Is California's medical error punishment program working?

California is the only state that issues both press releases and financial penalties when hospitals commit an immediate jeopardy error, defined as one that causes serious injury or death of a patient, but the state's unique program may not be working as California had hoped, according to analysis by The San Diego Union-Tribune.

The state's program involves fining hospitals — sometimes as much as $125,000 per medical error — and also publicizing the documented errors in press releases. The Union-Tribune found that the number of medical errors occurring in California hospitals is higher now than it was when the program started nine years ago.

For comparison, Minnesota mandates adverse event reporting but does not have a penalty program for immediate jeopardy events. Given the lack of improvements in California, Minnesota doesn't plan on starting to financially penalize its hospitals anytime soon.

"Since there hasn't really been a great improvement in the rates in California, no one has pushed for fines to be looked at legislatively," Rachel Jokela, director of the Adverse Events Program at the Minnesota Department of Health, told the U-T.

However, some in the industry think the fines are helping improve healthcare.

"I think it does change the way a hospital's board and CEO think about safety and the investments they're willing to make to prevent errors," Robert Wachter, MD, chief of the division of hospital medicine at UC San Francisco, told the paper.


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