HQI Patient Safety Awareness Week Webinars
March 12-16, 2018

Webinar

Healthcare quality professionals at Hospital Quality Institute (HQI) proudly join the Institute for Healthcare Improvement and the National Patient Safety Foundation, and those around the country in celebrating Patient Safety Awareness Week, March 12-16.

The week brings greater recognition for the healthcare quality profession and the contributions and impact these professionals make in their organization for patient safety and patient experience.

In celebration of the week, HQI has planned five special webinars on the following topics. Click on each topic for registration details:

March 12 – The HCRO Journey to High Reliability

Speakers

Gudrun Moll RN, MSN, MBA, NEA-BC, CPPS
VP Clinical Services/Chief Nursing Officer
San Antonio Regional Hospital, Upland, CA

Lisa Ramthun, RN, MSN, CPRHM, FASHRM
Senior Partner SG Collaborative Solutions

Objectives

  • Outline the path to sustainable high reliability in healthcare organizations
  • Describe the framework for reliability in high consequence industries including healthcare
  • Define the Iceberg Model of managing safety and risk

Date and Time

March 12, 12:00 pm – 1:00 pm PDT

View the Webinar Here

https://attendee.gotowebinar.com/recording/9014172746834907394 

CE Notice:

CEs will be available for a fee. Click here to register for the CE.

HQI is an approved continuing education (CE) provider by the California Board of Registered Nursing and will provide CHA or CHPSO members an opportunity to earn CEs. Provider Number CEP16793 for 1.0 contact hour.

HQI does not currently offer ACPE approved Pharmacy CE, but the State of California will accept CE from courses which have been approved for continuing education by the Medical Board of California, the California Board of Podiatric Medicine, the California Board of Registered Nursing or the Dental Board of California towards their California continuing education requirement (Section 1732.2(b) of the California Code of Regulations). Pharmacists need to keep track of CE from these sources on their own as they are not submitted to NAPB.

March 13 - Reliable Safety Event Response

Speaker

Rory Jaffe, MD MBA
Executive Director, CHPSO Patient Safety Organization, a Division of the Hospital Quality Institute

Objectives

  • Learn the difference between a traditional root cause analysis (RCA) and a response based upon the principles of Health Care Reliability Organizing.
  • Learn how to use retrospective information (event reports, near misses) for prospective control of risks to patients.
  • Learn why RCAs lead to inferior safety plans.

Date and Time

March 13, 11:00 am – 12:00 pm PDT

View the Webinar Here

https://attendee.gotowebinar.com/recording/2425963944403381260

CE Notice:

CEs will be available for a fee. Click here to register for the CE.

HQI is an approved continuing education (CE) provider by the California Board of Registered Nursing and will provide CHA or CHPSO members an opportunity to earn CEs. Provider Number CEP16793 for 1.0 contact hour.

HQI does not currently offer ACPE approved Pharmacy CE, but the State of California will accept CE from courses which have been approved for continuing education by the Medical Board of California, the California Board of Podiatric Medicine, the California Board of Registered Nursing or the Dental Board of California towards their California continuing education requirement (Section 1732.2(b) of the California Code of Regulations). Pharmacists need to keep track of CE from these sources on their own as they are not submitted to NAPB.

March 14 - OpenNotes: Advancing Patient Safety and Patient Engagement

Speakers

Jan Walker, RN, MBA
Co-Founder, OpenNotes
Associate Professor of Medicine, Harvard Medical School
Research faculty, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center

Sigall Bell, MD
Director of Patient Safety and Discovery, OpenNotes
Associate Professor of Medicine, Harvard Medical School
Director of Patient Safety and Quality Initiatives, Institute for Professionalism and Ethical Practice (IPEP), Boston Children’s Hospital

Liz Salmi 
Senior Multimedia Communications Manager, OpenNotes

Objectives

  • Define what OpenNotes is
  • Describe 3 effects of OpenNotes on patient engagement
  • Describe 3 ways that OpenNotes can improve patient safety
  • Define what OurNotes is

Date and Time

March 14, 11:00 am – 12:00 pm PDT

View the Webinar Here

https://attendee.gotowebinar.com/recording/2179214843585200898

CE Notice:

CEs will be available for a fee. Click here to register for the CE.

