| The Department of Defense Patient Safety Program works to eliminate preventable patient harm by empowering patients and engaging, educating and equipping patient-care teams, including the patient, to institutionalize evidence-based safe practices. Our eBulletin disseminates PSP program updates, news, tips you can use, success stories and upcoming educational activities that will help us achieve this goal. In this issue, you’ll learn about the Army approach to TeamSTEPPS® implementation, wrong site surgery in the Military Health System, the “Partnership for Patients: Better Care, Lower Costs” initiative and more. Enjoy!
Contents PSP Announcements
Happy Anniversary to the Patient Safety Reporting System!
Army Stays Committed to TeamSTEPPS Training
Wrong Site Surgery Focused Review Identifies Error Trends and Recommends Solutions
Administration Launches "Partnership for Patients: Better Care, Lower Costs”
Army Invests in Medication Safety Pharmacists
Air Force Medical Service Develops Patient Safety Toolkit
Upcoming Events
Patient Safety Learning Center –News and Notes
In the Patient Safety Headlines PSP Announcements The National Patient Safety Foundation’s 13th Annual Patient Safety Congress will take place from May 25-27 at the Gaylord National Hotel and Convention Center in the Washington, D.C. area. This year’s theme is “Sharing Accountability and Responsibility in Pursuit of Patient Safety.” The annual Congress provides an opportunity for attendees to learn from and exchange ideas with patient safety experts and practitioners from around the world. If you plan on attending, stop by the PSP exhibit at Booth #306. For more information, click here.
Heidi King, MS, FACHE, deputy director of the DoD Patient Safety Program is presenting at the Ninth International Conference on Occupational Stress and Health, which will take place from May 19-22 in Orlando, Fla. This year’s theme “Work, Stress and Health 2011: Work and Well-Being in an Economic Context” addresses the changing nature of work and the implications of these changes on workers. The conference is convened by the American Psychological Association, the National Institute for Occupational Safety and Health, and the Society for Occupational Health Psychology. For more information, click here.
The Food and Drug Administration has recently made several announcements about perinatal/obstetrics medication alerts and label changes. Click on the links below for more information on:
Antipsychotic drugs
Kaletra (lopinavir/ritonavir)®
MakenaTM
Terbutaline Back to top
Happy Anniversary to the Patient Safety Reporting System! PSR is one year old this month. The nine initial sites, plus Service Headquarters and the Patient Safety Analysis Center, began using PSR in May 2010. Sixty-two percent of implementation has been completed in the remainder of direct care system facilities and implementation should be completed in the continental United States, Europe... Read more Back to top
Army Stays Committed to TeamSTEPPS Training In March, Lt. Gen. Eric Schoomaker, M.D., the Army surgeon general, approved adding a strategic objective to the Medical Command Balanced Score Card related to Patient Safety. One of the measurements supporting the strategic objective will assess changes in the patient safety culture by implementing Team Strategies and... Read more Back to top
Wrong Site Surgery Focused Review Identifies Error Trends and Recommends Solutions Wrong site surgery -- surgeries or procedures performed on the wrong side or site of the body, or on the wrong patient -- is the third-highest ranking sentinel event reported to the Joint Commission. Root cause analyses and event reports submitted to the Patient Safety Analysis Center from MTFs and the Services contain data on root... Read more Back to top
Administration Launches "Partnership for Patients: Better Care,
Lower Costs” On April 12, Centers for Medicare and Medicaid Services Director Dr. Donald Berwick and Department of Health and Human Services Secretary Kathleen Sebelius launched “Partnership for Patients: Better Care, Lower Costs,” a new public-private partnership to improve the quality, safety, and affordability of health care... Read more Back to top
Army Invests in Medication Safety Pharmacists Members of the Army Medical Command Patient Safety Center visited the headquarters of the Institute for Safe Medication Practices to participate in their Practitioner in Residence Program. This program allowed Army representatives to spend a week working with ISMP medication safety experts and to discuss specific... Read more Back to top
Air Force Medical Service Develops Patient Safety Toolkit The Air Force Medical Service has created a Quality and Patient Safety toolkit to augment its ongoing Quality and Patient Safety Campaign. There are more than 60 tools, templates and ready to use materials available on the AFMS Knowledge Exchange. AFMS has collaborated with National Patient Safety Foundation... Read more Back to top
Upcoming Events Patient Safety Workshops (Instructor-led or self-paced online learning sessions focused on a specific product)
May 25, 1200-1330 ET
Agency for Healthcare Research & Quality TeamSTEPPS Webinar 20: Sharing the Successes of TeamSTEPPS - Part II
Click here to register
This activity is intended for DoD participants only. You will be directed to the Patient Safety Learning Center to register.
Patient Safety Learning Circles (In-person or web-based forums focused on a specific topic)
May 5, 1400-1500 ET
Perinatal Focus Review: Ensuring Entrusted Safe Care for Two
Click here to register
This activity is intended for DoD participants only. You will be directed to the Patient Safety Learning Center to register.
May 10, 1400-1500 ET
National Patient Safety Foundation Webcast: Shared Decision Making: The Safety & Quality Imperative for Patient Engagement in Care Delivery
Click here to register
May 18, 1400-1500
Army Patient Safety Initiatives: Establishing a Just Culture
Click here to register
This activity is intended for DoD participants only. You will be directed to the Patient Safety Learning Center to register.
May 26, 1400-1500
Data Management & Analysis: How to Present Data
Click here to register
This activity is intended for DoD participants only. You will be directed to the Patient Safety Learning Center to register.
Patient Safety Pathways to Success (Accredited and/or CEU training)
May 5, 1400-1500 ET
Professional Conduct Toolkit Series Part 1: From Avoidance to Engagement: A Strategic Approach for Promoting Professional Conduct
Click here to register
May 19, 1400-1500 ET
Professional Conduct Toolkit Series Part 2: When You Can’t Vote Them Off of the Island: Tips for Engaging with Surly Colleagues
Click here to register
Patient Safety Connection (In-person networking and leading practices discussions)
May 5, All day
SAVE LIVES: Clean Your Hands: WHO’s Global Annual Campaign
More information
May 25-27, All day
National Patient Safety Foundation’s 2011 Patient Safety Congress
More information
Patient Safety Helplines (1:1 sessions available to stakeholders)
No activities in May Back to top
Patient Safety Learning Center – News and Notes The DoD PSLC is a resource for medical and dental professionals to come together and partner for a new level of care. You can register for the PSLC on the DoD Patient Safety website at http://health.mil/dodpatientsafety/
It’s now easier to apply for access to the PSLC!
A new account request form and on-screen instructions guide applicants through three easy steps. If you are a member of the DoD, military, or an approved contractor engaged in patient safety activities, you can join the PSLC using the new application process. Go to the DoD Patient Safety Program website at http://health.mil/dodpatientsafety/ProductsandServices/PSLC and click on "Request a New PSLC Account"...Read more Back to top
In the Patient Safety Headlines These articles are external and provided for information purposes only. The DoD does not sponsor these websites.
Harvard Business Review: Strategies for Learning from Failure
Harvard Business Review: How to Avoid Catastrophe
Hospital Errors- How to Avoid Them
Joint Commission Urges Health Care Organizations to Focus on Achieving High Reliability
New List Offers Hospital-Specific Data on Patient Safety
Report to Congress: National Strategy for Quality Improvement in Health Care Back to top
Do you have a learning activity or networking opportunity that should be included? Email us here: patientsafety@tma.osd.mil.
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