Source: http://www.qups.org/med_errors.php?c=individual_state&s=43&t=all
Timestamp: 2019-07-19 22:41:25
Document Index: 514742211

Matched Legal Cases: ['§1200', 'art 2', '§68', 'art 2', '§ 63', '§ 63', '§1200', '§63', '§63', '§63', 'art2', '§68', '§1200', '§1200']

QuPS.org - Medical Errors and Patient Safety - Tennessee - All Topics Combined
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• 2000 DOH Rules Start Event Reporting
Tennessee's mandatory medical error reporting program was developed when Tennessee Rule 1200-8-1-.11 was filed by the Department of Health on March 18, 2000.
• Creation of Public/Private Task Force (TIPS)
Subsequent to the release in November 1999 of the IOM's To Err is Human: Building a Safer Health System, the Tennessee Department of Health convened a task force that addressed definitions and guidelines for error reporting, and it recruited a Tennessee Improving Patient Safety (TIPS) committee and coalition of volunteer stakeholders. Activity for the TIPS groups officially began in August 2001.
The combined private-public collaboration recommended revisions in the existing reporting program. Upon the recommendations from TIPS, the legislature passed the “Health Data Reporting Act of 2002,” creating new statute-based definitions for “unusual events” and defining a reporting program designed to create public accountability for medical facilities, while respective of confidentiality. The law was signed by the Governor in March 2002 and promulgated into amendments to existing rules and creation of new rules for all facilities licensed within the Department of Health, including Hospitals (Tennessee Rule 1200-8-1-.11).
June 2003 marked the beginning of mandatory reporting of over 30 “unusual events.” Simultaneously in 2002 with legislative deliberations, an electronic extranet report system, the Unusual Event Reporting System (UIRS ) was developed within the Department of Health and was implemented before passage of the law.
• Features of the Reporting Program
Public release of reported “unusual event” data does not identify individual medical facilities nor any individual licensed health professionals involved in these reportable events. The reporting program is designed to provide confidentiality without compromising public accountability. Reporting of aggregate data (without identification of individual facilities) has been provided for 2002 (released May 7, 2003) [PDF] and for 2003 (released in early 2004). In addition, aggregate data is available on a quarterly and annual basis by facility type after 2003.
The initial experience reveals that the performances of facilities within the state are characterized by under-reporting of “unusual events,” inadequate compliance, and generally inadequate quality of Corrective Action Plans (CAPs) that were developed and submitted to the Department of Health as mandated by statute. While the Department of Health has seen evidence of improvement from 2002 to 2003, some non-compliance has been evident. Whereas a non-punitive posture was adopted in 2002, sanctions against facilities for non-reporting and for late reporting were issued in 2003.
Tennessee has developed an ambitious medical error reporting program with a technically-sophisticated reporting system. Collaboration between public and private contributors has developed a well-thought reporting program with an extensive number of reportable “unusual events” under the regulatory control of the Department of Health.
Extensive education and training has characterized an ambitious state-of-the-art effort for translating definitions into reportable information, and the Department of Health has provided resources to evaluate the action plans with an intent to share lessons learned with all facilities. This latter element of the program has yet to be realized due to previously mentioned probelms, incomplete reporting to the UIRS, and logistical problems in the system that remain to be worked out.
A more detailed history of Tennessee's reporting program is available.
◊ Tennessee Rules and Regulations (TRR)
The entire list of administrative rules and regulations for the state of Tennessee is available at the Tennessee Department of State website. The rules are maintained in Chapters, numbered from 0020-##-## through 1730-##-## with designations for each department, agency, or other state entity. The chapters in the 1200-##-## group includes 31 groups of chapters 1200-1-## through 1200-31-##, which are the combined rules for both the Department of Health and the Department of Environment & Conservation. A breakdown of chapter groupings within 1200 by department and bureau/division/entity rules is available. An individual chapter, therefore, is a concatenation of three numbers, divided by hyphens, e.g., 1200-8-1. Tennessee provides its rules only in PDF format, with a separate file for each of these individual chapters, rendering Tennessee's Rules and Regulations searchable by keywords only one chapter at a time.
The Department of Health is responsible for licensure for health facililties via the Division of Health Care Facilities (HCF) and for 26 professional boards by the Division of Health Related Boards.
