Time Table

2006 January 23 - Registration, Keynote Lecture, Oral Presentation, Poster Presentation, Banquet

2006 January 24 – Keynote Lecture, Oral Presentation, Closing Remark

 

Place

Tetsumon Memorial Hall, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan

 

Official Language

English.   

      Simultaneous interpreter between English and Japanese.

 

Main Thesis

-  Facts and Preventive Strategies in Clinical Accidents.

-  Clinical and Community Networking for Better patient Safety

 

 

 

Program Topics   

KL: Keynote Lecture,     SL: Special Lecture,    GP: General Presentation

*Speaker

Room A (Testumon hall, 14th floor),    Room B (The 3rd seminar room, 13th floor)

Room C (The 1st seminar room, 2nd floor; staff room and lunch space for invited guest speakers)

             

 

 

 

 

(The first day)   January 23,  2005

 

 

Registration desk hour:  am 8:15   pm 16:30  Jan 23, 2005

 

Presentation should be performed in Room A, and Room B.

 

 

 

Opennig remarks  in the morning of Jan. 23, 2006  Room A

 

am 8:45 – am 9:00  Jan 23, 2005

         Tomomitsu Hotta                Dean & Prof. Tokai University, Medical School, Japan,

Ryoji Sakai                         Chair, Union of Risk Management for Preventive Medicine,

Ken-ichi Youshida              Prof. The University of Tokyo, Graduate School of Medicine, Japan

 

 

 

Forwards   in the morning of Jan. 23, 2006    Room A

 

am 9:00 - – am 9:10  Jan 23, 2005

Fumimaro1Takaku             President of the Japan Association of Medical Sciences,  Chair of Patient Safety Committee by Japan Government,

President of Jichi Medical University, Former Dean of Medical School in the University of Tokyo

 

 

 

 

Symposium (1)  in the morning of Jan. 23, 2006    Room A

 

Investigation system and legal issues on potentially therapeutic death (1)’

 

 

Organizers:       Research Group on Independent Investigation for Therapeutic Death, Japan

Chairpersons:    Prof. Ken-Ichi Yoshida (University of Tokyo, Japan)

Kazuhito Inaba (Research Center for Science, Technology, and Culture, Japan)

 

 

Recommended for attendance;   Nurses, doctors, citizens, lawyers, researchers, and students, who are interested in risk management, investigation, and law for medical practice-associated deaths, are welcome to the symposium.

 

Outline of the symposium (1) and (2):

The famous litigation on the mistaken injection of disinfectant raised controversies on report of medical practice associated deaths to the police according to the Medical Act article 21. After the controversy, the pilot study on investigation and analysis of deaths associated with medical practices has commenced since September 2005, with a financial support from the Ministry of Health, Welfare, and Labor. In this study, a forensic pathologist, a pathologist, and a clinical specialist co-operatively perform autopsy, and qualified specialist review the medical practice on the basis of autopsy, audit, and medical record. Then, the Regional Committee reviews the report of the qualified specialist. The final report is disclosed to the concerned parties.  To establish this model project enterprise, the procedures for autopsy, investigation, and review must be established.  Specialists (doctors, nurses) to coordinate the investigative process must also be educated.  Additionally, management and resolution for error/liability of doctors, accident prevention, emotional care, and compensation are required.  During these processes, patients, families, doctors, nurses, pathologists, lawyers, and administrators should understand mutually.  Information disclosure and privacy has to be negotiated.  As the transparency ensures fairness of investigation and human right, medical experts must be responsible for accountability.  To overcome these issues, we must be aware of various aspects and viewpoints associated with issues associated with medical practices, and discuss on the required revolution in the system in near future.  These are the themes addressed in this special symposium.

  In Anglo-Saxon countries, law defines the report of deaths associated with medical practices to an administrative organization, where legally qualified administrators disclose the cause of death by autopsy, and investigation.  The information is disclosed to the concerned parties. Additionally, more systematic approaches have been undertaken to prevent accidents.  To this end, we must discuss whether we should encourage report by crime immunity, and also how we should deal with doctor’s errors.  Moreover, as indemnity is not almighty, we must also consider on emotional care, and administrative disposition for technical and ethical issues of practitioners.  As results of intensive social discussions, the laws and systems have undergone revolution in these countries.

