1

A bill to be entitled

2

An act relating to the Florida Patient Safety Corporation;

3

amending s. 381.0271, F.S.; authorizing a representative

4

appointed by the Florida Council of Medical School Deans

5

to serve on the board of directors of the corporation;

6

deleting provisions requiring that the corporation

7

establish specific advisory committees; authorizing the

8

corporation to create and dissolve advisory committees

9

upon a majority vote of the board of directors; deleting

10

obsolete organizational provisions; requiring that the

11

corporation's board of directors conduct quarterly

12

meetings; requiring the Agency for Health Care

13

Administration to make available adverse incident reports

14

to designated agents of the Florida Patient Safety

15

Corporation; requiring the corporation to evaluate the

16

effects of the sharing of electronic records on patient

17

safety; requiring the corporation to encourage the use of

18

evidence-based medicine; deleting responsibilities related

19

to the provision of access to a library of evidence-based

20

medicine and patient safety practices; requiring a plan

21

for the implementation of patient safety technologies;

22

deleting obsolete provisions and reporting requirements;

23

providing an effective date.

24

25

Be It Enacted by the Legislature of the State of Florida:

26

27

     Section 1.  Paragraph (a) of subsection (4) and subsections

28

(5), (6), (7), (8), (9), and (10) of section 381.0271, Florida

29

Statutes, are amended to read:

30

     381.0271  Florida Patient Safety Corporation.--

31

     (4)  BOARD OF DIRECTORS; MEMBERSHIP.--The corporation shall

32

be governed by a board of directors. The board of directors shall

33

consist of:

34

     (a) The chair of or a representative appointed by the

35

Florida Council of Medical School Deans.

36

     (5) ADVISORY COMMITTEES.--Subject to a majority vote of the

37

corporation's board of directors, the corporation may establish

38

and dissolve advisory committees in order to assist the

39

corporation in carrying out its duties and responsibilities. In

40

addition to any committees that the corporation may establish,

41

the corporation shall establish the following advisory

42

committees:

43

     (a) A scientific research advisory committee that includes,

44

at a minimum, a representative from each patient safety center or

45

other patient safety program in the universities of the state who

46

are physicians licensed pursuant to chapter 458 or chapter 459,

47

with experience in patient safety and evidenced-based medicine.

48

The duties of the advisory committee shall include, but not be

49

limited to, the analysis of existing data and research to improve

50

patient safety and encourage evidence-based medicine.

51

     (b) A technology advisory committee that includes, at a

52

minimum, a representative of a hospital that has implemented a

53

computerized physician order entry system and a health care

54

provider that has implemented an electronic medical records

55

system. The duties of the advisory committee shall include, but

56

not be limited to, implementation of new technologies, including

57

electronic medical records.

58

     (c) A health care provider advisory committee that

59

includes, at a minimum, representatives of hospitals, ambulatory

60

surgical centers, physicians, nurses, and pharmacists licensed in

61

this state and a representative of the Veterans Integrated

62

Service Network 8, Virginia Patient Safety Center. The duties of

63

the advisory committee shall include, but not be limited to,

64

promotion of a culture of patient safety that reduces errors.

65

     (d) A health care consumer advisory committee that

66

includes, at a minimum, representatives of businesses that

67

provide health insurance coverage to their employees, consumer

68

advocacy groups, and representatives of patient safety

69

organizations. The duties of the advisory committee shall

70

include, but not be limited to, incentives to encourage patient

71

safety and the efficiency and quality of care.

72

     (e) A state agency advisory committee that includes, at a

73

minimum, a representative from each state agency that has

74

regulatory responsibilities related to patient safety. The duties

75

of the advisory committee shall include, but not be limited to,

76

interagency coordination of patient safety efforts.

77

     (f) A litigation alternatives advisory committee that

78

includes, at a minimum, representatives of medical malpractice

79

attorneys for plaintiffs and defendants and a representative of

80

each law school in the state. The duties of the advisory

81

committee shall include, but not be limited to, alternative

82

systems to compensate for injuries.

83

     (g) An education advisory committee that includes, at a

84

minimum, the associate dean for education, or the equivalent

85

position, as a representative from each medicine, nursing, public

86

health, or allied health service to provide advice on the

87

development, implementation, and measurement of core competencies

88

for patient safety to be considered for incorporation in the

89

educational programs of the universities and colleges of this

90

state.

