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Medical Commission Conference E-Book 2014 Medical Commission Educational Conference Putting the Patient in Patient Safety October 1-2, 2014 Capital Event Center Tumwater, WA A public service of the Washington State Medical Commission Washington State Medical Commission 2014 Educational Conference “Putting the Patient in Patient Safety” WEDNESDAY – October 1, 2014 – Capital Event Center Welcome: 9:15 a.m. Richard Brantner, MD Chair, Washington State Medical Commission Patient Safety Panel Bonnie Bizzell, MBA Stephen Lovell Patient and Family Advisory Board 9:30 a.m. Foundation for Health Care Quality, WPSC “(Re)Focus on Safety: Incorporating the Patient’s Perspective for Better Patient Safety” William M. Sage, M.D., J.D. James R. Dougherty Chair for Faculty Excellence 10:30 a.m. The University of Texas at Austin “Communication and Resolution Program” 11:30 a.m. Lunch Break (On your own) Presentation: Augustus A. White, III, M.D., Ph.D. Culturally Competent Care Education Program Orthopaedic Surgeon-in-Chief Emeritus, Beth Israel Deaconess 12:30 p.m. “What Dr. Martin Luther King would like us to know about Health Care Disparities” Introduction: Tom Green, M.D., Commissioner Pro Tem 1:30 p.m. Networking break Byron D. Joyner, M.D., M.P.A. Residency Program Director, Department of Urology 2:00 p.m. Seattle Children’s Hospital “Building A Better Professional: Iconoclasts & Idiosyncrasies (Dealing with Conflict)” Blake T. Maresh, M.P.A., C.M.B.E. Past Board Member, Federation of State Medical Boards 3:00 p.m. Executive Director, Board of Osteopathic Medicine and Surgery “Deep Dive: The Interstate Physician Licensure Compact” 4:15 p.m. Wrap up and discussion Washington State Medical Commission 2014 Educational Conference THURSDAY – October 2, 2014 – Capital Event Center Welcome: 9:15 a.m. Richard Brantner, MD Chair, Washington State Medical Commission Caleb Banta-Green, Ph.D. Senior Research Scientist 9:30 a.m. School of Public Health, University of Washington “Long-term Opioid Management of Chronic Pain: Trends, Risk, and Naloxone” Molly Voris, M.P.H. Director of Policy 10:30 a.m. WA Health Benefit Exchange “Status of the Washington Health Benefit Exchange” 11:30 a.m. Lunch Break (On your own) Presentation: John Wiesman, Dr.Ph., M.P.H. Secretary 12:30 p.m. Washington State Department of Health “Integration: Primary Care and Public Health” Introduction: Richard Brantner, M.D., Chair, Medical Commission 1:30 p.m. Networking Break Paul Buehrens, M.D. Medical Director 2:00 p.m. Evergreen Health Partners “The Clinically Integrated Network” Randy Simmons Deputy Director 3:00 p.m. Washington Liquor Control Board “The Marijuana Market in Washington” 3:45 p.m. Closing: MQAC strategic direction discussion and conference debriefing FRIDAY – October 3, 2014- PPE, Rooms 152 and 153 8:00 a.m.-9:00 a.m. Commission Business Meeting 9:00 a.m.-Complete Case Reviews (closed session) Bonnie Bizzell Stephen Lovell Foundation for Health Care Quality Patient & Family Advisory Council October 1, 2014 (RE)FOCUS on SAFETY Incorporating the Patient’s Perspective for Better Patient Safety And Now! Something Completely Different 70,000 -440,000 1/3 2.8 30 177 1/2 10 - 40 60 3 2 Goal & Agenda We want to… explore components needed for patient involvement in patient safety •The Trifecta, I – Process: Patient-Centered Practice •The Trifecta, II – Communication: Patient-Centered Service • The Trifecta, Grand Finish – Trust: Patient-Centered Partnership •Quick Detour: Patient- and Family- Centered Care •So What? Applications and Implications •Closing Remarks /Q&A 3 The Trifecta, I Process: Patient-Centered Practice You never get a second chance to make a first impression. • Decided to have neck surgery • Chose a well-respected surgeon • Office staff experience • Surgery outcome • But, what if it had not gone as expected? 4 The Trifecta, II Communication: Patient-Centered Service If speaking is silver, then listening is gold. 5 The Trifecta, Grand Finish Trust: Patient-Centered Partnership Process TRUST Communication 6 Quick Detour: Patient- and Family-Centered Care Driving forces for patient care •Family System--FCocusedentered ⁻WhileThe priorities the family of theis the system focus and or unit those of whocare, work interventions within it adrreive done the todelivery and for of them, health instead care. of with them. •Patient - Faocusednd Family -Centered ⁻The prioritiespatient is andthe focuschoices or ofunit patients of care. and Interventions their families are drdoivene theto and delivery for him/her, of health instead care. of with the patient. The patient is not seen within the context of family or community. 