Proper citation of Tenness Rules and Regulations, (where Comp. = Compilation) is a concatenation of Tenn Comp. R. & Regs. + [Chapter ##-##-##] + . + [section#]. For example, section 1 (Definitions) of Chapter 1200-8-1 (Standards for Hospitals) is cited as Tenn Comp. R. &Regs. 1200-8-1.1, which is designated on this website as TRR §1200-8-1.1.
◊ Tennessee Laws and Statutes
Tennessee's laws addressing patient safety and quality are provided in 2 categories of laws. Session Laws | Public Acts are general laws that are enacted by the Legislature and signed by the Governor. The legislative sessions are available on the web from 1997 through the present. Tennessee Code Annotated (TCA) is the codified compilation of all permanent laws now in force, and they are published by the West Group Publishing Company for public use.
Tenness Code is arranged in 71 Titles, each title addressing a sector of Tenness code, including:
Title 33 – Mental Health and Developmental Disabilities
Title 63 – Professions of the Healing Arts
Title 68 – Health, Safety, and the Environmental Protection
On this website, Tennessee Code is cited as annotated code: TCA § [Title]-[Chapter]-[Section]. For example, law addressing ‘Health Data Reporting’ for hospitals is found in section 211 of Part 2 (Regulation) of Chapter 11 (Health Facilities and Resources) within Title 68, designated as TCA §68-11-211.
• Laws and Regulations Governing Tennessee Programs
The public policy affecting “unusual event” reporting was created by the legislature by the passage of the “Health Data Reporting Act of 2002” (Title 68, Chapter 11, Part 2, Section 211). Many of the features of this law were developed with feedback from the Department of Health and the Tennessee Improving Patient Safety (TIPS) Committee and Coalition.
In 1998, the legislature passed the Health Care Consumer Right-to-Know Act of 1998 (T.C.A. § 63-51-101 through § 63-51-119), which requires designated licensed health professionals to furnish certain information to the Tennessee Department of Health. This legislation grew out of efforts to provide information on health providers to all Tennessee consumers, while also providing monitoring of medical malpractice claims on health professionals. In addition, Public Acts, 2004, c. 902 (HB 3252) [PDF] amended the Health Care Consumer Right-to-Know Act, mandating reporting of medical malpractice claims by Insurance carriers. The Tennessee Consumer, as a result of this law, has Internet access to this information on health professionals as part of the licensure process.
Within the Tennessee Department of Health, the Board for Licensing Health Care Facilities – Division of Health Care Facilities has created rules addressing “unusual event” [PDF] reporting requirements that reflect the statutory language of T.C.A. 68-11-211. Regulations reflecting the “Health Data Reporting Act of 2002” have been created and approved for multiple types of medical facilities, including hospitals [TRR §1200-8-1.11]
HMOs, practitioner offices (of all types – physicians, chiropracters, dentists, etc.), medical clinics, and others not included in this list of facility types are not included in the mandate for reporting of “unusual events.”
TENNESSEE LAWS / STATUTES
Chapter 6 - Medicine and Surgery, General Provisions
TCA §63-2-219
Legislative policy declaration - Medical review committees - Immunity of members - Confidentiality of records - Short title.
Chapter 51 - Health Care Consumer Right-to-Know Act of 1998
TCA §63-51-101 to
TCA §63-51-119
All Sections of Act
Title 68 – Health, Safety, and Environmental Protection
Chapter 11 – Health Facilities and Resources – Part2, Regulation
TCA §68-11-211
TRR §1200-8-1 – Standards for Hospitals
TRR §1200-8-1-.11
According to statute, mandatory reporting is required for “any facility licensed under this part,” i.e., all facilities licensed under the Department of Health.
As described in the Division of Health Care Facilities (HCF), and as supported by 20 separate set of department regulations for licensed facilities, it is apparent that Tennesse has extended the mandate for reporting to include most facilities. Hospitals, Ambulatory Surgical Treatment Centers, and Nursing Homes are the three primary targeted facilities.
HMOs, offices of practitioners (i.e., MDs, osteopaths, chiropracters, dentists, etc.), medical clinics, and healthcare facilities that require certification only but not licensure, (Comprehensive Outpatient Rehabilitation Facilities, Intermediate Care Facilities for Mentally Retarded, Occupational Therapists in Independent Practice, Physical Therapists in Independent Practice, Portable X-ray Units, Rehabilitation Centers,* Rural Health Clinics), are not included in the mandate for reporting of “unusual events.”
* It should be noted, however, that Tennessee hospitals are defined in administrative rules to include licensed rehabilitation hospitals, which obviously are not the same as unlicensed rehabilitation centers.