Dr. K Yoshida will overview these issues by comparison of the systems of the foreign countries and Japan.  Dr. T Noguchi reviews the revolution on the medical laws and systems in California.  Dr. J Ibrahim introduces the review & liaison system of deaths associated with medical practices, to prevent similar accidents.  Dr. Y Takeda will introduce the “model project enterprise” as an attending coordinator (nurse).

Medical practices require informed consent, and the information is also requested after unexpected deaths and accidents.  Dr R Lefler has pointed out the uniqueness of the perception of informed consent in Japan.  Consistently, Mr. Kawai’s study showed that the unique perception misleads the doctor’s understanding on report of death investigation in Japan. Dr. H Takeichi points out the undesirable effects of the privacy protection law, while the most serious problem on the legal autopsy of medical practice associated deaths is that the investigative information cannot be disclosed properly to the concerned parties.  Doctor E Katayama shows the perspectives on the system failure and legal liability in Japanese litigations. Dr. T Suzuki, a leading lawyer advocating patient’s right, has proposed renovation of law and system on death investigation associated with medical practices.  Dr Inaba was a judge, and a government lawyer for medical malpractice.  He has then investigated the alternative dispute resolution (ADR) system on medical disputes in USA, and advocated the ADR practices in Japan.  Finally, Dr. K Tahara (the Ministry of Health, Welfare, Labor) will present the direction of the pilot study from the administrative point of view.

 The lecturers will get together to discuss the required near future system for medical practice associated deaths in Japan at the end of this symposium.

 

 

 

am 9:10 - – am 9:50  Jan 23, 2005

KL:    How can we learn near future image of a system of report and investigation of medical practice-associated deaths from the foreign systems

Ken-ichi Youshida                Prof. The University of Tokyo, Forensic Medicine, Tokyo, Japan

 

 

am 9:50 - – am 10:30  Jan 23, 2005

SL:    Death investigation and law for medical practice-associated death in California

Thomas Noguchi                  Emeritus Prof. University of South California, Forensic Medicine, USA     

 

 

am 10:30 - – am 11:10  Jan 23, 2005

SL:    Clinical Liaison Service: A successful system for review of all cases reported from hospitals to coroner

Joseph E Ibrahim                 Prof. Clinical review specialist of Victorian Institute for Forensic Medicine, Australia,

Professor Director Aged Care Medicine, Peninsula Health, Rehabilitation, Aged & Palliative Care Services

 

 

am 11:10 - – am 11:30  Jan 23, 2005

 GP:     On the model enterprise for investigation of medical practice-associated deaths

                      Yoko Takeda                     Lecturer, Yamanashi Prefecture College of Nursing, Japan

 

 

 

am 11:30 - – pm 13:00  Jan 23, 2005      Lunch

 

 

 

 

Symposium (2)  in the afternoon of Jan. 23, 2006  Room A

 

‘Investigation system and legal issues on potentially therapeutic death (2)’

 

 

Organizers:  Prof. Ken-Ichi Yoshida & Dr. Kazuhito Inaba (University of Tokyo)

 

 

 

pm 13:00 - pm 13:15

Private information issues related to medical practices in Japan

              Shoko Tateichi                                   International University of Medical and Welfare, Japan

 

 

pm 13:15 - pm 13:45

System failure and legal liability in medical practice

Eiji Katayama*                                   Adjunct Prof. University of Tokyo, Institute of Frontier Sciences, Japan

Nodoka Nakamura                              Abe, Ikubo & Katayama, Tokyo Japan  

 

 

pm 13:45 - pm 14:00

        Informed consent affects report of medical practice-associated death in Japan

                            Kakuji Kawai                        University of Tokyo, Graduate School of Medicine, Japan, Lawyer

 

 

pm 14:00 - pm 14:30

                            Toshihiro Suzuki                  Prof. Meiji University, Graduate School of Law, Japan

 

 

pm 14:30 - pm 15:00

  Legal issues on investigation and dispute for medical practice-associated death in USA

Robert Leflar                       Prof. University of Arkansas, School of Law, Arkansas, USA

 

 

pm 15:00 - pm 15:30

        A proposed way from report to alternative dispute resolution of medical practice associated deaths in Japan

                     Kazuhito Ibana                     Research Center for Science, Technology, and Culture, Japan

 

 

pm 15:30 - pm 15:50

Administrative involvement in the revolution of medical practice-associated deaths”

                            Katsushi Tahara                   Manager, Department of Medical Safety, Ministry of Health, Welfare, and Labor, Japan

 

 

 

 

pm 15:50 - pm 17:00 Discussion

Attendants “Required near future image of investigative and legal systems for medical practice associated death: From the pilot study to legal revolution

