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Rhode Island
In Rhode Island, lawmakers have proposed a series of legislation that would establish a system to track and investigate "near misses" and preventable errors in the healthcare system. Bills introduced in the House and Senate to develop the system come after brain surgeons at Rhode Island Hospital operated on the wrong sides of patients? heads on three separate occasions in 2007.

First, S2280 would create the ?Patient Safety and Medical Error Reduction Act,? which would require each hospital in the state to participate in a comprehensive program -- including public reporting -- to improve patient safety and reduce medical errors in the respective hospitals.

S2474 and H7561, citing "an unacceptable high number of preventable medical errors in the healthcare system" and that "current solutions that focus on discipline and retraining of individuals have proven inadequate to address this systematic problem," would form a state patient safety organization charged with working with licensed healthcare facilities, providers and payors "for both the reporting of medical errors including situation in which a medical error was averted ? and evaluating the root causes of the errors."

The state Department of Health currently requires these organizations to report medical mistakes, but not near misses.

?It's a way to learn from our mistakes," says David Gifford, a health director who designed the proposed legislation, in a published report. "Right now, we're not seeing a change in errors overall."

The new organization would also investigate causes of errors, recommend improvements to healthcare providers, and recommend changes in statewide patient safety and quality improvement policies. The patient safety organization would also "facilitate the creation of, and maintain, a non-identifiable patient safety database that provides an interactive evidence-based management resource ? [that can] accept, aggregate and analyze non-identifiable patient safety work product and data."

Companion bill H 7465 would create the statewide healthcare quality and value database. The system would be voluntary and anyone reporting mistakes would not face punishment.

The legislation is modeled after 2005?s federal Patient Safety and Quality Improvement Act.

Massachusetts
Doctors in Massachusetts may find themselves required to complete at least 10 hours of prescription drug and pain medical training before they can receive or renew their licenses if a current bill becomes law.

House No. 4529, which was introduced by Rep. Steve Walsh, is intended to help control the over prescribing of addictive painkillers such as OxyContin by training providers to identify patients at high risk for substance abuse and other aspects of prescription medication abuse.

?Currently, there?s no requirement that a physician receive training in pain management before practicing medicine,? says Rep. Walsh in a published report. ?Unfortunately, we?re facing a drug abuse problem of epidemic proportions in the state and many of the drugs being abused are obtained legally through a prescription.?

The bill was recommended for passage by the committee on Mental Health and Substance Abuse and is now in the hands of the Joint Committee on Health Care Financing.