91

     (6) ORGANIZATION; MEETINGS.--

92

     (a) The Agency for Health Care Administration shall assist

93

the corporation in its organizational activities required under

94

chapter 617, including, but not limited to:

95

     1. Eliciting appointments for the initial board of

96

directors.

97

     2. Convening the first meeting of the board of directors

98

and assisting with other meetings of the board of directors, upon

99

request of the board of directors, during the first year of

100

operation of the corporation.

101

     3. Drafting articles of incorporation for the board of

102

directors and, upon request of the board of directors, delivering

103

articles of incorporation to the Department of State for filing.

104

     4. Drafting proposed bylaws for the corporation.

105

     5. Paying fees related to incorporation.

106

     6. Providing office space and administrative support, at

107

the request of the board of directors, but not beyond July 1,

108

2005.

109

     (b) The board of directors shall must conduct its first

110

meeting no later than August 1, 2004, and shall meet at least

111

quarterly thereafter as frequently as necessary to carry out the

112

duties of the corporation.

113

     (7)  POWERS AND DUTIES.--

114

     (a)  In addition to the powers and duties prescribed in

115

chapter 617, and the articles and bylaws adopted under that

116

chapter, the corporation shall, directly or through contract:

117

     1.  Secure staff necessary to properly administer the

118

corporation.

119

     2.  Collect, analyze, and evaluate patient safety data and

120

quality and patient safety indicators, medical malpractice closed

121

claims, and adverse incidents reported to the Agency for Health

122

Care Administration and the Department of Health for the purpose

123

of recommending changes in practices and procedures that may be

124

implemented by health care practitioners and health care

125

facilities to improve health care quality and to prevent future

126

adverse incidents. Notwithstanding any other provision of law,

127

the Agency for Health Care Administration and the Department of

128

Health shall make available to the corporation and its designated

129

agents any adverse incident report submitted under ss. 395.0197,

130

458.351, and 459.026. To the extent that adverse incident reports

131

submitted under s. 395.0197 are confidential and exempt, the

132

confidential and exempt status of such reports shall be

133

maintained by the corporation and its designated agents.

134

     3.  Establish a "near-miss" patient safety reporting system.

135

The purpose of the near-miss reporting system is to: identify

136

potential systemic problems that could lead to adverse incidents;

137

enable publication of systemwide alerts of potential harm; and

138

facilitate development of both facility-specific and statewide

139

options to avoid adverse incidents and improve patient safety.

140

The reporting system shall record "near misses" submitted by

141

hospitals, birthing centers, and ambulatory surgical centers and

142

other providers. For the purpose of the reporting system:

143

     a.  The term "near miss" means any potentially harmful event

144

that could have had an adverse result but, through chance or

145

intervention in which, harm was prevented.

146

     b.  The near-miss reporting system shall be voluntary and

147

anonymous and independent of mandatory reporting systems used for

148

regulatory purposes.

149

     c.  Near-miss data submitted to the corporation is patient

150

safety data as defined in s. 766.1016.

151

     d.  Reports of near-miss data shall be published on a

152

regular basis and special alerts shall be published as needed

153

regarding newly identified, significant risks.

154

     e.  Aggregated data shall be made available publicly.

155

     f.  The corporation shall report the performance and results

156

of the near-miss project in its annual report.

157

     4.  Work collaboratively with the appropriate state agencies

158

to evaluate the effects of the adoption and sharing of electronic

159

health records on patient safety in the development of electronic

160

health records.

161

     5. Encourage the use of evidence-based medicine by health

162

care practitioners and health care facilities in order to improve

163

health care quality and patient safety. Provide for access to an

164

active library of evidence-based medicine and patient safety

165

practices, together with the emerging evidence supporting their

166

retention or modification, and make this information available to

167

health care practitioners, health care facilities, and the

168

public. Support for implementation of evidence-based medicine

169

shall include:

170

     a. A report to the Governor, the President of the Senate,

171

the Speaker of the House of Representatives, and the Agency for

172

Health Care Administration by January 1, 2005, on:

173

     (I) The ability to join or support efforts for the use of

174

evidence-based medicine already underway, such as those of the

175

Leapfrog Group, the international group Bandolier, and the

176

Healthy Florida Foundation.

