Iowa regulators also pushing for reporting of patient harm

By Marshall Allen

Wednesday, July 21, 2010 | 2 a.m.

Nevada lawmakers aren’t alone in their efforts to increase hospitals’ transparency in reporting harm done to patients.

Iowa regulators, who, like their Nevada counterparts, read the Sun’s investigation of hospital care, are pushing for their hospitals to make similar disclosures.

Dean Lerner, director of the Iowa Department of Inspections and Appeals, a regulatory agency that licenses hospitals and protects patients from harm, wants Iowa hospitals to report to the state certain “never events” — cases of harm to patients known as sentinel events in Nevada.

The nickname of never events refers to the fact that they’re preventable incidents such as broken bones, advanced-stage pressure sores or certain infections that should never happen in a health care setting.

There is no reporting mechanism for never events in Iowa, but Lerner sent a proposal to create one to the state’s six-member Hospital Licensing Board, which advises his division on matters of policy. The licensing board is heavily weighted in favor of hospitals and has resisted reporting things such as never events, Lerner said.

Lerner said he plans to provide the Sun’s stories to the board members, who will meet Tuesday to discuss his proposal, to persuade them to favor more transparency and show them that similar efforts are under way elsewhere.

“More information for citizens is always better,” Lerner said. “It helps them make good choices. And it can’t be ignored that transparency would allow people to make choices which will influence the way people are treated at these facilities.”

Nationwide, regulators like Lerner confront the influence of hospital lobbyists looking to protect their interests — which are not always aligned with the interests of patients.

The Sun’s investigation — which analyzed records showing, by facility, where patients were infected or injured — is based on hospital billing data on file with the state. Since the stories ran, Nevada regulators have conducted a similar analysis.

Iowa keeps similar records and could conduct a similar analysis, Lerner said.

“That would be something we would be very interested in pursuing,” Lerner said. “You’ve laid the groundwork for that type of approach.”