Virginians Improving Patient Care and Safety Conference 2002 Agenda

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May 29, 2002, Richmond, VA

"The most important challenge facing the health care industry is patient safety," said keynote speaker Lucian L. Leape, M.D., at the second annual Virginians Improving Patient Care and Safety (VIPC&S) statewide conference held Wednesday, May 29, at the Richmond Marriott. Dr. Leape, adjunct professor of health policy at the Harvard School of Public Health, added, "It is important that we focus on the systems that are in place and not the individuals. Human errors are caused by the flaws in the systems. Doctors are not mechanics of the body, but sultans of the soul."

More than 470 of Virginia’s health care leaders and professionals attended the sold-out event that focused on patient safety initiatives and explored the role of leadership in safety improvement and accountability.

SCHEDULE

7:45 AM—8:00 AM	Welcome! Carl W. Armstrong, MD, President, VIPC&S; Senior Medical Advisor, Virginia Hospital & Healthcare Association & American Hospital Association Transcript
8:00 — 8:30 AM	Opening Remarks The Commonwealth’s Perspective The Honorable Jerry W. Kilgore, Attorney General, Commonwealth of Virginia *Introduced by* Thomas G. Snead, CEO and Chairman, Trigon Blue Cross Blue Shield
8:30 - 9:15 AM	Lessons From Above: The High Cost of Errors and Omissions John J. Nance, JD, ABC News Correspondent / Aviation Expert and founding board member of the National Patient Safety Foundation *Introduced by* Secretary Jane H. Woods, Secretary of Health and Human Resources, Commonwealth of Virginia OBJECTIVE: At the conclusion of this presentation participants will be able to describe three or more key components of a culture of safety appropriate for high-risk environments. This session will present an overview of the challenges and opportunities facing the aviation industry after the events of September 11, 2001 and will draw comparisons in terms of patient expectations and systems enhancements. Mr. Nance will outline a framework for patient safety accountability and describe the key components of a ‘culture of safety.’
9:15 - 10:00 AM	*Safe Health Care: Are we up to it?* Lucian L. Leape, MD, Harvard School of Public Health *Introduced by* J. Shelton Horsley III, MD OBJECTIVE: At the end of this presentation participants will be able to describe how medical error reporting has been treated historically within the healthcare organization and to articulate the reasons why these approaches have failed to improve patient safety. Participants also will be able to identify the essential elements of an empowered reporting system that promotes openness and rewards reporting errors and creates a system where patient safety remains paramount. Download Presentation (PDF)
10:00 - 10:25 AM	*Leape-led Panel Discussion with Virginia Health Care Leaders* -Rudolph Freeman, Jr., MD, Vice President, Medical Affairs, Riverside Regional Medical Center -Brenda Jo Simmons, Pharm D, MHA, Director of Pharmacy Services, Inova Fairfax Hospital -Shirley Tate-Gibson, RN, Vice President, Nurse Executive, Mary Washington Hospital -Senator John C. Watkins, Board Member, Chippenham Medical Center/Johnston-Willis Hospital OBJECTIVE: Participants will increase their knowledge of successful practices as the panelists -- drawing upon their experiences in the healthcare setting -- respond to and question Dr. Leape about the solutions he offers. Panelists will explore how to build useful and reliable systems for error reporting while working in institutions that are fraught with legal challenges.
10:50 – 11:30 AM	*Patient Safety: Why Bother?* James P. Bagian, MD, PE, Director, Veterans Health Administration’s National Center for Patient Safety (NCPS) *Introduced by* Delegate John M. O'Bannon, MD OBJECTIVE: Participants will be able to identify critical elements for reporting adverse and near adverse events without fear of punishment or disclosure. Through numerous case studies, participants will understand the value of close call reporting. Download Presentation (PDF)
