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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 116 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 116

 To encourage the use of medical checklists through research, and for 
                            other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            January 3, 2013

 Mr. Holt (for himself and Mrs. Capps) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
 To encourage the use of medical checklists through research, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medical Checklist Act of 2013''.

SEC. 2. RESEARCH INTO MEDICAL CHECKLIST DEVELOPMENT AND EFFICACY.

    (a) Study.--The Director of the Agency for Healthcare Research and 
Quality, acting through the Center for Quality Improvement and Patient 
Safety, shall conduct research and a study, in accordance with the 
requirements of this section, regarding the development and efficacy of 
medical checklists.
    (b) Contents.--In carrying out subsection (a), the Director shall 
conduct research and a study regarding the following:
            (1) Testing of different models of medical checklists to 
        measure the effect of checklist format, length, and design for 
        different clinical tasks on--
                    (A) adoption of checklists by health care 
                professionals;
                    (B) time spent by health care professionals on the 
                clinical task of interest; and
                    (C) reliable completion of health care procedures.
            (2) Examination of checklist development and use in other 
        industries, such as commercial aviation and nuclear power, and 
        the feasibility of applying and adapting methodology developed 
        in those industries to the health care industry in a way that 
        would result in health care quality improvement.
            (3) Identification of organizational characteristics needed 
        to effectively implement the use of medical checklists in 
        health care settings.
            (4) Measurement of the effects of the use of medical 
        checklists on patient safety and health outcomes.
            (5) Identification of health care procedures for which the 
        development and use of medical checklists would be beneficial.
            (6) Investigation of the development, implementation, and 
        use of available medical checklists, including checklists for 
        safe surgery and central line insertion and maintenance, to 
        inform further medical checklist development.
    (c) Scope.--The Director shall ensure that each aspect of the 
research and study conducted under subsection (a) is examined across a 
variety of health care provider characteristics, medical procedures, 
patient populations, and other factors that could affect the use of 
medical checklists.
    (d) Dissemination.--The Director shall make available to the public 
the results of the study conducted under subsection (a) and shall 
disseminate such results to patient safety organizations listed 
pursuant to section 924(d) of the Public Health Service Act (42 U.S.C. 
299b-24(d)).
    (e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2014 through 2017.

SEC. 3. COORDINATING MEDICAL CHECKLISTS AND HEALTH INFORMATION 
              TECHNOLOGY SYSTEMS.

    (a) In General.--The HIT Policy Committee in the Office of the 
National Coordinator for Health Information Technology (as established 
in section 3002 of the Public Health Service Act (42 U.S.C. 300jj-12)) 
shall develop policy recommendations regarding--
            (1) the extent to which the use of medical checklists 
        should be incorporated into health information technology 
        systems; and
            (2) measures to determine the effectiveness of such use.
    (b) Areas of Consideration.--In making recommendations under 
subsection (a), the HIT Policy Committee may consider the following 
areas:
            (1) The ease with which medical checklists in electronic 
        formats can be used by health care professionals.
            (2) The effect of the availability of medical checklists in 
        electronic formats on the adoption and use of medical 
        checklists by health care professionals.
            (3) The effect of the use of medical checklists in 
        electronic formats on the time spent by health care 
        professionals on medical procedures.
            (4) The ability of the health information technology system 
        to collect data on patient safety and health outcomes that 
        could be analyzed to aid in the design and update of medical 
        checklists.
            (5) The ease with which medical checklists in electronic 
        formats can be updated on an ongoing basis based on evidence 
        from medical research and local experience.
            (6) The capability of health information technology systems 
        to collect data, where applicable, regarding the use of medical 
        checklists by health care clinicians and providers, and any 
        relation between that use and patient safety and health 
        outcomes.

SEC. 4. INSTITUTE OF MEDICINE STUDY ON FURTHER MEDICAL CHECKLIST 
              RESEARCH.

