10 'Basic Patient Safety Reforms' to Save 85,000 Lives, $35 Billion

Public Citizen also proposes five steps to ensure near-universal adoption of these reforms:

1. The federal government should leverage its $750 billion annual investment in healthcare to compel providers to use proven patient safety practices. HHS can enact many reforms through the regulatory process. Congress could ensure rapid adoption by including instructions to HHS in legislation.

2. Congress should require HHS to take responsibility for accrediting providers to receive Medicare reimbursements. At present, the federal government delegates most accrediting authority to the Joint Commission, which derives its income from the very hospitals it oversees and denies accreditation to less than 1% of these hospitals.

3. Congress should make significant financial investments to increase the country's supply of nurses and set federal minimums of acceptable nurse-to-patient ratios.

4. Congress should require mandatory reporting of adverse events, including requiring hospitals to institute strong internal reporting, and creating whistle-blower protections for healthcare workers. National reporting of the most serious medical errors is largely left to the Joint Commission. However, that organization estimates that it learns of only about one-tenth of 1% of serious medical errors despite its stated requirement that doctors disclose all errors to patients.

5. Congress should ensure that the requirements for hospitals to report doctor discipline and maintain viable peer review processes are followed. Hospitals have been required since 1990 to report to the federal government cases in which doctors are suspended for more than 30 days. But nearly 50% of hospitals have never reported a single disciplinary action.