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– OHIO –
Public and Private Policy
Medical Errors and Patient Safety

Definitions

  • •  Health Care Services Outcomes Performance Program

    The Health Care Services Program measures performance by assessing each and every patient in each service area. This reporting contrasts to adverse event reporting, where only patients with an identified reportable event are reported. This mandate for patient safety “quality-of-care” standards is detailed in the outcomes data reporting requirements for each of the 9 discrete clinical service areas.

    • ◊  Solid organ transplant Services
    • ◊  Stem Cell and Bone Marrow Transplant Services
    • ◊  Adult Heart Catheterization
    • ◊  Adult Heart Surgery Services
    • ◊  Pediatric Heart Catheterization
    • ◊  Pediatric Heart Surgery Services
    • ◊  Obstetric / Newborn Services
    • ◊  Pediatic Intensive Care Services
    • ◊  Radiation Therapy and Stereotactic Radiosurgery Services

    ODH rule, OAC §3701-84-02 [PDF], requires that each of nine clinical services in all Ohio medical care facilities report according to the Health Care Services Reporting Program data collection guidelines, with annual results provided at Health Care Services Reports.

  • •  Licensed vs Unlicensed Health Care Facility Reporting

    Ohio has no reportable event program for hospitals. The reportable events for other facilities are inconsistently and variably referenced as “adverse events” and “incidents.” Facilities' reporting requirements vary so much by facility-type that it is apparent that no co-ordinated effort to track and compare these events by facility exists in Ohio. As a matter of fact, except for reporting of fires by Nursing Homes, there is no true ‘event reporting’ in Ohio. The state asks for total ANNUAL number of incidents and events and not the specific events as they occur. Therefore, for the most part, Ohio has a risk-unadjusted ‘outcome reporting’ system as part of some facility licensure requirements.

    The table below lists all facilities/services with any defined general, quality assessment, or reporting requirements to the ODH.

    Hospitals have a DRG reporting requirement only.

    Nursing homes and the 6 types of licensed Ohio "health care facility"s and centers with linear accelerators generating radioactive materials are the only facility types with requirements to report defined outcomes or adverse events to the ODH. The defined reportable events are provided in the attached rules:

Facility Type   Reporting Rules
Licensed Health Facilities
Ambulatory surgical facilities
OAC §3701-83-22
Freestanding dialysis centers
OAC §3701-83-24
Freestanding rehabilitation facilities
OAC §3701-83-32
Freestanding birthing centers
OAC §3701-83-42
Freestanding radiation therapy centers
OAC §3701-83-50
Freestanding mobile diagnostic imaging centers
OAC §3701-83-55
Regulated Facilities
Nursing homes and rest homes
OAC §3701-17-12
Community Alternative Homes for Persons Having AIDS or HIV
OAC §3701-16-18
Hospice
OAC §3701-19-07
Licensing Requirements for By-Product and Accelerator Produced Radioactive Materials
OAC §3701:1-40-20
Deregulated Unlicensed Facilities
Hospital DRG Reporting Requirements
OAC §3701-14-01

Among the facilities with event or outcome reporting requirements, freestanding dialysis centers have no specified reporting requirements.

  • •  Reporting Requirements by Health Care Facilities

    The highlighted reporting requirements in the Ohio programs/facilities below reflect medical events | incidents mandated by the ODH that are similiar to and/or satisfy the definitions for medical event/incident reporting requirements in other states or national programs.

    • ◊  Nursing Homes & Rest Homes (Residential Care Facilities) – §3701-17-12 [PDF]
      • C. Report any incident of fire, damage due to fire and any incidence of illness, injury or death due to fire or smoke inhalation of a resident within twenty-four hours to the office of the state fire marshal and to the director.
    • ◊  Ambulatory Surgical Facility (ASF) – § 3701-83-22 [PDF]

      Each ASF shall collect and maintain the following data on an annual basis and shall report such data to the Director of Health upon request:

      • A.  total number of patient visits,
      • B.  total number of patient transfers to a hospital and the reason why,
      • C.  total number of deaths in the ASF,
      • D.  total number of deaths resulting either from the surgery or from surgical complications that occur in the ASF.
    • ◊  Freestanding Inpatient Rehabilitation Facility – § 3701-83-32 [PDF]

      . . each inpatient rehabilitation facility shall collect and maintain the following data on an annual basis and shall report such data to the director upon request:

      • C. The total number of patients transferred to an acute care setting, such as a hospital,
      • D. The total number of patients transferred to a long-term care setting, such as a nursing home
    • ◊  Freestanding Birthing Center – § 3701-83-42 [PDF]

      ... each freestanding birth center shall report to the director:

      • (1)  The total number of women who delivered;
      • (2)  The total number of live births by weight, in grams;
      • (3)  The total number of fetal deaths;
      • (4)  The total number of neonatal deaths;
      • (5)  The total number of maternal deaths;
      • (6)  The total number of emergency cesarean-sections performed including:
        • (a)  The total number of primary cesarean-sections, and
        • (b)  The total number of repeat cesarean-section;
      • (7)  The total number of attempted vaginal births after a previous cesarean-section and the total number of successful vaginal births after a cesarean-section;
      • (8)  The total number of newborns whose estimated gestational age is less than thirty-seven weeks, and the total number of newborns whose estimated gestational age is greater than forty-two weeks;
      • (9)  The total number of maternal transfers to an obstetric and newborn care services including;
        • (a)  The total number of transfers prior to delivery, and
        • (b)  The total number of transfers after delivery;
      • (10)  The total number of patients seeking admission and the total number of patients admitted.
    • ◊  Freestanding Radiation Therapy Center – § 3701-83-50 [PDF]
      • (B)  As part of the quality assessment and improvement program requirements under paragraph (C) of rule 3701-83-12 of the Administrative Code, each freestanding radiation therapy center shall evaluate the provision of radiation therapy services including a review of case management and treatment results and a review of complications and adverse events which occurred during the provision of the center's services.
    • ◊  Freestanding Diagnostic Imaging Center – § 3701-83-55 [PDF]
      • (B)  As part of the quality assessment program required under paragraph (D) of rule 3701-83-12 of the Administrative Code, each freestanding or mobile diagnostic imaging center shall report to the director:
        • (5)  The number and type of complications associated with sedation and the administration of contrast agents;
        • (6)  The number of patients who required hospitalization, as a result of a complication, within twenty-four hours of a procedure;
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