Letter from the BWPO Chairman

Dear Colleagues:

Our state leaders are making strides in improving safety and quality reporting requirements for all health care facilities in Massachusetts. Specifically, the state is stepping up its regulations around serious reportable events (SREs). While these new regulations continue to evolve, we should applaud state lawmakers for making all of us more accountable to our patients, payers and the public.

At BWH and across Partners HealthCare, we have processes in place to support our physicians through all aspects of adverse events, including identification of such an event, determining whether or not it's preventable and reportable and leading analysis efforts to develop corrective actions to ensure similar adverse events do not happen in the future. The first step, as always, is filling out an online incident report or calling Risk Management whenever an unexpected adverse event occurs.

The latest regulations concerning preventable SREs came in June when five state agencies adopted a non-payment policy for costs associated with preventable SREs that cause harm or disability to patients. When a potentially preventable SRE is first reported, we put a hold on all patient bills until a root cause analysis has been completed. If there are expenses attributed to a preventable error, the hospital will not bill the patient or his or her insurance provider for that care.

There are more details and billing issues that we are continuing to work out on the state level, across Partners and at BWH. For example, if we accept a patient transferred from another facility and we discover a preventable SRE that caused harm or disability, we are responsible for reporting it to the state. If the transfer is within the same system, like Partners (Faulkner to BWH) or Caritas (Norwood Hospital to St. Elizabeth's), the receiving hospital cannot bill for care made necessary by a preventable SRE at its sister hospital. In addition, we are developing an equitable formula to account for professional fees associated with preventable SREs.

Despite all the questions that remain, these regulatory changes are advances in patient safety and transparency. Statewide data from mandatory reporting and thorough examinations of what went wrong can only help us improve care for our patients.

Sincerely,

Robert Barbieri, MD
Chairman, BWPO