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What Can We Learn from Ambulatory Patient Safety Reports?

While much of patient safety efforts focus on inpatient care, the majority of medical care occurs in the outpatient, or ambulatory, setting. Join UCSF physician researcher Dr. Anjana Sharma, in a presentation of a series of analyses of CHPSO event reports from the ambulatory setting. Her mixed methods work has identified attributes of CHPSO events most correlated with patient harm. Her qualitative work has explored the role of patients and caregivers in ambulatory reports, as well as ambulatory medication adverse reports. Her work is conducted in partnership with a stakeholder advisory council including patients, caregivers, and primary care clinicians, and staff.

Participants will gain an expanded understanding of the landscape of ambulatory safety reporting and will discuss how research in this domain can be expanded and improved.

2022 Safe Table Meeting Schedule

CHPSO will host safe table meetings via teleconference. If you are interested in a specific topic or sharing a case, please let us know at info@chpso.org. Schedule is as follows: Date Time Topic 01/12/2022 10:00-11:00 a.m. Pacific The Pressure of Preventing Skin Injuries – An Evidence-Based Approach 01/27/2022 10:00-11:00 a.m. Pacific Searches by Private Citizens in […]

Combating the Rise in Syphilis: A Novel Screening Program Implemented in the Emergency Department

The incidence of syphilis is growing in California and in the United States (U.S.). The U.S. Preventive Services Task Force and Centers for Disease Control and Prevention recommend targeted syphilis screening of all persons at increased risk of infection. Emergency departments (EDs) represent an important setting to test and treat patients who are not seen in outpatient clinical settings. On November 27, 2018 the UC Davis emergency department developed and implemented an ED-based syphilis screening program that employed an electronic health record best practice alert (BPA). Over a period of 11 months post BPA, there was a 135% increase in syphilis diagnosis following BPA implementation. The screening program demonstrated that the use of a targeted BPA-driven screening protocol can increase the number of new syphilis diagnoses, without an increase in inappropriate testing. Furthermore, this screening strategy may also help capture patients in demographic groups who may otherwise not be offered testing in settings where screening is clinician-initiated.

The Shocking Truth Regarding Job-Related Problems Prior to Nurse Suicide

We have known for several years that nurses are at higher risk of suicide than the general population and that nurses have more job-related problems recorded prior to death by suicide. What we have now learned about those job-related problems is troublesome at best with implications for risk managers, hospital executives, and all leaders in healthcare. This panel will describe the issues and implications for advocacy and policy change necessary to right the wrongs leading to death by suicide amongst nurses through personal testimony and review of recent research findings.

Recent CDC Studies about COVID in California: An Epidemiological Review and Critique

New studies about various aspects of the COVID pandemic are released daily and the sheer volume makes it impossible to keep up. These studies vary in their designs and methodological rigor and therefore in their level of research validity. In this webinar, HQI’s epidemiologist will provide a historical perspective of the COVID epidemic in California and review the findings, point out strengths, and critique the methodologies used in several recent COVID studies based on California data. The following CDC studies are currently potential candidates for review during the webinar, though the actual studies reviewed will differ if particularly interesting ones are published in the interim:

Addressing Racial Inequity in Healthcare Outcomes with a Focus on Cherished Futures for Black Moms and Babies

Addressing racial inequity in healthcare requires focused attention and concerted action. A new initiative in Los Angeles County (now in its third year) is doing just that. Cherished Futures for Black Moms and Babies helps participating hospitals evaluate their data, collaborate with community partners, and implement institutional changes to improve care for Black women, birthing people, and families.

Patient Safety Culture Change

How can a health plan incentivize hospitals to develop reliable, sustainable and transparent cultures of safety? Learn about a groundbreaking new partnership of Inland Empire Health Plan (IEHP), BETA Healthcare Group (BETA) and Hospital Quality Institute (HQI) that rewards hospitals for participating in HQI Cares: Implementing BETA HEART® (HQI Cares), a comprehensive, multi-year program aimed at transforming patient safety and caregiver well-being. HQI Cares is now a part of IEHP’s Hospital Pay for Performance Program providing financial rewards to hospitals that meet quality improvement targets.

Transgender Healthcare: Safety Considerations for Both Patient and Institution

In this presentation we will discuss who transgender patients are, and review relevant epidemiologic information about this diverse patient population. We will then discuss the treatments and care plans that many patients undergo in the course of care. This discussion will include a brief overview of surgeries, and what these surgeries require from both patients and the institutions who provide care. We will then reflect on how transcare actually contributes to – and improves, care quality for all (i.e. cis-gender) adult and pediatric patients at an institution. Lastly, we will spend time focusing on how culturally sensitive care is, in fact, a safety issue for trans patients that come to our institutions, and, how not delivering culturally competent care should be a concern for institutions

Prescription for Safety: Just What the Doctor Ordered – Simple Strategies to Promote Safe Medication Use

Medication use is a complicated process that spans many steps and many players. There are several opportunities in which an error may occur.  Having knowledge of common causes of medication errors can promote effective safety planning interventions to prevent errors or reduce the likelihood of harm from medication use. Please join us for a session on promoting safe medication use during National Patient Safety Awareness Week.