 

Chairpersons:    Prof. Ken-Ichi Yoshida (University of Tokyo, Japan)

Kazuhito Inaba (Research Center for Science, Technology, and Culture, Japan)

 

 

 

 

 

 

 

Educational Lectures   in the afternoon of Jan. 23, 2006  Room B

 

    Educational program’

 

 

 

am 9:30 - am 11:15 (60 minute English lecture, 30 minutes Japanese, and 15 minute discussion) 

(Title)  Medical error statistics, and the roles and duties of risk manager in the US hospitals

 

Martin A. Makary                 Assist Prof.  Department of Surgery, Johns Hopkins University, Baltimore, USA.

Co-Director Johns Hopkins Quality and Safety Research Group Johns Hopkins University

 

 

 

am 11:15 - pm 12:00 (30 minute English  lecture,  10 minute Japanese translation, and 5 minute discussion)

(Title)  Introductory Remarks on the Needs of Model-based Statistical Decision.

 

   Hiroe Tsubaki                    Prof. Tsukuba University, Graduate School of Business Sciences, MBA in International Business, Japan

                                                        Director of Risk Analysis Research Center, Institute of Statistical mathematics

 


 

 

 

pm 12:00 - pm 13:00   Lunch

 

 

 

 

pm 13:00 - pm 13:20   (20 minute Japanese lecture)

(Title)  Thunderbird Project -  Risk management networking of welfare facilities in Japanese private sectors.

 

              Yasunari Koyama,  CEO Koyama Welfare Group, Tokyo, Japan

 

 

 

 

pm 13:20 - pm 16:05 (60 minute English lecture, 30 minute Japanese translation, and 15 minute discussion) 

(Title)  Patient safety education, risk communication,  safe culture in the Johns Hopkins University and Harvard University hospitals.

 

Marthin A. Makary               Assist Prof.  Department of Surgery, Johns Hopkins University, Baltimore, USA.

Co-Director Johns Hopkins Quality and Safety Research Group Johns Hopkins University

 

 

 

 

 

 

General presentations  in the afternoon of Jan. 23, 2006  Room B

 

(Note) Each presentation should be performed in English with 8 minutes, and 2 minutes discussion.

 

 

(Chairpersons)

              Irina Ermakova,  Leading Scientist, Russian Academy of Science, Moscow, Russia

Yasuyuki Rakue,    Prof. Preventive Medicine, International University of Medical and Welfare, Japan.

 

 

 

 

pm 16:05 - pm 16:15 

GP    development of SAFETY Climate scale for medical facilities: nurses’attributes related

to their Perceptions of and Attitudes toward safety

Shinichi Matsubara*1), Junko Ayuzawa2), Akihito Hagihara1)

1) Department of Health Services Management and Policy, Kyushu University Graduate school of Medicine, Fukuoka, Japan

2) Department of Health Care Administration & Management, Kyushu University Graduate School of Medicine, Fukuoka, Japan

 

 

pm 16:15 - pm 16:25 

GP: Taiwan teaching hospital website the investigation of health education on patient’s right to seek medical advice

                                  Huei Ching Hung, Mingi Chan-Liao, Feng Huang Yang

Department of Risk Management and Patient Safety, Jen Ai Hospital,  Tali-Taichung, Taiwan

 

 

pm 16:25 - pm 16:35 

GP:   Investigation of safety of patient-controlled analgesia (PCA) ---- 10 years experience.

                 Yip W.H.*, Ooi S.J., Chen S.C., Chiang Y.Y., Chan-Liao M., Chung S.J.1, Kuo C.W.1

   Department of Anesthesiology, Department of Pharmacy1, Jen-Ai Hospital, Tali, Taiwan 

 

 

pm 16:35 - pm 16:45 

GP:  Safety Evaluation For Short-Term Treatment Of Morbid Obese Patients Using Very Low Calories Formula

Yi-Cheng Liu, Seh-Huang Chao, Mingi Chan Liao

Department of Nutrition Therapy, Surgery, Risk Management and Patient Safety, Jen-Ai Hospital, Tali-Taichung, Taiwan

 

 

pm 16:45 - pm 17:00 

GP :  The effect of GM-SOYA on rats and their posterity

                                 Irina Ermakova

          Leading scientist, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Science, Moscow, Russia

 

 

 

 

 

 

Banquet    in the evening of Jan. 23, 2006      Japanese classic pub

 

 

 

 

 

 

 

(The second day)  January 24,  2005

 

 

Registration desk hour:   am 8:15   pm 18:00  Jan 24, 2005

 

 

Presentation should be performed in Room A, only.

