," said Clinton in the press release.

The IOM report found that illegible handwriting in medical records has resulted in the administration of drugs to patients with known allergies, according to an IOM press release.

The IOM press release is available at <www4.nationalacademies.org/news.nsf/isbn/0309068371?OpenDocument>. The IOM report, "To Err Is Human, Building a Safer Health System," is posted at <www.nap.edu/books/0309068371/
html/>.—C.L.