Speaker Category: Pediatric Adverse Drug Events Panel

Dr. Pasko has been involved in medication safety since becoming a clinical pharmacy specialist in 2003. She chaired the Pediatric Medication Safety committee at the University of Michigan from 2009-2014 and was also a voting member of the Adult Medication Safety committee during the same time frame. She has been a clinical pharmacy specialist specializing in pediatrics and critical care since 2003. Her expertise includes being a project manager and large project coordination over clinical, operational, and technology initiatives. Dr. Pasko was also an intermittent consultant for almost 2 years with the medication safety team at the Joint Commission and she understands rules and regulations within hospital systems. She received LEAN training and certification through the University of Michigan and acts as a LEAN coach at ASHP and previously at UMHS and JC. Her current work at ASHP includes lead pharmacist for Antimicrobial Resistance, Opioid Use/Misuse/Abuse, IV and Oral Liquid Standardization, Medical Marijuana, and other safety and public health initiatives.

Ridley Barron is an author, internationally known speaker and tireless advocate for patient safety. He is also the Founder and President of Ridley Barron Ministries in Thompson Station, Tennessee. Carrying the power of personal experience, Ridley approaches the subject of Patient Safety as few can. His powerful message of hope, healing, and forgiveness empowers patients, families, clinicians and those impacted by adverse medical events. It leaves a lasting impression and offers challenging improvements in patient safety. Ridley’s story of hope has continued to have an impact with business executives, members of our military, healthcare workers and many families. The power of his story is evident by the number of people who have said it has changed their life forever. Ridley has shared his story, “Every 1/2 Second Counts,” in a variety of settings from coast to coast as well as in the words of his long awaited book, Twist of Faith.

Anne Lyren is the Clinical Leader of the Children’s Hospitals’ Solutions for Patient Safety National Network. She is an Associate Professor of Pediatrics and Bioethics at Case Western Reserve University School of Medicine and a pediatrician at UH Rainbow Babies & Children’s Hospital where she also currently serves as Strategic Advisor of the Quality & Safety Program. Dr. Lyren received her Bachelor’s Degree at Harvard University and a Master’s Degree in Philosophy as a Rotary Scholar at the University of Edinburgh, Scotland. She then completed medical school at Case Western Reserve University School of Medicine, her residency and chief residency at Rainbow, and subsequently served as an attending and Director of Rainbow Center for Pediatric Ethics. At Rainbow, she has served in a number of additional roles including Medical Director of Quality, Vice Chair of Quality & Ethics, and Interim Co-Chair of the Department of Pediatrics. In 2010, she completed the IHI Improvement Advisor Course. Since that time, she led the successful Pediatric Surgical Site Infection Improvement Collaborative of the Ohio Children’s Hospitals Solutions for Patient Safety and co-led the Ohio hospitals in their efforts to eliminate serious harm. In 2011, she assumed the role of Co-Clinical Leader and recently became Clinical Leader of the Children’s Hospitals’ Solutions for Patient Safety National Network, a collaborative of over 100 children’s hospitals working together to eliminate serious harm to hospitalized children. In this role, she leads efforts to eliminate the most common hospital-acquired conditions as well as efforts to address cultural barriers to consistently performing practices that keep hospitalized patients and hospital employees safe.

Sun ‘Coco’ Yang holds a Ph.D. in Pharmacology and is a Board Certified Pediatric Pharmacy Specialist (BCPPS) actively practicing in pediatric pharmacy. She completed a general practice pharmacy residency as well as an additional 1-year specialty practice residency in Pediatrics at the Children’s Hospital of Orange County (CHOC) with a research emphasis in Pediatric Oncology.

Dr. Yang received her Bachelor of Pharmacy degree from Shandong Medical University School of Pharmacy and went on to receive her Master’s degree in Pharmaceutical Sciences. Upon graduation with honors, she continued to study molecular pharmacology at the graduate school of Peking Union Medical College, where she received her Ph.D. degree in Pharmacology. These initial experiences spurred her interest in bench-to-bedside translational research. Following graduation, she joined the University of California, Irvine’s Chao Family Comprehensive Cancer Center where she went on to become an Adjunct Assistant Professor of Pharmaceutical Sciences prior to joining Chapman University’s School of Pharmacy as an Assistant Professor of Pharmacy Practice.