 

 

 

Panel (1)    in the morning of Jan. 24, 2006   Room A

 

‘Safe medical and welfare networking, and the economics.’

 

Chairpersons:

Kazuyuki Serada                   Prof. Showa University, Japan

Yoon-Shin Kim                    Prof. College of Medicine, Hanyang University, Korea

 

 

am 8:30 - am 8:45

           SL:  Japanese Governmental policy of technological development to prevent medical errors

                                  Takashi Gotoh    Japan Ministry of Health, Labour and Welfare

 

am 8:45 - am 9:15

KL:  Continuing the global patient safety challenge: Clean care is safer care.

                    Jostacio M. Lapitan     World Health Organization Health (WHO)   Health Development Center

 

am 9:15 - am 9:35

KL:  OECD Index for patient safety

                                  Yasuhisa Kawamura     Organisation for Economic Co-operation and Development (OECD) Tokyo Office

 

am 9:35 - am 10:05

KL:  Introduction of clinical governance in the UK

Edward Wright          British Embassy of Tokyo

 

am 10:05 - am 10:35

KL:     A management model for health care quality and patient safety by means of an incident report system and

an electronic patient record system

 Prof. Hiroshi Takeda1)2),  Assoc. Prof. Yasushi Matsumura1)  and Prof. Kazue Nakajima3)

1) Department of Medical Information Science and Center for Medical Quality Management, Osaka University Medical Hospital

  2) President, Medical Safety Association of National University Hospitals of Japan, Vice-President, International Medical Informatics Association

3) Department of Medical Quality Management, Osaka University Medical Hospital

 

 

 

am 10:35 - am 10:45 Coffee break

 

 

 

 

am 10:45 - am 11:00

           GP:  A proposal of environmental intervention factors for old people’s life

A proposal of environmental intervention factors for old people’s life

                                   Young-Ae Yang1), Jin-Gang Hur2), Yoon-Shin Kim3), Young-Man Roh3), Seoung-Cheol Hong4), Korea

1Dept. of Occupational Therapy, Inje University, Korea

2Dept. of Physical Therapy, Kang Dong Sacred Heart Hospital, Hallym University, Korea

3Dept. of Occupational and Environmental Medicine, College of Medicine, Hanyang University, Korea

4Dept. of Occupational Health & Safety Engineering, Inje University, Korea 

 

am 11:00 - am 11:15

GP:     Cost of risk management focused on patient safety- the first year assessment

                Mingi Chan-Liao , Huei Ching Hung, Ing Ling Cheng

                   Department of Risk Management and Patient Safety, Jen Ai Hospital, Taiwan.

 

am 11:15 - pm 12:00

           (Panel discussion)

Special Comment:   Risk management in a link between hospital and welfare facility

                                     Hideki Miyaguchi,   Prof. Hiroshima University, Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan

 

 

 

 

pm 12:00 - pm 13:00   Lunch

 

 

 

 

 

Panel (2)    in the afternoon of Jan. 24, 2006   Room A

 

Specially sponsored by JANSSEN PHARMACEUTICAL K.K. and CHUGAI PHARMACEUTICAL CO.,LTD.

 

‘Safe Drug Management for Cancer Patient’

 

 

(Panel Organizer, Chairperson)  Tomomitsu Hotta      Dean of Medical School, Tokai University, Japan

 

 

pm 13:00 - pm 13:30

KL           Medication Errors: Causes, Prevention and Risk Management

          Allen Vaida         Executive Director,  Institute for Safe Medication Practices (ISMP)

 

pm 13:30 - pm 13:55

SL            Safety Management for New Anticancer Drug Development

                                              Alexander Zukiwski

                        Vice President, Associate Therapeutic Area Head, Oncology Johnson & Johnson Pharmaceutical Research & Development

 

pm 13:55 - pm 14:15

SL            Safety Management of Anticancer Drugs

                                             Tatsuya Horiuchi               Gunmna University Hospital, Dept. Pharmacology, Japan

 

pm 14:15 - pm 14:30

SL           Heterogeneity in Adverse Drug Reactions (ADR) and Individualized Dosing in Cancer Chemotherapy

                                 Yuuici Ando                       Saitama Medical University, Clinical Oncology, Japan

 

 

pm 14:30 - pm 14:55

         (Panel discussion)

