News

Great News Regarding our new book “Advocacy Heals U”

My amazing coauthor, Joni James Aldrich, and I just received some incredible news today about our new book that its going to print, by our publisher, Motivational Press, in October! The first bit of good news, after reviewing our final manuscript for “Advocacy Heals U -15 Keys to Fast Track Results and Emotional Fulfillment” our book is being nominated for a Pulitzer Prize! If that wasn’t enough…The second bit of good news, we are in the process of working on our book signing tour with our publisher and Joni just called me this morning to let me know that we will be kicking the tour off with a keynote speech and subsequent book signing at the prestigious, Rosalyn Carter Institute’s National Summit, in Americus Georgia, on October 22 & 23. If any our friends would like to attend this very special event with Joni & I, just let us know. If you would like Joni and I to personally sign your copy, we would be honored to do so at either this event, or at any of the events we are planning during our book signing tour (details and formal schedule to follow shortly). Joni and I are so truly excited to start these new chapters in our lives (no pun intended!) If you would like us to visit your small town, or big city, bookstore for a book signing we would love to do it. Just let us know! The following is JUST one great review from my friend Dr. Bob Wachter, there are many more to follow. A big “shout out” to Bob, for all of your continued support our efforts!!!

“In this important book, Joni James Aldrich and Chris Jerry describe what it is like to lose a loved one because of a medical illness and the all-too-frequent hazards of our medical care system. Impressively, they have channeled their pain into a series of lessons to help others who – like them – wish to use their experience to try to improve the healthcare system. Their strength, wisdom, and courage are remarkable, and their book will be an essential guide to others who wish to follow a similar path.”

Robert M. Wachter, MD
Interim Chair, Department of Medicine, University of California, San Francisco, and author of the New York Times bestseller, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

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CMS Non-Disclosure of Medical Errors Indicates Need for Change in how Healthcare Performance is Measured, Reported in U.S.

Note from Chris: The following is a new article in its entirety that I wrote earlier this month, with my friend and colleague, Michael Wong, from the Physician-Patient Alliance for Health & Safety. The article is titled “CMS Non-Disclosure of Medical Errors Indicates Need for Change in how Healthcare Performance is Measured, Reported in U.S.” This article that Michael and I wrote together, was in response to an article that ran in USA Today titled “Feds stop public disclosure of many serious hospital errors” on August 6th regarding the Centers for Medicare and Medicaid Services (CMS) decision to completely remove important data on “hospital acquired conditions” (HACs) from their Hospital Compare website. The following are my true sentiments on this very important issue that I had posted on Facebook on August 15th.

“I read this article in USA Today last week and it made me absolutely nauseous! In my opinion our government and in particular, the Centers for Medicare and Medicaid (CMS), are very quickly becoming a huge part of the problem, instead of the solution, to preventable medical errors that are senselessly claiming over 440,000 lives every year in the United States. Why would any government regulatory agency involved in patient safety want to stop disclosing ANY preventable medical errors to the public? Could it be that the government feels that “We the people”, can’t handle the real truth? By continually minimizing and “sugar coating” the real statistics and error reporting data that’s gathered, these organizations are actually perpetuating a “culture of denial” instead of positively changing the culture of medicine!

I lost my beautiful two year old daughter Emily to a very tragic and preventable medication error in 2006. Subsequently, I established The Emily Jerry Foundation (www.emilyjerryfoundation.org) to be an active part of the real solution to preventable medical errors. Please help us to honor the millions of people, like Emily, that have been lost to preventable medical errors by joining us and supporting our vital “life saving” cause. By doing this, you can help be the voice of all those who can no longer speak for themselves!”

If the federal government decided that the nation’s automakers were no longer required to publicly announce recalls of cars equipped with life-threatening defects, the protest from the masses would be deafening.

Yet, a similar scenario is playing out now in the nation’s healthcare industry with relatively little public outcry. As recently reported in USA Today, the federal Centers for Medicare and Medicaid Services (CMS) has quietly stopped publicly reporting when hospitals make certain errors that threaten the lives of patients.

This CMS decision is not only misguided, but it also points to an even more critical issue that exists in our healthcare system today: the need to address the mind-boggling variability in the quality and measures of healthcare provided across the nation.

Currently, CMS, the Agency for Healthcare Research and Quality, the Joint Commission, the Leapfrog Group and the National Committee for Quality Assurance, as well as most states and for-profit companies, such as Healthgrades and U.S. News and World Report, all offer various – and frequently conflicting — performance measures, ratings, rankings and report cards.

Meanwhile, hospitals are creating their own standards and posting their performance on their websites, often with little or no validation of their methodology or data.

