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There Are 31 Different Codes and Alerts with OSF 9/15/2016 Welcome to Welcome Harmonizing Healthcare Emergency Codes Charles Denham, MD Chairman, TMIT TMIT High Performer Webinar September 15, 2016 For resource downloads go to: www.safetyleaders.org © 2016 TMIT 1 © 2016 TMIT 2 If you are still having difficulty hearing the webinar: Please click on Participants With regard to webinar sound volume, please check: Then the “Request Phone” button to receive a toll dial-in o WebEx volume o Computer volume o External speaker volume © 2016 TMIT 3 © 2016 TMIT 4 1 9/15/2016 5 6 TMIT Purpose Statement If you wish to follow us on Twitter, go to: http://twitter.com/TMIT1 Our Purpose: or use #safetyleaders hashtag We will measure our success by how we protect and enrich the lives of families…patients AND caregivers. Our Mission: Also, go to: To accelerate performance solutions that save lives, www.facebook.com/SafetyLeaders save money, and create value in the communities we and related sites serve and ventures we undertake. © 2016 TMIT 7 © 2016 TMIT 8 2 9/15/2016 The following panelists certify: Disclosure Statement Speakers and Reactors that unless otherwise noted below, each presenter provided full disclosure information; does not intend to discuss an unapproved/investigative use of a commercial product/device; and has no significant financial relationship(s) to disclose. If unapproved uses of products are discussed, presenters are expected to disclose this to participants. William R. Scharf, MD, is a Physician Change Agent in the Division of Clinical Excellence with OSF HealthCare Systems. He graduated from Illinois Wesleyan University, and received his medical degree from the University of Illinois in Chicago. Dr. Scharf received postdoctoral training in general surgery from the University of Illinois Hospital, Cook County Hospital, and the West Side Veterans Administration Hospital in Chicago. He has nothing to disclose. Mr. Keil has 41 years of direct experience in the healthcare field of facilities management. Mr. Keil's background includes 15 years of direct experience in the management of healthcare facilities, 13 years as the Director of Plant and Technology Management for the Joint Commission on Accreditation of Healthcare Organizations®. Has nothing to disclose James Mitchell, MBA, joined Texas Children’s in September of 2015 and has an extensive background in Crisis Management, Business Continuity and IT Disaster Recovery in both the Energy (BP) and Investments (Invesco) industries. While at Invesco, James developed the IT Crisis Management and Disaster Recovery process as well as developing and leading an international team to drive these efforts. He has nothing to disclose. Aaron Freedkin, MS, CHEP, EMT, is the most recent addition to the Texas Children’s Emergency Management Team having just arrived in May of 2016. Aaron previously served in Emergency Management with MD Anderson in the Texas Medical Center for over 6 years, is an Emergency Medical Technician, is a Certified Health Emergency Professional and has a Master of Science in Disaster & Emergency Management from Touro University. He has nothing to disclose. William Scharf Ode Keil James Mitchell Aaron Freedkin William Adcox Chief William H. Adcox serves as the Chief of Police and CSO at The University of Texas MD Anderson Cancer Center and The University of Texas Health Science Center. Chief Adcox holds an MBA degree from UTEP and is a graduate of the PERF's Senior Management Institute for Police and the Wharton School ASIS Program for Security Executives. He has nothing to disclose. Inspector Vicki King served 27 years with the Houston Police Department, rising to the rank of Assistant Chief and earning a master's degree in Criminal Justice. As Chief of Detectives, Tactical Support Commander, and Director of Forensic Services, she oversaw some of HPD's highest-profile cases, including serial homicides, corruption, domestic violence, sexual assaults, and gangland slayings. She has nothing to disclose. Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center. He received his medical degree from George Washington University School of Medicine in Washington, DC. He completed an internship in internal medicine at Huntington Memorial Hospital and then completed a residency in anesthesiology and a fellowship in critical care medicine at Stanford University in California. He also completed a medical simulation fellowship at Stanford with Dr. David Gaba and the Laboratory for Human Performance in Healthcare. Dr. Botz is board-certified in anesthesiology and critical care medicine. He is a Fellow of the American College of Critical Care Medicine. Has nothing to disclose. Jennifer Dingman realized, after her mother's death in 1995 due to errors in medical