Despite the state activity, federal programs are leading the way, said Donald M. Berwick, MD, an IOM report committee member and president and CEO of the Institute for Healthcare Improvement. The Dept. of Veterans Affairs in May 2000 launched the Patient Safety Reporting System, patterned after the aviation reporting system. It required staff training in patient safety at its 172 medical centers. The VA was a safety leader before the IOM report, consolidating its safety programs in 1997 and creating its National Center for Patient Safety in 1998. The Food and Drug Administration has proposed a new format for prescription drug labeling designed to reduce medication mistakes through clearer and more readable package inserts.
Private sector steps up Some health plans are heeding the report's call for action.
In a pilot program sponsored by Tufts Health Plan and AdvancePCS, about 200 Massachusetts physicians in April began using wireless handheld devices for patient information and electronic prescribing. Minnesota-based Allina Health System has set up medication safety educational programs and automated drug records in hospitals. The Leapfrog Group, a consortium of about 80 Fortune 500 companies and other large health care purchasers, plans to use incentives to fuel safety improvements. Employers such as General Motors and IBM have agreed to base purchase of health care on principles encouraging stringent safety measures, including computerized physician order entry and evidence-based hospital referral. Quality experts say the report has prompted many private and public initiatives that will lead to a reduction in medical errors and improving patient safety.