Senate Bill 36 would fix one of the problems with Oregon’s Patient Safety Commission. The 2003 Oregon Legislature created the commission to reduce the number of patients killed or injured by mistake. According to the commission’s partial data from last year, 18 people died due to medical errors in Oregon hospitals. There were likely more deaths that went uncounted.

When the commission was set up, the intent was that participation in the program would be voluntary, but the fees to fund it would be mandatory. For instance, hospitals pay a fee based on how many patients they discharge annually. The largest hospitals – like St. Charles Medical Center-Bend — that discharge 10,000 or more patients a year pay $8,500 annually. Hospitals that discharge between 3,000 and 10,000 patients a year pay $3,500. Smaller hospitals pay $1,000 a year. But the law that created the commission didn’t make it clear that all hospitals would have to pay the fees whether or not they were participating.

It’s unfair to stick just the medical facilities that support patient safety with the cost of supporting the commission’s work. Jim Dameron, the commission’s executive director, says it has not had trouble getting facilities to pay. He still wants the legislative fix to ensure it is not a problem in the future.

The commission is just getting started. The safety effort for hospitals is up and running. All the hospitals in Central Oregon are participating. Only three hospitals in the state are not. Now, the commission is recruiting pharmacies to participate. And the commission is developing rules for nursing homes and surgery centers. Only hospitals are being asked to pay fees now since that is the only reporting program that is running.

Participating facilities report their medical errors to the commission. The commission looks for patterns and suggests ways to avoid errors in the future. The specifics of the incidents reported to the commission remain confidential. The law protects that information from being made public in any way.

The events reported last year included leaving sponges and guide- wires inside patients and operating on the wrong site or performing the wrong surgery.

We have said before that we think it’s not only the commission’s fees that should be mandatory; it should also be participation in the commission’s program. Why should it be optional for a hospital, nursing home, surgery center or pharmacy to participate in the state’s patient safety program? Dameron can make a case either way. He says he doesn’t want to go around holding up medical facilities to “blame and shame.” And by making the program voluntary, the commission has a strong incentive to run well and make facilities want to participate.

That’s fine. But the purpose of the commission is to improve patient safety. Making participation mandatory does more to improve patient safety than by making it optional.