7 So What? Applications & Implications What Patients Want – Process: Patients Involved •Patients need to prepare for appointments •Ways patients can participate: ⁻Medical lists ⁻Medical history ⁻List of questions •Providers can set expectations for patients •The provider community is helping •Ask for advice ⁻PFAC and other councils 8 So What? Applications & Implications What Patients Want – Communication: Patients Invited 9 So What? Applications & Implications What Patients Want – Trust: Patients Included •Communication and Resolution Program (CRP) ⁻Managed by HealthPact (Foundation for Health Care Quality) ⁻Based on just culture approach ⁻Goals *Ensure that patient/families harmed by healthcare have needs met *Promote learning within and across providers/institutions to prevent reoccurrence ⁻Creates transparent and accountable system *(Re)Builds trust 10 So What? Applications & Implications •The best resolution is to have no issues (we all know this) •However, there will always be unexpected outcomes •How might a difficult situation turn out differently if there was trust in the relationship? •The impact on the Commission could be significant 11 And Now! Something Completely Different 70,000 deaths due to med. errors-440,000 trillion spent on healthcare billion177 treading medication hosp. patients1/3 harmed during stay 2.8 30% of amount wasted problems adults with chronic disease wrong site surgeries/week % benefit from aspirin 1/2 - 40 10 60but no advice % invested in prevent 3 12 Few Closing Remarks 13 Q&A What do you want to know about patients and families in the system? We will be here through lunch to address additional questions OR contact us for a consultation Bonnie Bizzell [email protected] Steve Lovell [email protected] http://pfacqualityhealth.wix.com/pfac 14 References Slides 2 & 12 American Public Health Association (a non-profit organization). (2014). Prevention and Public Health Fund. Retrieved from http://www.apha.org/advocacy/Health+Reform/PH+Fund/. Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. Jama, 307(14), 1513-1516. Centers for Disease Control and Prevention. (2009, December 17). Chronic diseases the power to prevent, the call to control: At a glance 2009. Retrieved from http://www.cdc.gov/chronicdisease/resources/publications/aag/chronic.htm. Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group. (n/d). NHE tables. Retrieved fromhttp://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/ Downloads/tables.pdf. Classen, D. C., Resar, R., Griffin, F., Federico, F., Frankel, T., Kimmel, N., ... & James, B. C. (2011). ‘Global trigger tool’ shows that adverse events in hospitals may be ten times greater than previously measured. Health Affairs, 30(4), 581-589. Cobb, T. K. (2012). Wrong site surgery—where are we and what is the next step?. Hand, 7(2), 229-232. James, J. T. (2013). A new, evidence-based estimate of patient harms associated with hospital care. Journal of patient safety, 9(3), 122-128. McGinnis, M. MD; MPP. (2014, August 8). Networking, learning, and evidence: Strengthening the foundation for progress. The 6th International Conference on Patient- and Family-Centered Care: Partnerships for Quality and Safety. Lecture conducted from Institute for Patient- and Family-Centered Care, Vancouver, BC, Canada. Munro, D. (2014, February 2). Annual U.S. healthcare spending hits $3.8 trillion. Forbes. Retrieved from http://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare-spending-hits-3-8-trillion/. Slides 7 & 8 Adapted from: Schwab, B. MD. (2014, March 31). Recognizing patient- and family-centered care. Moving Forward with Patient- and Family-Centered Care: Partnerships for Quality and Safety. Lecture conducted from Institute for Family- and Patient-Centered 15 Care, Burlingame, CA. Bonnie Bizzell Stephen Lovell Foundation for Health Care Quality Patient & Family Advisory Council October 1, 2014 Thank you! (RE)FOCUS on SAFETY Incorporating the Patient’s Perspective for Better Patient Safety Communication and Resolution Programs: Policy Goals and Legal Issues William M. Sage, MD, JD The University of Texas at Austin The Real Malpractice Problem Little Connection Between the Malpractice System and the Health Care System! How Medical Liability Affects Cost/Access/Quality of Care • Two -sided mismatch between negligence and litigation – Not only unjustified lawsuits, but also – Uncompensated injuries – High rates of avoidable error • Poor process – Restricted information – Limited non-monetary remedies – Extreme delay – Lack of quality feedback to providers • Misdirected focus on individual physicians rather than “systems” – F ear of harm to reputation – Financial stress over insurability – Defensive assurance: costly over-testing and overtreatment – Defensive avoidance: refusing “risky” (sick or litigious) patients Why
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