HQI is an approved continuing education (CE) provider by the California Board of Registered Nursing and will provide CHA or CHPSO members an opportunity to earn CEs. Provider Number CEP16793 for 1.0 contact hour.

HQI does not currently offer ACPE approved Pharmacy CE, but the State of California will accept CE from courses which have been approved for continuing education by the Medical Board of California, the California Board of Podiatric Medicine, the California Board of Registered Nursing or the Dental Board of California towards their California continuing education requirement (Section 1732.2(b) of the California Code of Regulations). Pharmacists need to keep track of CE from these sources on their own as they are not submitted to NAPB.

March 15 - Keys to Unlocking Safety Culture for Medication Use

Speaker

Katayoon Kathy Ghomeshi, PharmD, MBA, BCPS, CPPS
Medication Safety Specialist, University of California, San Francisco Medical Center
Assistant Clinical Professor, UCSF School of Pharmacy

Objectives

  • Define the types of human behavior that may be involved in medication errors and explain how they are managed in a just culture
  • Identify tools that may be used to measure or assess aspects of safety culture
  • Describe a “Care for the Caregiver” program and how it can provide support to caregivers after a medication error

Date and Time

March 15, 12:00 pm – 1:00 pm PDT

View the Webinar Here

https://attendee.gotowebinar.com/recording/4761675187030781453

Q&A

  1. What is the best way for patients to help push this effort forward with doctors?   

    The first step a patient could take is asking their doctors for a copy of their notes after a visit. We created a template letter a patient could send to their doctors via email and posted it on the OpenNotes website: https://www.opennotes.org/join/. Liz tested this letter with three doctors at the two different health systems where she receive care and got three different answers with three different solutions. In short, all three doctors were in favor of her seeing her notes, but it wasn’t easy for them to get the notes to her and involved time and effort from their staff, or copying and pasting notes into a portal email (a process in which copy/paste errors may have occurred). This is just her personal (N of 1) experience. 

    Dr. Santa mentioned: If a health system  has a PFAC (Patient and Family Advisory Council) then advisors on that council (or councils if they have more than one) can bring OpenNotes to the Council and ask that it be a topic of discussion in a meeting. OpenNotes staff could present to the group in person or virtually if there is interest in that. If the group is interested in pursuing bringing ON to their system then look to meet with IT and/or clinical leadership (CMIO, CIO, CMO, CNO, etc.) to discuss and see how they can partner on this effort.

    Lots more information in the PFAC toolkit: https://www.opennotes.org/pfac-toolkit/
     
  2. Did you increase documentation specialists to help in documentation? Was the information shared limited or 100% shared?

    Three projects were discussed on the call. 1)OpenNotes—most organizations have moved forward with OpenNotes without extensive retraining around documentation. They include information about suggested documentation changes in newsletters, training, presentations etc . They often distribute the attached paper—it is our most commonly requested paper. Some organizations have specific documentation training but they are a minority. Some know who the problem documenters are and proactively reach out to them. We have not heard that there is an increase in documentation specialists as a result of OpenNotes. We have also asked about the HIM process in medical records and usually hear that there is either no change in volume of HIM work or a small increase. 2)Dr. Bell’s safety project does include the organization of a team of nurses and other staff who evaluate input from the patients who have been encouraged to identify errors. Patients are instructed to email this team directly and not the clinician. So there is an increase in staffing. I don’t have information about the number of FTE etc. This safety project encourages patients to engage about errors so there is increased volume of engagement. There is of course a return on investment of the staff FTE increase but we have not quantified that. 3) OurNotes is in an early stage and too soon to estimate what if any impact it may have on documentation specialists. In terms of information shared in most cases the entire note is shared in OpenNotes. There are some organizations who are able to hide a portion of the note. Many organizations are able to hide whole individual notes but the rate of doing so is low—less than 1%. But it is important to note that portal registration rates are highly variable, navigation rates are highly variable. Overall only a modest % of patients are now able to see their notes but that will change.

