Lessons Learned

Lessons Learned: TB Misdiagnosed as Pneumonia

Case: A 46-year-old substance-dependent male went to the Emergency Department for sweating, chest pain and one week of cough, and the emergency physician had a chest x-ray ordered for him. The patient was diagnosed with pneumonia and was discharged with a prescription for an antibiotic. For weeks later, the patient returned to the ED because he was coughing up blood. The clinical team completed both a tuberculosis skin test (TST) and sputum for acid-fast bacilli.


HEN 2.0: HQI Selected to Continue Work in Improving Patient Safety, Quality of Care at California Hospitals

The Hospital Quality Institute (HQI) has been selected by the American Hospital Association/Health Research & Education Trust (AHA/HRET) as one of 30 state and regional hospital associations across the country to participate in a second phase of the Hospital Engagement Networks (HENs). 

The HENs, which are part of the federal Partnership for Patients initiative, are results-oriented networks of hospitals working towards the goal of reducing preventable hospital-acquired conditions by 40 percent and patient readmissions by 20 percent.


CHPSO Reporting Underway with NextPlane Solutions

CHPSO member hospitals are heavily engaged in the implementation of NextPlane Solutions for voluntary reporting. The process involves a series of three calls: the first is an introductory to review exporting capabilities, the second involves file processing and PSO submission, and the third (if needed) involves a review of the search capabilities, data editing, and document submission. NextPlane has accommodated hospitals using reporting systems from all vendors as well as from MS Access and Excel users.


Ask CHPSO: What and with whom can we share our event reports?
–E.K. -A Bay Area hospital

Data, reports, records, memoranda, analyses or written or oral statements which could improve patient safety, health care quality or outcomes that are specifically assembled for the purpose of reporting to a PSO may be shared with your health care organization’s workforce. Data may be disclosed with your affiliated providers, with your PSO, contractors such as management consultants and legal counsel. Additionally, you can share data with other providers within the same PSO.