International patient safety congress 2021

Never again?! What do never events tell us about patient safety?

Overview speakers

The congress will cover the significance, compilation and investigation of never events and provide a platform for exchanging information and discussions. Outstanding speakers from Switzerland and abroad will share experiences from other countries along with different approaches to the issue.

Opening addresses

Welcome by the Swiss Patient Safety Foundation, at 9:10 on 18 November 2021

Prof. Dr. med. Dieter Conen

Prof. Dr. med. Dieter Conen is a co-founder of the Swiss Patient Safety Foundation and has occupied the position of president since 2003. A prominent quality and patient safety expert, he studied philosophy and medicine before specializing in internal medicine. From 1987 he was the director of the department of internal medicine at the Aarau Cantonal Hospital, then medical director from 1989 to 2001. He retired in 2008. From 2007 to 2018 he was a member of the Hospital Board of the University Hospital Zurich.


Welcome from the FMCH, at 09:15 on 18 November 2021

Prof. Dr. med. Michele Genoni

Prof. Dr. med. Michele Genoni is the president of the FMCH, the federation of surgeons and invasive medicine practitioners. Until 2018, the cardiac surgeon was a head physician at the cardiac surgery clinic of Triemli City Hospital and the deputy director of the cardiac surgery clinic at Zurich University Hospital. Since February, he has been the medical director at the Seewis Rehabilitation Clinic.


Welcome from the Federal Quality Committee, at 09:20 on 18 November 2021

Prof. Dr. med. Pierre Chopard

Prof. Dr. med. Pierre Chopard is the president of the new Federal Quality Committee. With an MSc in healthcare management, he is the medical director in the department of healthcare quality at the University Hospitals of Geneva and associate professor at the University of Geneva.

 


Main speakers

Presentation at 14:30 on 18 November 2021: The role of a national policy and governance for learning from Never Events

Dr. Susan Burnett

Dr. Susan Burnett has been involved in patient safety research at Imperial College for 15 years and is now an honorary research fellow. She is also an independent advisor to healthcare organizations in the field of patient safety and clinical governance. She was recently the president of the Patient Safety Section at the UK Royal Society of Medicine and served on the National Steering Committee for Safety Standards for Invasive Procedures. Her work includes an analysis of the root causes of over 70 never events all over England on which there have been a number of publications. She has also conducted research into the impact of mortality alerts in NHS hospitals and led part of the large-scale EU research programme examining quality and safety (QUASER) conducted in five European countries.


Presentation on 18 November 2021, 9:25 a.m. WHO Global Action Plan

Dr. Neelam Dhingra

Dr. Neelam Dhingra works as Coordinator Patient Safety and Quality Improvement at the World Health Organization. She will highlight the WHO Global Action Plan for Patient Safety and specifically how to deal with Never Events in the first keynote presentation.

 


Presentation at 13:45 on 18 November 2021: Helios patient safety indicators – mandatory reporting, results and outlook

Dr. med. Bente Heinig

Dr. med. Bente Heinig studied law and human medicine at the Free University of Berlin and Greifswald University. From 2011 to 2019, she worked as a doctor at the Charité hospital. In 2015, she completed her doctorate in allegations of medical malpractice. In 2018, she specialized in internal medicine, and in 2019 the gained an additional qualification in geriatric medicine. Since 2020, she has been working as a patient safety officer at Helios Kliniken. She is responsible in particular for evaluating treatment errors, developing preventive measures and monitoring their implementation.


Presentation at 13:45 on 18 November 2021: Helios patient safety indicators – mandatory reporting, results and outlook

Andreas Meyer

Andreas Meyer  studied healthcare economics at Bayreuth University. He has been working at Helios Kliniken since 2007, in charge of insurance management and recording and evaluating medical error allegations. Since 2010, he has been head of risk management/insurance. From 2008 to 2019 he was a member of the treatment error register working group at the German Coalition for Patient Safety.


