The federal patient safety mandates are an effort to find a solution to a problem identified in the Institute of Medicine's 1999 report, To Err Is Human, which said hospitals' efforts to improve quality and safety were hampered because they didn't share when things went wrong, or came close.
But Foster laments that the industry lacks clarity on the extent to which they will be required to work with such a PSO. Those PSOs qualifying are so designated by the federal Agency for Healthcare Research and Quality, which has approved only 77 such organizations so far.
That might be enough. But Foster says, "if you look at the PSOs that they've designated, many of them are very restrictive in terms of what they cover. For example, there's one blood banking organization, but they're only interested in errors related to blood use."
Other PSOs appear to focus only on pediatric care, or only on breast cancer care, or anesthesia safety issues, or vascular surgery.
CMS has yet to clarify the situation for hospitals and health plans and it's unclear when and if the agency will issue regulations on how the provision of the PPACA will be enforced. A spokeswoman for CMS's Office of Communications said the agency could not say when such a regulation might be issued.
That's "problematic," Foster says, because "this is a complex issue. Lots and lots of details need to be worked through in order to make that small phrase in the [PP]ACA come to life. We have yet to see anything on it. We haven't seen any preliminary indication of what CMS is thinking at all. And this is a complex area."