Dr. Yang has published more than 17 articles and is the recipient of a Mentored Clinical Scientist Research Career Development Award (K08) from the National Cancer Institute for her work in translational human melanoma research. As a clinical pharmacist, Dr. Yang is also interested in studies of pediatric medication safety and clinical outcomes in pediatric patients.

James Broselow, MD Clinical Associate Professor of Emergency Medicine Department of Emergency Medicine University of Florida College of Medicine Shands Jacksonville Jacksonville, Florida Curricula Vitae Dartmouth College: Graduated with Honors in Economics: 1965 New Jersey College of Medicine graduate 1969 Internship: Conemaugh Memorial Hospital 1969 to 1970. Family Practice 1970 to 1979: Frankenmuth Michigan. Diplomate American Board of Family Practice: 1976 Full time Practice of Emergency medicine 1980 -2005.. Diplomate of American Board of Emergency Medicine: 1989 Fellow of American College of Emergency Medicine Developer of “Broselow Tape” for pediatric emergencies 1988. Co-developer of Broselow-Hinkle Organizer 1990 Co-developer of Broselow-Luten Pediatric System Developer of Artemis electronic product Medical Director for Artemis Project, Pediatric Pharmacy Advocacy Group (PPAG) Publications: selected articles on use of a length based pediatric emergency system and color-coding applications. Numerous articles published in US and abroad related to evaluating the length based system of medication dosing and equipment selection. 2011 Winner of ISMP Lifetime Achievement Award.

Nat Sims, M.D., is a clinician, teacher, cardiac anesthesiologist and physician advisor to Biomedical Engineering at Massachusetts General Hospital (MGH). He is also an Assistant Professor of Anesthesia at Harvard Medical School. Dr. Sims is a strategic and hands-on innovator who has developed numerous technologies that make patient care safer and more efficient. Working with interdisciplinary teams involving biomedical engineering, nursing and various hospital departments, Dr. Sims and colleagues have pioneered improvements in patient monitoring, patient transport and error-free intravenous drug delivery systems. The original concepts for “Smart Drug Infusion Pumps” were developed in 1992, by Dr. Sims at MGH and implemented clinically in 1997. His career focus has been in developing advanced systems technologies to improve safety and patient care while reducing cost. Dr. Sims holds numerous U.S. patents (rights assigned to MGH) and has used licensing revenues to create an Innovation Support Center and an Innovation Fund at MGH. Dr. Sims is the 2006 winner of the Association for the Advancement of Medical Instrumentation (AAMI) Foundation Laufman/Greatbatch Prize for his significant contributions to the advancement of medical instrumentation through development of “smart drug infusion pump” technology and “flexible monitoring” systems. He is a 2011 recipient of the AAMI Standards Developer Award and is also Vice-Chair for Research and a Board Member of AAMI.

Christopher Jerry lost his beautiful two-year-old daughter, Emily, after a fatal medication error in March of 2006. After the tragic loss, he created The Emily Jerry Foundation to increase public awareness of the systems aspects of medicine, as well as, addressing key patient safety related issues by identifying technology and best practices that are proven to minimize the “human error” component of medicine. Mr. Jerry is a relentless patient safety and caregiver advocate who spreads a message of hope, change, forgiveness, compassion, collaboration, and how to turn a tragedy into honoring Emily by inspiring positive change in our nation’s medical facilities.

When Mr. Jerry first joined the patient safety movement, shortly after his daughter’s death, he was simply advocating for the patient. In the past seven years he has learned much about patient safety and the “human error” component of medicine. Over time he has discovered that most all of these issues relating to patient safety are systems related and that in order to effectively make our nation’s medical facilities safer for everyone, we all need to join together to positively change the underlying “culture” of medicine in the United States. With that being said, he is now finding himself advocating just as passionately for the caregiver as well.

“The Emily Jerry Story – From Tragedy to Triumph”

The following are the CE learning objectives for my presentation:

• Discuss the events surrounding the medical error that resulted in Emily Jerry’s tragic death in 2006.
• Describe the “lessons learned” from Emily’s tragic death.
• Identify and discuss the qualities of a safety culture that enhance harm prevention.