(1) The Board of Registration in Medicine, in promulgating 243 CMR 3.00, has as its primary goal, ensuring that patients in both institutional and office settings receive optimal care. Accordingly, 243 CMR 3.00 is intended to assist the physicians and health care institutions of the Commonwealth in their efforts to identify problems in practice before they occur and to put in place preventive measures designed to minimize or eliminate substandard practice. This enhancement of patient care assessment will be accomplished through the strengthening and formalizing of programs of credentialing, quality assurance, utilization review, risk management and peer review in institutions and by assuring that these functions are thoroughly integrated and overseen by the institutions' corporate and physician leadership. 243 CMR 3.00 contemplates active self-scrutiny and reporting of adverse incidents in in-patient and out-patient settings to permit individual physicians, institutions and the Board to recognize patterns requiring corrective action. Further, 243 CMR 3.00 encourages the creation and adoption of minimum standards of practice in areas in which expert consensus is reached in order to permit physicians to establish and utilize touchstones of practice, to allow the Board and other tribunals to determine with a high degree of predictability when a practice pattern falls within consensus standards, and to guarantee that all patients will be treated in accordance with generally accepted principles of care. Achieving these goals will decrease avoidable adverse patient outcomes and will contribute to the maintenance of an atmosphere of mutual trust between physicians and their patients. In so doing, 243 CMR 3.00 will concomitantly achieve the reduction or stabilization of the frequency, amount and cost of claims against physicians and institutions that was the goal of the legislature in M.G.L. c. 111, § 203, and M.G.L. c. 112, §§ 5 through 5K. To assure free self-examination by physicians and institutions, the legislature provided extensive safeguards of confidentiality, immunity and privilege for both internal reviews and reports to the Board. It is the explicit intent of 243 CMR 3.00 that such safeguards be strengthened and extended to the extent permitted by law.
In establishing these patient care assessment requirements, the Board of Registration in Medicine intends to formalize and enhance the functions of committees many or all institutions may already have in place. Such committees include, for example, groups responsible for efforts usually designated as Quality Assurance, Utilization Review, Risk Management, and Credentialing. Wherever already in existence, such committees need not be replaced or removed, so long as in the aggregate they henceforth provide, at minimum, for all of the functions enumerated by the Board of Registration in Medicine herein as the functions of a Qualified Patient Care Assessment Program.
A further purpose of 243 CMR 3.00 is to help the Board satisfy its data collection and disciplinary responsibilities and to assist health care providers in the fulfillment of their reporting obligations under M.G.L. c. 112, § 5F. Finally, 243 CMR 3.00 is in further fulfillment of the Board's obligation to "adopt rules and regulations governing the practice of medicine in order to promote the public health, welfare and safety," pursuant to M.G.L. c. 112, § 5.