Newsletters

In this issue:

• ONC Takes Steps to Promote Common Formats
• Incident Report System Vendors Readying for Data Collection
• Presentations Now Available on Website
• CHPSO Member Support Options
• Pharmacies Reminded to Use Only Board-Licensed Wholesalers
• Learning From Defects
• Don Berwick to Keynote Accelerate Change Today Event on May 17
• Hospital Council Calendar Notes
• Hospital Association of Southern California Calendar Notes
• CHPSO Calendar Notes
• Editor’s Note

In this issue:

• Court Affirms Patient Safety Work Product
• Self-Reporting
• Participate in CHPSO-led Project on Retained Surgical Items
• Software Reduces Effort to Perform FMEAs
• Quality Improvement and Patient Safety Positions Open
• CHPSO Seeks Input on Website
• Affordable Care Act Ruling Keeps PSO Participation Mandate Intact
• CHPSO Calendar Notes
• Hospital Council Calendar Notes
• HASD&IC Calendar Notes

In this issue:

• ECRI Institute PSO Deep Dive Analyzes Medication Events
• Save the Date: CHPSO Annual Meeting
• The Value of Proactively Addressing Systemic Risks
• RCA Webinar Recording Available
• Call for Speakers
• CHPSO Calendar Notes
• Hospital Council Calendar Notes
• HASD&IC Calendar Notes

In this issue:

• The New CHPSO/ECRI System — Upcoming Conferences
• Register Now for Annual Meeting
• Check Your Medication Refrigerators
• Minimizing Bias in Clinical Peer Review
• Responding to Serious Adverse Events
• Wrong-Site Surgery: Contributing Factors
• CHPSO Calendar Notes

In this issue:

• Measuring Clinical Performance
• Responding to Serious Adverse Events
• International Survey of Patients with Complex Care Needs
• Register Now for Annual Meeting
• CHPSO Membership Free for CHA Member Hospitals
• Show Your Support for Patient Safety
• Calendar Notes

In this issue:

• Guidewires Left Behind
• Learning to Improve Safety
• Hospital-Wide Measures Do Not Tell the Whole Story
• CHPSO News Briefs
• WHO Releases Patient Safety Curriculum Guide
• Event Calendar

In this issue:

• CEO Holds Key to Improved Outcomes
• QA vs. QI: The Battle Royale
• Fentanyl Patch Use Guide Released
• Brief Notes
• Event Calendar

In this issue:

• FMEA Trial Opportunity
• Interpersonal Conflict Part 1: Case
• Interpersonal Conflict Part 2: Discussion
• Hidden Potential for Improvement
• Pooling Experience: Retained Surgical Items
• Secure Discussions
• Serious Reportable Events Update
• NQF webinar
• Just Culture Roadmap to Adoption
• Event Calendar

In this issue:

• Culture is Imperative
• Just Culture and CRM
• Medical Error Nurse Suicide
• Peer Review and Patient Safety Privilege Call
• 2011 Annual CHPSO Meeting Planning
• CHPSO Member Calls
• Pooling Experience: Retained Foreign Bodies
• Event Calendar

In this issue:

• Preventing Learning
• Smart Phones, Unsmart Choices
• Template Policy for CHPSO Participants Released
• Protecting Against Misconnections: Status Update
• Event Calendar

In this issue:

• Multi-Disciplinary RSI Reduction — New AORN Recommended Practices
• Peer Review Study Released
• Error Identifying Anesthetic Agent
• Illegibility
• Reducing Errors in Electronic Prescriptions
• Teleconferences
• Participant Recognition Program
• Safe Surgery Guide
• Event Calendar

In this issue:

• Mindfulness
• Double-Checks Work, Often
• Joint Commission Program for Improving Hand-Offs
• Patient Safety Tidbit

In this issue:

• Learned Behavior Contributes to Low Hand Hygiene Rates
• Quality, Safety and Peer Review
• Hand-Hygiene Music Video Débuts
• The Accounting of Responsibility
• Patient Empowerment for Hand Hygiene Promotion
• PSO Requirement for State-Based Health Insurance Exchange Participation
• PSO Incident Report Submission Instructions Released

In this issue:

• Misconnections
• Health Care Reform Includes PSO Provision
• An Amazing Assumption
• FDA Initiates Infusion Pump Safety Program
• Infusion Pump Use Hazard Examples (from the FDA draft guidance for industry and FDA staff)

In this issue:

• Implementing a Measurement Plan Is Critical to Success
• For Safe Care, Experience is Not Always the Best Teacher
• Information Exchange —Looking to the Future
• AHRQ Releasing HL7 Clinical Document Architecture For Data Transfer Among Systems

In this issue:

• CHPSO Database System Deployment Schedule
• Wrong-Drug Errors with Paralyzing Agents
• Medication Packaging
• Helping Teams of Experts become Expert Teams
• Patient Safety Organization Participation: What Every Provider Needs to Know
• Note to Reader

In this issue:

• The Joint Commission Supports Use of WHO Checklist
• Joint Commission Statement: The WHO Surgical Checklist
• Name That Drug
• WHO ‘SAVE LIVES: Clean Your Hands’
• The Power of Followers
• Oh Schnocks!
• Introducing CHPSO Web Interface

In this issue:

• CHSO Chooses Quantros as Technology Provider
• Is the Patient Safety Movement Killing the Art of Medicine?
• Join the Effort to Reduce CLBSIs
• Safety and Quality Collaborative Focuses on Maternity Care in California
• IJ Corner
• Reliable Patient-Centered Care
• CHPSO Workgroup Addresses Patient-Safety Action Priorities
• CDPH ALERT — Check Your Medication Refrigerators
• New LinkedIn CHPSO Group

In this issue:

• Call for Best Practices: WHO Surgical Checklist and the Joint Commission Universal Protocol
• Review of Patient Safety in Children Issued
• Essential Practices for Checklist Success
• Potential Negative Effects of Surgical Checklists
• Just Culture: Another Algorithm for Identifying Unsafe Acts
• Just Culture Event Investigation Training Now Available

In this issue:

• 15 San Diego Hospitals Standardize IV Medication Concentrations and Dosage Units
• Final WHO Clean Your Hands Implementation Toolkit Available May 5
• Are High Scores on Safe Practices Survey by Leapfrog Related to Improved Outcomes?
• A Message from the California Department of Public Health (CDPH)
• Kaizen — One Approach to Continuous Process Improvement
• WHO Surgical Safety Checklist Survey Underway
• Hospitals in Pursuit of Excellence
• IJ Corner