,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #aaf  ,,in ,,the ,,house ,,of   
,,representatives  ,january #c1 #bjac   
,mr4 ,holt 7for himself and ,mrs4       
,capps7 introduced the following bill2  
which was referred to the ,committee on 
,energy and ,commerce  ,a ,,bill  ,to   
encourage the use of medical checklists 
through research1 and for other         
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,medical ,checklist 
,act of #bjac4  #b4 ,research into      
medical checklist development and       
efficacy  7a7 ,study ,the ,director of  
the ,agency for ,healthcare ,research   
and ,quality1 acting through the ,center
 for ,quality ,improvement and ,patient 
,safety1 shall conduct research and a   
study1 in accordance with the           
requirements of this section1 regarding 
the development and efficacy of medical 
checklists4  7b7 ,contents ,in carrying 
out subsection 7a71 the ,director shall 
conduct research and a study regarding  
the following3  7#a7 ,testing of        

different models of medical checklists  
to measure the effect of checklist      
format1 length1 and design for different
 clinical tasks on--  7,a7 adoption of  
checklists by health care professionals2
  7,b7 time spent by health care        
professionals on the clinical task of   
interest2 and  7,c7 reliable completion 
of health care procedures4  7#b7        
,examination of checklist development   
and use in other industries1 such as    
commercial aviation and nuclear power1  
and the feasibility of applying and     
adapting methodology developed in those 
industries to the health care industry  
in a way that would result in health    
care quality improvement4  7#c7         
,identification of organizational       
characteristics needed to effectively   
implement the use of medical checklists 
in health care settings4  7#d7          
,measurement of the effects of the use  
of medical checklists on patient safety 
and health outcomes4  7#e7              
,identification of health care          

procedures for which the development and
 use of medical checklists would be     
beneficial4  7#f7 ,investigation of the 
development1 implementation1 and use of 
available medical checklists1 including 
checklists for safe surgery and central 
line insertion and maintenance1 to      
inform further medical checklist        
development4  7c7 ,scope ,the ,director 
shall ensure that each aspect of the    
research and study conducted under      
subsection 7a7 is examined across a     
variety of health care provider         
characteristics1 medical procedures1    
patient populations1 and other factors  
that could affect the use of medical    
checklists4  7d7 ,dissemination ,the    
,director shall make available to the   
public the results of the study         
conducted under subsection 7a7 and shall
 disseminate such results to patient    
safety organizations listed pursuant to 
section #ibd7;d7 of the ,public ,health 
,service ,act 7#db ,u4,s4,c4            
#bii;b-#bd7;d774  7e7 ,authorization of 

appropriations ,there are authorized to 
be appropriated to carry out this       
section such sums as may be necessary   
for each of fiscal years #bjad through  
#bjag4  #c4 ,coordinating medical       
checklists and health information       
technology systems  7a7 ,in general ,the
 ,,hit ,policy ,committee in the ,office
 of the ,national ,coordinator for      
,health ,information ,technology 7as    
established in section #cjjb of the     
,public ,health ,service ,act 7#db      
,u4,s4,c4 #cjj;jj-#ab77 shall develop   
policy recommendations regarding--  7#a7
 the extent to which the use of medical 
checklists should be incorporated into  
health information technology systems2  
and  7#b7 measures to determine the     
effectiveness of such use4  7b7 ,areas  
of consideration ,in making             
recommendations under subsection 7a71   
the ,,hit ,policy ,committee may        
consider the following areas3  7#a7 ,the
 ease with which medical checklists in  
electronic formats can be used by health

 care professionals4  7#b7 ,the effect  
of the availability of medical          
checklists in electronic formats on the 
adoption and use of medical checklists  
by health care professionals4  7#c7 ,the
 effect of the use of medical checklists
 in electronic formats on the time spent
 by health care professionals on medical
 procedures4  7#d7 ,the ability of the  
health information technology system to 
collect data on patient safety and      
health outcomes that could be analyzed  
to aid in the design and update of      
medical checklists4  7#e7 ,the ease with
 which medical checklists in electronic 
formats can be updated on an ongoing    
basis based on evidence from medical    
research and local experience4  7#f7    
,the capability of health information   
technology systems to collect data1     
where applicable1 regarding the use of  
medical checklists by health care       
clinicians and providers1 and any       
relation between that use and patient   
safety and health outcomes4  #d4        

