Coalition Urges Creation of National Patient Safety Board

Prior to COVID-19, medical errors were the third-leading cause of death in the United States, after heart disease and cancer. A coalition of healthcare organizations and experts is calling for the creation of an independent federal agency, the National Patient Safety Board (NPSB), that would be modeled in part on the National Transportation Safety Board.

The NPSB would improve and promote public health and welfare by monitoring and anticipating adverse events, creating recommendations and solutions to prevent medical error, and bringing lessons into practice.

Such a safety center is not a new idea. The Office of the National Coordinator for Health IT had the creation of such a center in is fiscal 2015 budget, but it was never funded by Congress. 

The campaign to establish the NPSB is managed by a growing coalition of healthcare organizations, provider associations, businesses, nonprofit organizations, and consumer advocacy groups.

Former Chairman of the NTSB Robert L. Sumwalt has joined the NPSB Policy and Advocacy Coalition coordinated by the Pittsburgh Regional Health Initiative (PRHI), which has been working to reduce medical errors and prevent medical harm for over 20 years. Adapting quality improvement techniques from other industries—like aviation, nuclear power, and automobile production—has been proven by PRHI to reduce healthcare errors, improve reliability, and create efficiencies.

“I’ve seen the incredible influence of the National Transportation Safety Board to improve safety across transportation, and I believe there are aspects of the NTSB that can be translated to medicine, which can lead to profound effects on improving the safety of health care and consequently save lives,” Sumwalt said in a statement.

Critical issues such as eliminating wrong-site surgeries and infections acquired in hospitals; improving patient flow in emergency departments; reducing errors in hospital pathology labs; anticipating shortages of PPE; improving transitions such as acute to long-term care; and more are uncoordinated at the federal level, the coalition maintains. There’s no single entity responsible for studying healthcare catastrophes or for sharing best practices, key learnings, or recommendations nationally.

Unless the federal government mobilizes now and creates an NPSB, the healthcare industry is destined to repeat past and present mistakes, the group says.

An NPSB Policy and Advocacy Coalition has recently come together to request immediate action. Stakeholders from more than 50 healthcare organizations, consumer groups, and businesses are asking the White House and Congress to take the necessary legislative steps to expeditiously form the NPSB.

Individuals representing the following organizations have joined the coalition:

• AARP Public Policy Institute
• ABIM Foundation
• Ariadne Labs
• BETA Healthcare Group
• Business Group on Health
• Carilion Clinic
• Cincinnati Children’s Hospital Medical Center
• Dartmouth-Hitchcock
• Families USA
• Healthcare Council of Western PA
• HR Policy Association
• IHI Lucian Leape Institute
• Institute for Healthcare Improvement
• Jewish Healthcare Foundation
• John D. Stoeckle Center for Primary Care Innovation, Division of General Internal Medicine, Massachusetts General Hospital
• Johns Hopkins Armstrong Institute for Patient Safety and Quality
• Marshfield Clinic Health System
• MedStar Health Research Institute
• MedStar Institute for Quality and Safety
• Mothers Against Medical Error
• National Alliance of Healthcare Purchaser Coalitions
• National Association for Healthcare Quality (NAHQ)
• National Quality Forum
• National Retail Federation
• Network for Excellence in Health Innovation (NEHI)
• Patient Safety Movement Foundation
• Patients for Patient Safety US
• Pittsburgh Regional Health Initiative
• Project Patient Care
• Purchaser Business Group on Health
• Quality and Safety First
• Stratis Health
• The John A. Hartford Foundation
• The ERISA Industry Committee (ERIC)
• The Leapfrog Group
• University of Chicago Pritzker School of Medicine
• Value Capture, LLC
• Verily Life Sciences
• Virginia Mason Franciscan Health