177

     (II) The means by which to promote research using Medicaid

178

and other data collected by the Agency for Health Care

179

Administration to identify and quantify the most cost-effective

180

treatment and interventions, including disease management and

181

prevention programs.

182

     (III) The means by which to encourage development of

183

systems to measure and reward providers who implement evidence-

184

based medical practices.

185

     (IV) The review of other state and private initiatives and

186

published literature for promising approaches and the

187

dissemination of information about them to providers.

188

     (V) The encouragement of the Florida health care boards

189

under the Department of Health to regularly publish findings

190

related to the cost-effectiveness of disease-specific, evidence-

191

based standards.

192

     (VI) Public and private sector initiatives related to

193

evidence-based medicine and communication systems for the sharing

194

of clinical information among caregivers.

195

     (VII) Regulatory barriers that interfere with the sharing

196

of clinical information among caregivers.

197

     b. An implementation plan reported to the Governor, the

198

President of the Senate, the Speaker of the House of

199

Representatives, and the Agency for Health Care Administration by

200

September 1, 2005, that must include, but need not be limited to:

201

estimated costs and savings, capital investment requirements,

202

recommended investment incentives, initial committed provider

203

participation by region, standards of functionality and features,

204

a marketing plan, and implementation schedules for key

205

components.

206

     6.  Develop and recommend core competencies in patient

207

safety that can be incorporated into the undergraduate and

208

graduate curricula in schools of medicine, nursing, and allied

209

health in the state.

210

     7.  Develop and recommend programs to educate the public

211

about the role of health care consumers in promoting patient

212

safety.

213

     8.  Provide recommendations for interagency coordination of

214

patient safety efforts in the state.

215

     (b)  In carrying out its powers and duties, the corporation

216

may also:

217

     1.  Assess the patient safety culture at volunteering

218

hospitals and recommend methods to improve the working

219

environment related to patient safety at these hospitals.

220

     2. Inventory the technological information technology

221

capabilities related to patient safety of health care facilities

222

and health care practitioners and recommend a plan for expediting

223

the implementation of patient safety technologies statewide.

224

     3.  Recommend continuing medical education regarding patient

225

safety to practicing health care practitioners.

226

     4.  Study and facilitate the testing of alternative systems

227

of compensating injured patients as a means of reducing and

228

preventing medical errors and promoting patient safety.

229

     5.  Conduct other activities identified by the board of

230

directors to promote patient safety in this state.

231

     (8) ANNUAL REPORT.--By December 1, 2004, the corporation

232

shall prepare a report on the startup activities of the

233

corporation and any proposals for legislative action that are

234

needed for the corporation to fulfill its purposes under this

235

section. By December 1 of each year thereafter, the corporation

236

shall prepare a report for the preceding fiscal year which

237

includes. The report, at a minimum, must include:

238

     (a)  A description of the activities of the corporation

239

under this section.

240

     (b) Progress made in improving patient safety, including

241

the reduction of and reducing medical errors.

242

     (c)  Policies and programs that have been implemented and

243

their outcomes.

244

     (d)  A compliance and financial audit of the accounts and

245

records of the corporation at the end of the preceding fiscal

246

year conducted by an independent certified public accountant.

247

     (e)  Recommendations for legislative action needed to

248

improve patient safety in the state.

249

     (f)  An assessment of the ability of the corporation to

250

fulfill the duties specified in this section and the

251

appropriateness of those duties for the corporation.

252

253

The corporation shall submit the report to the Governor, the

254

President of the Senate, and the Speaker of the House of

255

Representatives.

256

     (9) FUNDING.--The corporation shall is required to seek

257

private sector funding and apply for grants to accomplish its

258

goals and duties.

259

     (10) PERFORMANCE EXPECTATIONS.--The Office of Program

260

Policy Analysis and Government Accountability, the Agency for

261

Health Care Administration, and the Department of Health shall

262

develop performance standards by which to measure the success of

263

the corporation in fulfilling the purposes established in this

264

section. Using the performance standards, the Office of Program

265

Policy Analysis and Government Accountability shall conduct a

266

performance audit of the corporation during 2006 and shall submit

267

a report to the Governor, the President of the Senate, and the

268

Speaker of the House of Representatives by January 1, 2007.

269

     Section 2.  This act shall take effect July 1, 2008.