Presentation at 13:00 on 18 November 2021: Eliminating serious and preventable medication errors: how the never events concept was implemented in France and its impact

Dr. med. David Osman

Dr. med. David Osman is an intensivist, working in the intensive care unit of Bicêtre Hospital (Paris-Saclay University Hospitals). Dr Osman completed his medical studies at the Paris-5 Medical School and earned his degree in 2000, specializing in pneumology and intensive care medicine. Since 2013, he has been the coordinator of healthcare associated risk management at the Paris-Saclay University Hospitals and since 2018 he has been in charge of the drug quality management system at the Assistance Public-Hôpitaux de Paris (AP-HP).


Presentation at 10:00 on 18 November 2021: Never events in Switzerland: what is our past and what is our future?

Prof. Dr. David Schwappach

Prof. Dr. David Schwappach, MPH, has been the scientific director of the Swiss Patient Safety Foundation since 2008 and the director general since 2018. Since 2012, he has been titular professor of patient safety at the Institute of Social and Preventive Medicine (ISPM) at Bern University. His research is in patient safety during acute care, especially clinical cancer care.


Presentation at 11:05 on 18 November 2021: Can we learn anything from aviation about patient safety investigations?

Dr. med. Kevin Stewart

Kevin Stewart is the medical director of the Healthcare Safety Investigation Branch (HSIB) in the UK. The HSIB undertakes professional patient safety investigations that do not attribute blame or liability, based on just culture principles and human factor techniques adapted from aviation and other safety-critical industries. He trained in internal medicine and geriatrics, which he still practises part time. In 2009/10 he was a Health Foundation QI fellow at the Institute for Healthcare Improvement in Boston, USA, during which time he also completed a masters in public health at Harvard. He worked for the Royal College of Physicians in London, leading its programmes on quality and patient safety, before joining HSIB.


Opinion summit and panel discussion

Discussion panel on 18 November 2021, 4:20 p.m.

Adriana Degiorgi

Adriana Degiorgi, lic. rer. pol. and master in healthcare management, is the head of management support at the Ente Ospedaliero Cantonale Ticino, a member of the management and head of the quality and patient safety department. She has more than 20 years' experience in quality and patient safety. She is active in various associations and working groups at national level and as a lecturer in MAS, DAS and CAS programmes at the SUPSI university of applied sciences and the USI in Lugano.


Opinion summit and discussion panel on 18 November 2021, 3.35 and 4:20 p.m.

Sophie Michaud Gigon

Sophie Michaud Gigon is the president of Pro-salute, a new organization for the six largest associations representing patients as consumers. She is also the secretary general of the Fédération Romande des Consommateurs and national councillor for Vaud Canton.

 


Opinion summit and discussion panel on 18 November 2021, 3.35 and 4:20 p.m.

Dr. Dr. Carl David Mildenberger

Dr. Dr. Carl David Mildenberger studied economics (including in St Gallen and Boston) and philosophy (including Paris and St Andrews). Since 2015, he has been the CEO of mildenberger + cie, a specialist insurance brokerage for the Swiss healthcare system. He lectures in philosophy at various Swiss and German universities.
 


Discussion panel on 18 November 2021, 4:20 p.m.

Prof. Dr. David Schwappach

Prof. Dr. David Schwappach, MPH, has been the scientific director of the Swiss Patient Safety Foundation since 2008 and the director general since 2018. Since 2012, he has been titular professor of patient safety at the Institute of Social and Preventive Medicine (ISPM) at Bern University. His research is in patient safety during acute care, especially clinical cancer care.


Opinion summit and discussion panel on 18 November 2021, 3.35 and 4:20 p.m.

PD Dr. René Schwendimann

PD Dr. René Schwendimann is the head of patient safety at Basel University Hospital and lectures at Basel University. Having trained as a psychiatric nurse, he obtained a doctorate in nursing science. He is involved in training and teaching along with various development and study projects on patient safety.
 