11:30 – 12:00 PM	**Bagian-led Panel Discussion with Virginia Health Care Leaders -Gail B. Cameron, RN, MEd, CNAA, FACHE, Vice President, Nursing, Rappahannock General Hospital -Randolph L. Gordon, MD, MPH, Senior Vice President and Chief Medical Officer, Bon Secours Richmond Health System -W. Scott Johnson, Esquire, Crews and Hancock, L.L.C. -Sue Perkins, RN, BSN, CPHQ, Director of Risk Management, Valley Health System -Janet A. Silvester, RPh, MBA, Director of Pharmacy Services, Martha Jefferson Hospital OBJECTIVE:** Drawing from personal experiences, panelists will offer various scenarios to Dr. Bagian which allow them to probe how his approach to creating a culture of safety can meet the various needs for reasonable and fair treatment of the provider, the facility, the patient, and state licensing boards.
12:00 – 12:30 PM	Boxed Lunch
12:45 – 1:30 PM	*View from the Lily Pad-- The Leapfrog Initiative: How private industry is reshaping Healthcare* Suzanne F. Delbanco, PhD, Executive Director, The Leapfrog Group *Introduced by* Rebecca P. Snead, RPh, Secretary, VIPC&S; Executive Director, Virginia Pharmacists Association OBJECTIVE: At the end of this presentation participants will be able to describe why The Leapfrog Group was created and who are its members and what the Leapfrog Group is doing nationwide as it mobilizes large purchasers. Participants will be able to identify the rewards used by The Leapfrog Group as incentives to healthcare organizations to initiate and make improvements in the safety of health care. Download Presentation (powerpoint)
1:30 - 2:30 PM	Virginia Success Stories: Session 1 Both Sessions Moderated by: Wally R. Smith, MD, Associate Professor and Chair of The Division Of Quality Health Care, Department of Internal Medicine, Virginia Commonwealth University *Introduced by* Richard M. Hamrick III, MD, MBA, Vice President, VIPC&S; Secretary-Treasurer, Medical Society of Virginia; Immediate Past Chairman, Richmond Academy of Medicine OBJECTIVE: Virginia health care providers from diverse disciplines and organizations will share and present new information on patient safety programs. The session will touch upon the latest research findings, program successes, lessons learned and problems solved. Conference participants will be provided information which allows them to replicate these programs in their environments and a resource list from which they can cull names of individuals or organizations available to consult with them. Three years of Multi-disciplinary Research in Perioperative Patient Safety: What have we learned? J. Forrest Calland, MD, Department of Surgery, University of Virginia Health Systems Stephanie A. Guerlain, PhD, Department of Systems and Information Engineering, University of Virginia School of Engineering and Applied Sciences Download Presentation (PDF) Related Articles A systems approach to surgical safety Thirty-Day Postoperative Death Rate at an Academic Medical Center CPOE: Lesson Learned from 20 Years of Experience Craig F. Kirkwood, PharmD, Department of Pharmacy Services, Virginia Commonwealth University Health System Download Presentation (PDF)
2:45-3:45 PM	Virginia Success Stories: Session 2 Using Information Technology to Improve Patient Care and Safety James F. Holman, MD, Senior Vice President of Medical Affairs, Carilion Health System Creating a Safer Hospital, A Case Study Chalmers M. Nunn, Jr., MD, Senior Vice President and Chief Medical Officer, Centra Health Download Presentation (PDF) Medication Safety Champion Program Joe Ciezkowski, MS, RPh , Pharmacy Director, Danville Regional Medical Center Barbara H. Wilkins, RN, BSN, CPHQ, Performance Improvement Coordinator, Danville Regional Medical Center Download Presentation (PDF) Related Articles Medication Safety Champions Proposal Medication Safety Champions Curriculum Improving Medication Safety using an Integrated Approach Mark A. Szalwinski, RPh, MHA, Vice President, Support Services, Sentara Southside Hospitals Download Presentation (PDF)
3:45 - 4:30 PM	What have we learned? Where are we going? John Nance and Virginia Success Story Presenters John Nance and our Virginia speakers will co-facilitate a large group wrap-up discussion. In the audience will be 5 roving leaders to identify persons who want to speak. Ideas will be presented on a large screen for all participants to see. OBJECTIVE: To review the knowledge and skills learned during the course of the day, to discern their value and portability to the work environment; to identify areas where additional information is needed.