PROVIDENCE, R.I. (AP) – Lawmakers have proposed a system to investigate and track medical mistakes and so-called “near misses” after brain surgeons at Rhode Island Hospital operated on the wrong side of patients’ heads last year on three separate occasions.

Bills introduced in the House and Senate would create a Rhode Island Patient Safety Organization, which is designed to hunt down the potential causes of medical errors and fix them at hospitals and nursing homes statewide before patients are hurt.

The legislation was introduced by Rep. Joseph McNamara, a Democrat, and Sen. David Bates, a Republican, and designed by Health Director David Gifford.

Gifford said Monday he was prompted to act by last year’s problems at Rhode Island Hospital.

“It made us ask, ‘What else could we do?’ Clearly, we do not want to see this happen again,” Gifford said. “When we look at our data, Rhode Island Hospital wasn’t the only one who’s had problems.”

The Department of Health already requires hospitals and nursing homes to report medical mistakes, but they don’t have to report near misses. So while the department can investigate and take action against doctors or hospitals after a patient has already been hurt by a medical error, there’s not a strong system for examining the cases when doctors and nurses narrowly avoiding making a mistake.

“It’s a way to learn from our mistakes,” Gifford said. “Right now, we’re not seeing a change in errors overall.”

The Department of Health said it gets about 300 reports of medical errors from hospitals every year as well as 275 reports from nursing homes.

The system would be voluntary, and doctors and nurses could not be punished for reporting mistakes to the Patient Safety Organization. Bill supporters said that was to encourage people to come forward so the organization can keep better track of what’s happening.

Lifespan Corp., owner of the not-for-profit Rhode Island Hospital, and the Rhode Island State Nurses Association also support the legislation. George Vecchione, Lifespan’s CEO, said the legislation would make hospitals safer.

“We recognize that more can be done,” he said.

Once it gets a report, the Patient Safety Organization would investigate and enter its findings into a database. The database would help the group make recommendations to the state’s health providers.

For example, if it found persistent problems with pre-surgery checklists designed to ensure that a doctor doesn’t operate on the wrong part of a patient’s body, it could recommend all hospitals in the state use a standard checklist, Gifford said.

Rhode Island’s legislation is modeled on the federal Patient Safety and Quality Improvement Act, which passed in 2005. Gifford said the state proposal focuses more than the federal law does on investigating and making recommendations for change.

While the state is in the middle of a budget crisis, with widespread layoffs and cutbacks, the bills’ sponsors said they were hopeful. Money for the Patient Safety Organization would not come out of the state budget, but would be funded by surcharges paid by hospitals, nursing homes and insurance providers licensed in the state. Bates pointed out that medical mistakes are expensive, and reducing them will benefit not just patients, but insurers and health providers.

“This is an investment,” he said. “They are going to save money in the long run by correcting these problems.”

AP-ES-02-25-08 1734EST

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