    (a) In General.--The Secretary of Health and Human Services shall 
enter into an agreement with the Institute of Medicine and the National 
Academy of Engineering of the National Academies to conduct a study in 
accordance with this section.
    (b) Study.--The Secretary shall ensure that the study conducted 
under this section--
            (1) reviews available medical checklists and similar 
        quality improvement techniques, data on the adoption and use of 
        such techniques by health care professionals, and evidence of 
        the efficacy of such techniques in relation to patient safety 
        and health outcomes;
            (2) identifies areas of research needed to improve medical 
        checklists in order to increase the adoption and efficacy of 
        medical checklists;
            (3) analyzes organizational impediments to the adoption and 
        use of medical checklists;
            (4) reviews the degree to which there is sufficient 
        evidence with which to develop new medical checklists and, if 
        such evidence is insufficient, identifies areas requiring 
        further study in order to develop such evidence; and
            (5) determines whether the availability of an increased 
        number of medical checklists would improve patient safety and 
        health outcomes and, if so, identifies methods for using recent 
        medical research to develop new medical checklists.
    (c) Methodology of Study.--
            (1) Scope.--The Secretary shall ensure that the agreement 
        entered into under subsection (a) provides that the study 
        conducted under such subsection will consider the perspectives 
        of--
                    (A) various types of health care professionals in 
                various types of health care settings;
                    (B) individuals conducting academic research in 
                health care quality; and
                    (C) patients.
            (2) Consultation with relevant organizations.--The 
        Secretary shall ensure that the agreement entered into under 
        subsection (a) provides that relevant agencies and 
        organizations with expertise on medical checklists will be 
        consulted during the study conducted under such subsection, 
        including the following:
                    (A) The Agency for Healthcare Research and Quality.
                    (B) The American Nurses Association.
                    (C) The Institute for Healthcare Improvement.
                    (D) The American Hospital Association.
                    (E) The American Medical Association.
                    (F) The World Health Organization.
                    (G) The National Committee for Quality Assurance.
                    (H) The Joint Commission.
                    (I) The American Academy of Physician Assistants.
    (d) Report.--The Secretary shall ensure that the agreement entered 
into under subsection (a) provides that not later than 18 months after 
the date of the enactment of this Act, a report providing the findings 
and recommendations made in the study conducted under such subsection 
will be submitted to the Secretary, the Committee on Energy and 
Commerce of the House of Representatives, and the Committee on Health, 
Education, Labor, and Pensions of the Senate.

SEC. 5. DEFINITIONS.

    In this Act, the following definitions apply:
            (1) Health care professional.--The term ``health care 
        professional'' means an individual who provides health care 
        services, including a physician, physician assistant, nurse 
        practitioner, clinical nurse specialist (as those terms are 
        defined in section 1861 of the Social Security Act (42 U.S.C. 
        1395x)), and such other individuals as the Secretary of Health 
        and Human Services determines appropriate.
            (2) Health care setting.--The term ``health care setting'' 
        means a facility at which health care services are provided, 
        including a hospital providing inpatient hospital services (as 
        that term is defined in section 1861 of the Social Security Act 
        (42 U.S.C. 1395x)), an ambulatory surgical center (meeting the 
        standards specified under section 1832(a)(2)(F)(i) of the 
        Social Security Act (42 U.S.C. 1395k)), and such other settings 
        as the Secretary of Health and Human Services determines 
        appropriate.
            (3) Health care provider.--The term ``health care 
        provider'' means a health care professional or a health care 
        setting.
            (4) Medical checklist.--The term ``medical checklist'' 
        means a predetermined, evidence-based, well-defined set of 
        steps that should be completed during a designated medical 
        clinical encounter or medical procedure, as further defined by 
        the Director of the Agency for Healthcare Research and Quality 
        in consultation with the Institute of Medicine and the National 
        Academy of Engineering of the National Academies.
                                 <all>
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