Medical Error Tab Menu
State Comparison
Individual State
Performance Measure Tab Cardiac Registries Tab

Overview
Rationale
Statutes/Rules
Definitions
Facility Participation
Physician Participation
State Agency Roles
Operational Features
Provider-indentifed Info
Disclosure
Data Protections
Participant Protections
Sanctions / Punishments
Patient Safety Coalitions
Funding Issues
Other Factors
Performance Experience
Legislative Activity
All Topics Combined

 

Summary of Facility Participation in States's
Incident and Outcomes Reporting Programs


  • •  HOSPITALS

    Hospitals compose the largest group of facilities/entities that are targeted to provide and report data. Among the 32 States with some form of reporting program, 30 States have some form of hospital reporting. Among these 32 States, only New Mexico and North Carolina have no hospital reporting options. Reporting Options by hospitals are detailed in the table below.

    TYPES OF HOSPITAL REPORTING
    State Incident
    Reporting
    Non-cardiac
    Outcomes
    Cardiac
    Outcomes
    Other
    1.CAXXXX
    2.COXX
    3.CTX
    4.FLX
    5.GAX
    6.ILXX
    7.INX
    8.KSX
    9.MEXX
    10.MDX
    11.MAXX
    12.MNX
    13.NEX
    14.NVX
    15.NJXX
    16.NM
    17.NYXXX
    18.NC
    19.OHXX
    20.ORXX
    21.PAXXX
    22.RIXXX
    23.SCX
    24.SDX
    25.TNX
    26.TXXX
    27.UTX
    28.VAX
    29.WAX
    30.WVX
    31.WIX
    32.WYX
    TOTALS27 25992
    X  = States (KS, NE) that report physicians only and that have been misclassified historically as incident reporting programs
    • ◊  Mixed Classification of Hospitals

      A hospital in one state is not necessarily a hospital in another State.

      Most States require licensure and recertification based on inspection and maintenance of quality standards, whereas some States like Ohio in abandoning Certificate of Need (CON) have no licensure requirement, except for 6 categories of freestanding health facilities. Consequently, Ohio government has no authority to mandate hospital incident reporting programs, (although the legislature provided that selected hospital sub-specialty services are subject to quality review via outcomes reporting).

      More commonly the differences among States is simply related to how the States choose to classify health facilities. Dissimilar classifications across States are common. Some examples include:

      • √  MARYLAND – Maryland's statute MD Health-General Code §19.307 hospital classification includes four distinct types of hospitals: General hospitals, Special Hospitals (e.g., Orthopedic, Mental Health/Psychiatry, Children's hospitals, etc.), Special Rehabilitation Hospitals, and Limited services hospitals (e.g., Critical Access Hospitals).
      • √  FLORIDA – In defining licensed facilities that must report in its incident reporting program, a Florida hospital "regularly makes available at least clinical laboratory services, diagnostic X-ray services, and treatment facilities for surgery or obstetrical care, or other definitive medical treatment of similar extent.." By this definition, certain specialty hospitals and rehabilitation hospitals defined as hospitals in Maryland are not hospitals in Florida.
      • √  MINNESOTA – Minnesota law does not segregate hospitals nor provide definitions for subtypes of hospitals so that there is no designation in law for any specialized hospitals, including Psychiatric Hospitals.
      • √  PENNSYLVANIA – Pennsylvania law includes rehabilitiation facilities, but specifically excludes Psychiatric Hospitals from inclusion as "hospitals." Indiana similarly excludes any psychiatric hospital as a type of hospital.

      Therefore, States agree that general acute hospitals meet the definition of "hospitals," there is lack of agreement as to what specialty hospitals (if any) are included as hospitals.

    • ◊  Incident Reporting Hospitals

      The 28 Incident Reporting program States, 27 of which have hospital participation, are discussed in greater detail in the national Overview, Part III. Of all States incident reporting programs, only New Mexico has no hospital incident reporting. The hospital participants in this group includes

      • √  21 States with a single mandatory program,
      • √  1 state with 2 mandatory programs (Massachusetts),
      • √  1 State with both voluntary and mandatory reporting programs (Georgia),
      • √  2 States with voluntary programs (Oregon, West Virginia), and
      • √  2 States that have been historically misclassified as incident reporting states (Nebraska, Kansas).1

      Therefore, 25 States have HOSPITAL incident reporting programs.


      1   Kansas and Nebraska are not true incident reporting programs, although both States have been referenced in literature as having adverse event reporting programs.2 They are more properly termed "physician reporting" programs since only a physician must be reported. In Kansas, the "reportable incident" is "an act by a health care provider," while Nebraska administrative rules require reporting of "gross Incompetence or a pattern of negligent conduct," whether associated with an adverse event or not. Neither State provides lists or definitions of incidents that might qualify as reportable events in State laws or regulations.

      2   Rosenthal J and Booth M, "Defining Reportable Adverse Events: A Guide for States Tracking Medical Errors," National Academy for State Health Policy, GNL50; March 2003. [PDF, p6]


    • ◊  Outcomes Reporting Hospitals

      Unlike most incident reporting programs, outcomes reporting is usually published by facility or provider, as designated by State laws or rules.

      The 13 Outcomes Reporting program States are discussed in greater detail in the national Overview, Part IV. With one exception (Virginia), these 13 States with some form of outcomes reporting also have mandatory or voluntary (Oregon) incident reporting programs. 5 States have more than one type of outcome reporting, as listed below, and California and Pennsylvania have more than one non-cardiac outcome reporting program.

      TYPES OF HOSPITAL OUTCOME REPORTING
      State AHRQ
      IQIs
      Non-cardiac
      Outcomes
      Cardiac Outcomes Reporting
      Facility
      Only
      Facility &
      Physician
      1.CAXX
      2. COX
      3. ILX
      4. MEX
      5. MAX
      6. NJX
      7. NYXX
      8. OHXX
      9.ORX
      10.PAXX
      11. RIXX
      12. TXX
      13.VAX
      TOTALS4554
    • ◊  Hospitals with Other Reporting

      The 3 States with ‘Other’ reporting programs that are not incident reporting or outcomes reporting programs are discussed in greater detail in the national Overview, Part V. Two of these programs (California and Wisconsin) require reporting by hospitals. Wisconsin's voluntary and privately-supported CheckPoint program for reporting of hospital compliance with JCAHO National Patient Safety Goals is the sole reporting program in Wisconsin for hospitals. California's medication-error reporting is a mandatory reporting program that provides multiple options via which to achieve compliance.

  • •  Ambulatory Surgical Centers / Facilities (ASCs / ASFs)
  • •  Birthing Centers
  • •  Psychiatric Hospitals
  • •  Physicians / Clinics
  • •  End Stage Renal Disease (ESRD) Facilities
  • •  Nursing Homes
  • •  Rehabilitation Facilties
  • •  HMOs
  • •  Other
Design support from Skysoft Consulting
©QuPS.org   Terms of Use
©QuPS.org   Privacy Policy