    Individual patients/caregivers can ask their clinicians to share notes with them-either electronically or via paper. This shows that patients are interested. And if the system has a portal that allows notes to be shared but clinicians are not actively sharing, hearing from more patients that they want notes can help push them toward sharing.
     
  3. How did you get providers to buy-into the idea of Open Notes?  What was your biggest challenge as it relates to getting buy-in from providers?

    Providers are anxious about this transparency, even those who support OpenNotes. Patients are not anxious. Most of the provider anxiety is around workflow impact but we do think there is a subset of providers who are poor documenters or upcode who are much more threatened by OpenNotes. Our research and real world implementation results help reassure many providers that the benefits to patients are substantial and the “risks” to them in terms of workflow are minimal. We find it really helps if a subset of providers in a system actively advocate for OpenNotes. If needed they are willing to pilot and confirm that their experience is the same as our research suggests. We also urge that patients who understand what notes are and what OpenNotes is, be involved in the conversation about OpenNotes at the highest levels. They almost always balance the provider skeptics and often quiet them quickly. Our founders coined the term “Nothing about me without me” many years ago and we urge that when it comes to notes patients be part of the decision making process.

    To make a big impact a patient could join their local PFAC (or bring this issue to their PFAC) to be part of a bigger voice.

CE Notice:

CEs will be available for a fee. Click here to register for the CE.

HQI is an approved continuing education (CE) provider by the California Board of Registered Nursing and will provide CHA or CHPSO members an opportunity to earn CEs. Provider Number CEP16793 for 1.0 contact hour.

HQI does not currently offer ACPE approved Pharmacy CE, but the State of California will accept CE from courses which have been approved for continuing education by the Medical Board of California, the California Board of Podiatric Medicine, the California Board of Registered Nursing or the Dental Board of California towards their California continuing education requirement (Section 1732.2(b) of the California Code of Regulations). Pharmacists need to keep track of CE from these sources on their own as they are not submitted to NAPB.

March 16 – Designing a Medical Center Transgender Care Program: Patient Centered Strategies to Optimize Patient Satisfaction, Safety, and Cultural Competence of the Care Environment

Speaker

Maurice Garcia, MD, MAS
Director, Transgender Surgery and Health Program
Cedars-Sinai Medical Center

Objectives:

  1. Review of culturally competent terminology related to transgender and gender non-binary people
  2. Identify common potential pitfalls in the care environment for transgender and gender non-binary patients, and discuss strategies to avoid and/or mitigate such pitfalls
  3. Describe key partners in the care environment for transgender patients, and effective strategies for interdisciplinary collaboration
  4. Identify examples of resources available to providers to guide effective, patient centered care of the transgender patient

Date and Time

March 16, 12:00 pm – 1:00 pm PDT

View the Webinar Here

https://register.gotowebinar.com/recording/2321114515645976065

CE Notice:

CEs will be available for a fee. Click here to register for the CE.

HQI is an approved continuing education (CE) provider by the California Board of Registered Nursing and will provide CHA or CHPSO members an opportunity to earn CEs. Provider Number CEP16793 for 1.0 contact hour.

HQI does not currently offer ACPE approved Pharmacy CE, but the State of California will accept CE from courses which have been approved for continuing education by the Medical Board of California, the California Board of Podiatric Medicine, the California Board of Registered Nursing or the Dental Board of California towards their California continuing education requirement (Section 1732.2(b) of the California Code of Regulations). Pharmacists need to keep track of CE from these sources on their own as they are not submitted to NAPB.