In late July Congress saw some movement on legislation that would address the issue of medical errors. The Patient Safety and Quality Improvement Act of 2004 (S 720, HR 663) would establish a framework for the voluntary reporting of medical errors to entities known as patient safety organizations (PSOs) and create a national patient safety database within the Department of Health and Human Services to catalog these reports and identify trends in medical mistakes. Whistleblower protections are granted in both bills to protect nurses and other providers from retaliation for good-faith reporting of medical errors to PSOs.

The Patient Safety and Quality Improvement Act of 2003 had been stalled in the Senate for more than a year because of concerns about the relationship between PSO data and current medical malpractice discovery-the process by which individuals (lawyers) obtain facts to bring up a case. However, technical changes were made to the Senate bill that clarified the fact that the legal processes currently available to patients who wish to obtain evidence will remain unchanged. This opened the door to advancement.

PSOs could be run by states, local governments, or private organizations, as long as their primary activity is the collection and analysis of medical error data. Both bills state that the data reported to a PSO are privileged and shall not be subject to federal, state, or local civil, criminal, or administrative subpoena. Nor will it be subject to discovery in a federal, state, or local civil, criminal, or administrative proceeding.

The ANA supports the House and Senate versions of the Patient Safety and Quality Improvement Act because both promote a blame-free environment for the reporting and analysis of medical errors. The bills promote the honest reporting of medical errors and will help health care professionals build better systems. However, the ANA maintains that medical error reporting should be mandatory. In addition, the ANA has expressed to Congress the fact that improved staffing and the elimination of mandatory overtime are necessary to make real strides toward reducing medical errors. The bills must now go before a House-Senate conference committee and be voted on by both houses before they become law.