,institute of medicine study on further 
medical checklist research  7a7 ,in     
general ,the ,secretary of ,health and  
,human ,services shall enter into an    
agreement with the ,institute of        
,medicine and the ,national ,academy of 
,engineering of the ,national ,academies
 to conduct a study in accordance with  
this section4  7b7 ,study ,the          
,secretary shall ensure that the study  
conducted under this section--  7#a7    
reviews available medical checklists and
 similar quality improvement techniques1
 data on the adoption and use of such   
techniques by health care professionals1
 and evidence of the efficacy of such   
techniques in relation to patient safety
 and health outcomes2  7#b7 identifies  
areas of research needed to improve     
medical checklists in order to increase 
the adoption and efficacy of medical    
checklists2  7#c7 analyzes              
organizational impediments to the       
adoption and use of medical checklists2 
7#d7 reviews the degree to which there  

is sufficient evidence with which to    
develop new medical checklists and1 if  
such evidence is insufficient1          
identifies areas requiring further study
 in order to develop such evidence2 and 
7#e7 determines whether the availability
 of an increased number of medical      
checklists would improve patient safety 
and health outcomes and1 if so1         
identifies methods for using recent     
medical research to develop new medical 
checklists4  7c7 ,methodology of study  
7#a7 ,scope ,the ,secretary shall ensure
 that the agreement entered into under  
subsection 7a7 provides that the study  
conducted under such subsection will    
consider the perspectives of--  7,a7    
various types of health care            
professionals in various types of health
 care settings2  7,b7 individuals       
conducting academic research in health  
care quality2 and  7,c7 patients4  7#b7 
,consultation with relevant             
organizations ,the ,secretary shall     
ensure that the agreement entered into  

under subsection 7a7 provides that      
relevant agencies and organizations with
 expertise on medical checklists will be
 consulted during the study conducted   
under such subsection1 including the    
following3  7,a7 ,the ,agency for       
,healthcare ,research and ,quality4     
7,b7 ,the ,american ,nurses             
,association4  7,c7 ,the ,institute for 
,healthcare ,improvement4  7,d7 ,the    
,american ,hospital ,association4  7,e7 
,the ,american ,medical ,association4   
7,f7 ,the ,world ,health ,organization4 
7,g7 ,the ,national ,committee for      
,quality ,assurance4  7,h7 ,the ,joint  
,commission4  7,i7 ,the ,american       
,academy of ,physician ,assistants4  7d7
 ,report ,the ,secretary shall ensure   
that the agreement entered into under   
subsection 7a7 provides that not later  
than #ah months after the date of the   
enactment of this ,act1 a report        
providing the findings and              
recommendations made in the study       
conducted under such subsection will be 

submitted to the ,secretary1 the        
,committee on ,energy and ,commerce of  
the ,house of ,representatives1 and the 
,committee on ,health1 ,education1      
,labor1 and ,pensions of the ,senate4   
#e4 ,definitions ,in this ,act1 the     
following definitions apply3  7#a7      
,health care professional ,the term     
health care professional means an       
individual who provides health care     
services1 including a physician1        
physician assistant1 nurse practitioner1
 clinical nurse specialist 7as those    
terms are defined in section #ahfa of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciex771 and such other      
individuals as the ,secretary of ,health
 and ,human ,services determines        
appropriate4  7#b7 ,health care setting 
,the term health care setting means a   
facility at which health care services  
are provided1 including a hospital      
providing inpatient hospital services   
7as that term is defined in section     
#ahfa of the ,social ,security ,act 7#db

 ,u4,s4,c4 #aciex771 an ambulatory      
surgical center 7meeting the standards  
specified under section                 
#ahcb7;a77#b77;,f77i7 of the ,social    
,security ,act 7#db ,u4,s4,c4 #aciek771 
and such other settings as the          
,secretary of ,health and ,human        
,services determines appropriate4  7#c7 
,health care provider ,the term health  
care provider means a health care       
professional or a health care setting4  
7#d7 ,medical checklist ,the term       
medical checklist means a predetermined1
 evidence-based1 well-defined set of    
steps that should be completed during a 
designated medical clinical encounter or
 medical procedure1 as further defined  
by the ,director of the ,agency for     
,healthcare ,research and ,quality in   
consultation with the ,institute of     
,medicine and the ,national ,academy of 
,engineering of the ,national           
,academies4