diagnoses and treatment, that there is little to no help available for patients and their families in similar situations. This life-changing experience left her feeling vulnerable, and she decided to dedicate her life to help prevent medical tragedies from happening to others. She has nothing to disclose. Charles Denham, MD, is the Chairman of TMIT; a former TMIT education grantee of CareFusion and AORN with co-production by Discovery Channel for Chasing Zero documentary and Toolbox including models; and an education grantee of GE with co-production by Discovery Channel for Surfing the Healthcare Tsunami documentary and Toolbox, including models. HCC is a former contractor for GE and CareFusion, and a former contractor with Siemens and Nanosonics, which produces a sterilization device, Trophon. HCC is a former contractor with Senior Care Centers. HCC is a former contractor for ByoPlanet, a producer of sanitation devices for multiple industries. Dr. Denham is a collaborator with Professor Christensen. Vicki King Gregory Botz Jennifer Dingman Charles Denham © 2016 TMIT 9 © 2016 TMIT 10 Voice of the Patient and Family In the News and Polling Highlights: News Update and Jennifer Dingman August 2016 Webinar Polling Founder, Persons United Limiting Substandards and Errors in Healthcare (PULSE), Colorado Division Co-founder, PULSE American Division TMIT Patient Advocate Team Member Charles Denham, MD Pueblo, CO Chairman, TMIT TMIT High Performer Webinar September 15, 2016 TMIT High Performer Webinar September 15, 2016 © 2016 TMIT 11 © 2016 TMIT 12 3 9/15/2016 In The News In The News Opioid Overdose Hits Mainstream September 2016 September 15, September Articles 2016 • Root Cause Analysis of Ambulatory Adverse Drug Events That Present to the Emergency Department • Measuring Adverse Events in Hospitalized Patients: An Administrative Method for Measuring Harm • Multidisciplinary Testing of Floor Pads on Stability, Energy Absorption, and Ease of Hospital Use for Enhanced Patient Safety • Rapid Learning of Adverse Medical Event Disclosure and Apology • Associations of Injurious Falls and Self-Reported Incapacities: Analysis of the National Health Interview Survey Improving Patient Safety Culture in Primary Care: A Systematic Review • Pharmacists Views and Practices in Regard to Sales of Antibiotics Without a Prescription in Madinah, Saudi Arabia • Building a Highway to Quality Health Care • Setting Up a Patient Care Call Center After Potential HCV Exposure • Three Simple Rules to Improve Medication Safety Source: Park M. Grandmother in heroin photo gets 180 days in jail. CNN. 2015 Sept 15. Source: Journal of Patient Safety September 2016 http://www.cnn.com/2016/09/15/health/heroin-photo-woman-court/index.html http://journals.lww.com/journalpatientsafety/pages/currenttoc.aspx © 2016 TMIT © 2016 TMIT © 2006 HCC, Inc. CD000000-0000XX 13 © 2006 HCC, Inc. CD000000-0000XX 14 Learn from Mortality Review AND the Living: Part 2 - A Deeper Dive Omission vs. Commission Jeanne M. Huddleston, MD, FACP, FHM Hospitalist Chairperson of Mortality Review Subcommittee Mayo Clinic Rochester, MN TMIT High Performer Webinar July 21, 2016 Mayo Clinic, Mortality Review System © 2016 TMIT 15 ©2013 MFMER | slide-16 4 9/15/2016 Anonymous Polling Questions Raw Information case I am interested in a webinar with speakers who have reviews launched Mortality Review from scratch 100% Identification of No Problem issues problem 90% 84% Agreed and 71% Strongly or Very Strongly Agreed, 80% and 57% Very Strongly Agreed Prioritization of Further No further 70% information review review 60% 57% Reviewer Work Is there anything 50% that could mitigate Yes No future events? 40% 30% Aggregate Committee Work Report 20% learning 14% 9% 10% 8% 4% 5% 1% 1% Clinical 10 9 8 7 6 5 4 3 2 1 Quality Very Practice Strongly Agree Agree Neutral Neutral Negative to Disagree Strongly Very Strongly Agree Neutral Disagree Strongly Agree Disagree Source: TMIT High Performer Webinar Series; Learn from Mortality Review AND the Living: Part 2 – A Deeper Dive – August 18, 2016 © 2016TMIT ©2013 MFMER | slide-17 © 2006 HCC, Inc. CD000000-0000XX 18 High MeaningfulImpact Care Hazards Use isto Patients,dead. Long Students, live and something Employees better! The Mortality Review topics I want to learn more about are: Cardiac Arrest • 30 Day Heart Failure and Pneumonia Mortality • How to recognize the infection in post-op patient and timely treatment • Adverse event prevention tools and education that have worked • Identified trends in mortality • all that can impact improved patient care and hospital processes • IS there a difference in quality of care for patients < 65 vs >65? Choking and Drowning A Medical-Tactical Approach • AMI within 24h • Missed Diagnosis undertaken by clinical and
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