U.S. creates new program for reporting, analyzing adverse medical outcomes

The U.S. has created a new system whereby physicians and health care provider entities can confidentially report adverse medical events, and organizations can collect this data and use it to make safety recommendations.

The new program encourages health care providers to voluntarily report patient safety events to entities called “Patient Safety Organizations,” or PSOs.

Read more

Q&A: Domestic violence reporting

Q: What steps can be taken to improve or clarify the reporting system for suspected acts of domestic violence?

“Many victims’ experiences of domestic violence do not fit into categories of prosecutable crimes. A seemingly innocuous data collection system can compromise the health care provider’s primary responsibility to increase victim safety. Every health care worker needs deep training and support to conduct a conversation and screening in a safe and respectful environment, to identify both victims and perpetrators, to address these complex and often high-risk situations and to facilitate referrals to domestic violence programs and other resources in ways that allow for victim autonomy in decision-making and do not endanger them or their children.”

- Isa Woldeguiorguis, director of policy & systems advocacy, Jane Doe Inc.

“By creating a new domestic violence unit in Worcester and giving a direct supervisor to three full-time attorneys, we can put a renewed focus on these cases. Because 30 to 60 percent of domestic violence cases also involve child abuse, filing a [report] with the Department of Social Services (DSS) lets the offender know that we’re watching. But we also need to show compassion to the victim’s family - in these times of economic stress, going straight for a guilty verdict is not always the best solution. If a spouse loses his job and his house, it’s the mother and children who suffer.”

- Joseph D. Early Jr., Worcester County District Attorney

“Educating staff on a regular basis about the many facets of domestic violence, from its most concrete to more obscure forms, is a very important step. For staff that have a suspicion that domestic violence is occurring but are hesitant to report it, I think it would be helpful to have a system in place where workers are organized into small groups of two or three, so that they can immediately consult with colleagues on these difficult decisions. In such emotional situations, this kind of close-knit support could mitigate the stress of the environment and help them to make a clearer decision about the next steps to take.”

- Manisha H. Bhatt, senior counsel, Greater Boston Legal Services

“The most important thing to consider when responding to suspected domestic violence is the safety of the victim. Providing resources and information about victim services, including safety planning, counseling and shelter, can be critical. Policies that diminish a victim’s control over decision-making with respect to reporting can have the unintended consequence of diminishing victim safety. When health care providers are encouraged to screen for domestic violence, the goal is not to increase reports to officials, but to provide potentially life-saving and empowering information and choices to victims as well as to make them aware of the effects of domestic violence on their health.”

- Carlene Pavlos, director, Mass. Department of Public Health Violence & Injury Prevention Program

Doctor’s View: The public health problem of domestic violence

It was another first for the state. Last June, Governor Patrick signed a violence intervention bill making Massachusetts the first state to require health care providers to refer victims of violence to a variety of social services.

The impetus behind the action was clear: the soaring number of deaths from domestic violence. Murders of domestic partners in the Commonwealth were nearly three times higher in 2007 than in 2005, reaching 42 in 2007, with an additional 13 suicides. In 2008, 25 homicides occurred, with 10 suicides.

Read more