Opinion summit and discussion panel on 18 November 2021, 3.35 and 4:20 p.m.

Dr. med. Christian Westerhoff

Dr. med. Christian Westerhoff has been the chief clinical officer at Privatklinikgruppe Hirslanden since 2015. He is a surgeon and holds a master in business administration and in medical quality management. He has been working for Privatklinikgruppe Hirslanden since 2005, initially as the head of corporate development, then responsible for medical service provision at Klinik Hirslanden. With the move to the corporate office in 2009, Christian Westerhoff took charge of the strategic content in quality management and clinical governance.


Workshop leaders

WORKSHOP I on 19 November 2021, 8.35 a.m.: Internal reporting channels

Adriana Degiorgi

Adriana Degiorgi, lic. rer. pol. and master in healthcare management, is the head of management support at the Ente Ospedaliero Cantonale Ticino, a member of the management and head of the quality and patient safety department. She has more than 20 years' experience in quality and patient safety. She is active in various associations and working groups at national level and as a lecturer in MAS, DAS and CAS programmes at the SUPSI university of applied sciences and the USI in Lugano.


WORKSHOP I on 19 November 2021, 8.35 a.m.: Internal reporting channels

Helmut Paula

Helmut Paula has been the head of CIRRNET since 2019. Having originally worked in emergency medical services, anaesthesia and intensive care, he later studied health service management. He has been involved in patient safety for more than 20 years and has held various positions in this field in several hospitals.
 


WORKSHOP II on 19 November 2021, 10.30 a.m.: Never Events – patient safety in context with legal considerations

Dr. iur. Iris Herzog-Zwitter

Dr. iur. Iris Herzog-Zwitter is an education officer at Swiss Insurance Medicine (SIM) for eastern Switzerland, which is responsible for medical evaluations. As a legal counsel in the FMH legal service, Iris Herzog-Zwitter designed the FMH and SIM liability module for medical experts and is responsible for its content and organisation. As a research associate in insurance medicine and law at Basel University Clinic, she bears editorial responsibility for Medimal, a knowledge platform for medical malpractice law.


WORKSHOP II on 19 November 2021, 8.35 a.m.: Never Events analysis using human factor approaches

Dr. med. Kevin Stewart

Dr. med. Kevin Stewart is the medical director of the Healthcare Safety Investigation Branch (HSIB) in the UK. The HSIB undertakes professional patient safety investigations that do not attribute blame or liability, based on just culture principles and human factors techniques adapted from aviation and other safety-critical industries. He trained in internal medicine and geriatrics, which he still practises part time. In 2009/10 he was a Health Foundation QI fellow at the Institute for Healthcare Improvement in Boston, USA, during which time he also completed a masters in public health at Harvard. He worked for the Royal College of Physicians in London, leading its programmes on quality and patient safety, before joining HSIB.


WORKSHOP IV on 19 November 2021, 10.30 a.m.: Never Events and safety culture

Dr. Yvonne Pfeiffer

Dr. Yvonne Pfeiffer graduated as an occupational and organizational psychologist from Albert Ludwigs University in Germany. She was awarded a PhD from ETH Zurich for her research into safety culture and the motivation to report incidents in Swiss hospitals. During her postdoc, she studied organizational learning and causal safety thinking at MIT Sloan School in the USA and at ETH Zurich. Since 2016, Yvonne has been a senior researcher at the Swiss Patient Safety Foundation, conducting research into such subjects as the double-checking of high-risk drugs, health information technology hazards and safety culture. She is in charge of the safety in organizations section at the foundation.


Steering Committee

Prof. Dr. David Schwappach, MPH
Director
+41 43 244 14 80
Mail

Helmut Paula EMBA HSM
CIRRNET Manager
+41 43 244 14 84
Mail

Sandra Burkhalter
Head of Finance and Administration

+41 43 244 14  87
Mail