VIRGINIA AT FOREFRONT OF REDUCING MEDICAL MISTAKES

CONFERENCE LAYS GROUNDWORK FOR SAFETY CULTURE

"This conference represents the very type of progress an enlightened society can make." With these words, Lieutenant Governor John Hager saluted Advancing Patient Safety in Virginia, a multi-disciplinary conference held in Richmond on April 17 and 18. The sold-out event, which attracted more than 400 participants, marked the public debut of Virginians Improving Patient Care & Safety, a non-profit alliance of 34 medical institutions, insurers, and professional organizations in pursuit of safer medicine through new models of systems performance.

The conference was designed as the first step toward a long-term strategic relationship among participants. National experts as well as diverse health care stakeholders from across the state explored the incentives and disincentives for safety improvement in a variety of formats, including speeches, a panel discussion, and a "town meeting" focused on a video case study.

Noted patient safety expert John Nance said Virginia is out in front of the effort to reduce medical errors. "It’s time to stop blaming one another for human mistakes, and start working together to make sure they don’t happen again," Nance said. "It’s like when a plane goes down and everyone is killed, you don’t turn around and then shoot the pilot. Your efforts here to collaborate are unprecedented and should be commended." Nance, who is also a pilot, author and aviation analyst for ABC News, was one of the conference's keynote speaker.

The Institute of Medicine reports that between 44,000 and 98,000 Americans die each year because of medical errors, making that the fifth leading cause of death in this country. Dr. Ken Kizer, president and CEO of the National Forum for Healthcare Quality Measurement and Reporting talked about the need for standardizing the way medications are stored, packaged and delivered to cut down on mistakes. "If drugs were bar coded the way food is at grocery stores and hospital patients wore bar coded wrist bands, a lot of mistakes could be avoided," said Kizer. He also recommended that doctors and hospitals follow proven best practice patterns and clinical guidelines and have a non-threatening means of reporting medical errors when they do occur.

In his parting remarks, Nance said that the "participation level, sincerity and enthusiasm" he saw at the conference put VIPC&S ahead of all other state safety coalitions. "The world will be watching as you stay in the lead," he added.

VIPC&S is a statewide not for profit organization created in response to the National Institute of Medicine’s (IOM) report, To Err is Human. Founded last year by Medical Society of Virginia, Trigon Blue Cross Blue Shield, Virginia Association of Health Plans, Virginia Pharmacists Association and the Virginia Hospital and Healthcare Association, VIPC&S has worked with the Joint Commission on Healthcare to review the IOM report and address patient safety issues.