 

 

 

 

 

 

pm 14:55 - pm 15:00 Coffee break

 

 

 

 

Panel (3)    in the afternoon of Jan. 24, 2006   Room A

 

‘Toward a Friendly, Safe and Steady Hospital

 

 

 

(Part 1)  A friendly and hard hospital

 

Chairpersons:

Taro Shirakawa    Prof. The University of Kyoto, Health Promotion & Human Behavior, Japan

Huei Ching Hung    Department of Risk Management and Patient Safety, Jen Ai Hospital,  Tali-Taichung, Taiwan

 

 

pm 15:00 - pm 15:25

SL:  Development of A New Generation Disaster Manual -Efficient use of information for integrated urban disaster management-

Kimiro Meguro,    Prof. The University of Tokyo, Institute of Industrial Science, Tokyo, Japan

 

pm 15:25 - pm 15:50

SL:  The present state of medical malpractice and dispute resolution in Japan:

An outline of ten years activities of the Japanese Society for Investigation of Medical Malpractice

Isao Mori* and Sachiyo Fujimoto

                          *President, Japanese Society for Investigation of Medical Accidents, Osaka, Japan

 

 

pm 15:50 - pm 16:05   Discussion

 

 

 

 

 

(Part 2) Safe and steady clinical practice

 

Chairpersons:

Alexander Zukiwski              Vice President, Associate Therapeutic Area Head, Oncology Johnson & Johnson Pharmaceutical Research & Development

Isao Mori                            President, Japanese Society for Investigation of Medical Accidents, Osaka, Japan

 Kazuyuki Serada                  Prof. Showa University, Anesthesia, Japan

 

 

 

pm 16:05 - pm 16:25

KL:  Karolinska Institute’s risk management for medical errors

                                          Emiko Tamura           Embassy of Sweden, Tokyo

 

pm 16:25 - pm 16:55

SL:  The Science of Patient Safety: Measuring a Culture of Safety and Changing Hospital Systems

Martin A. Makary          Department of Surgery, Johns Hopkins University, Baltimore, USA.

 

 

pm 16:55 - pm 17:05

GP:   Implementation of anesthesia consent form-Taiwan’s National Action Plan for Patient Safety

                 Mingi Chan-Liao ,Wang Hin Yip, Seng Jin Ooi

                   Department of Risk Management and Patient Safety, Jen Ai Hospital, Taiwan.

 

 

 

 

pm 17:05 - pm 17:20   Discussion

 

 

 

Cross-cutting discussion    Room A

 

‘What’s the next for safe and health development in our world medicine

 

pm 17:20 - pm 18:00

 

Chaired by     Mitsutomo Hotta            Dean, Tokai University. Medical School, Japan

                     Ryoji Sakai                   URMPM Chair

                     Allen Vaida                   Executive Director, Institute for Safe Medication Practices (ISMP)

 

 

Main panelists

Ken-ichi Youshida                Prof. The University of Tokyo, Forensic Medicine, Tokyo, Japan

Thomas Noguchi                  Emeritus Prof. University of South California, Forensic Medicine, Los Angels, USA  

Shigeki Hayashi                    Vice-Director, National Disaster Medical Center of Japan, Internal Medicine, Tokyo, Japan

Martin A. Makary                 Assit Prof. Department of Surgery, Johns Hopkins University, Baltimore, USA.

Yip W.H.                             Director, Department of Anesthesiology, Department of Pharmacy, Jen-Ai Hospital, Tali, Taiwan 

And so on.

 

     Commentator   Isao Mori,  President, Japanese Society for Investigation of Medical Accidents, Osaka, Japan

         Toward global networking of patient safety

 

 

Closing remarks

pm 18:00 - pm 18:10

 

Taro Shirakawa                  Prof. The University of Kyoto, Health Promotion & Human Behavior, Japan

Kazuyuki Serada                   Prof. Showa University, Anesthesia, Japan

 

 

 

 

 

Presentation manners (tentative)

Power Point Material is recommendable.

 

 

 

Registration fee

(Participation of 2 days) 

200 USD    for a paid-up member of the URMPM or WHRMC.

300 USD    for a non- paid-up member of the URMPM or WHRMC

 

(Participation of 1day)  The banquet is additionally charged with 100 USD.

100 USD    for a paid-up member of the URMPM or WHRMC.

150 USD    for a non- paid-up member of the URMPM or WHRMC

 

 (Banquet)   100 USD


    


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