This quagmire of information is illustrated in the “2013 National Pharmacy Technician Regulation Scorecard” released by the Emily Jerry Foundation following the heartbreaking death of two-year-old Emily Jerry. It shows variation in training provided to pharmacy technicians.

What all this means is that for patients and their loved ones today, choosing a physician or hospital based on publicly available information has become a daunting and confusing process. Ironically, even though a vast wealth of information is available to them, patients can’t make what could truly be described as informed decision about their care.

How can this problem be solved? For certain, the CMS decision to stop publicly reporting information on life-threatening “hospital acquired conditions” (HACs) is not the answer. When hospitals make mistakes – like leaving foreign objects in patients’ bodies during operations or neglecting to continually monitor patients receiving potentially lethal opioid medication after surgery – the public deserves to be informed about those medical errors just as they are now informed about recalls of defective automobiles. Such information should not – and must not – be swept under the rug.

With that thought in mind, it is imperative that all information and error data be truthfully and honestly disclosed to everyone involved, including the patients receiving medical care. If organizations like CMS, continue to limit and censor the data that is being shared with the public, then we as a society are perpetuating a “culture of denial” and mistrust in medicine, instead of positively affecting the underlying “culture of medicine” and how it is practiced. When this occurs, the public’s trust in modern day healthcare, unfortunately, gets seriously diminished. As a result, the public then loses sight of all the advancements that have been made in recent years, by everyone working together, on all levels, to find comprehensive solutions to preventable medical errors that tragically claim so many lives.

By recent, very credible estimates, preventable medical errors are now the third leading cause of death in the United States, aside from cancer and heart disease. Unfortunately, preventable medical errors are now tragically claiming more than 440,000 lives in America every year (The Journal of Patient Safety “A New Evidence-based Estimate of Patient Harms Associated with Hospital Care”, September 2013 – Volume 9 – Issue 3 – p 122–128). By sighting these astounding numbers of preventable deaths that are occurring, the core objective is to stress the importance of transparently acknowledging the real problem at hand, as well as, the corresponding error data, as shocking as it may be. Subsequently, safeguards and solutions, that effectively save countless lives, can then be implemented as quickly as possible.

These solutions should begin with creating policies that improve – and ultimately create universal standards – for measuring performance quality in our healthcare system.

To create such standards, “Achieving the Potential of Health Care Performance Measures,” a recent report from the Robert Wood Johnson Foundation (RWJF), offers seven recommendations on how to develop better measures; when and how to use measures; and how to ensure the validity and comparability of publicly-reported performance measure data. Described in greater detail in the RWJF report, the recommendations are to:

1. Decisively move from measuring processes to outcomes;
2. Use quality measures strategically, adopting other quality improvement approaches where measures fall short;
3. Measure quality at the level of the organization, rather than the clinician;
4. Measure patient experience with care and patient-reported outcomes as ends in themselves;
5. Use measurement to promote the concept of the rapid-learning health care system;
6. Invest in the “basic science” of measurement development and applications, including an emphasis on anticipating and preventing unintended adverse consequences; and
7. Task a single entity with defining standards for measuring and reporting quality and cost data, similar to the role the Securities and Exchange Commission (SEC) serves for the reporting of corporate financial data, to improve the validity, comparability, and transparency of publicly-reported health care quality data.

Of these recommendations, the last is a game-changer. Creating an entity to serve as the healthcare industry’s equivalent of the SEC would provide patients – who are now forced to swim against seemingly endless waves of competing and often contradictory information – a single source of quality data that has a national consensus behind it.

Should there be an SEC for healthcare? Although this concept will no doubt stir debate, no one can argue that our current systems for measuring performance quality are flawless.

What’s also undeniable is that beyond creating national policies that improve performance reporting – including consistent and accurate information about life-threatening medical mistakes– our nation’s healthcare system needs to take greater steps to prevent those mistakes from happening in the first place.

Fortunately, significant progress on that front is already underway — with myriad action plans and initiatives developed by patient safety experts and advocates groups across the nation, such as these recommendations and this checklist from the Physician-Patient Alliance for Health & Safety.

With national protocols in place to prevent medical errors from occurring – and accurately measuring and reporting them when they do — the lives and safety of literally thousands of patients could be protected each year.

Most sincerely,
Christopher Jerry
President & CEO, The Emily Jerry Foundation

Michael Wong, JD
Founder & Executive Director, Physician-Patient Alliance for Health & Safety

* You can view this article where it was originally published on the Physician-Patient Alliance for Health & Safety website by clicking here.

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Announcing a New Partnership Between The Emily Jerry Foundation and KLAS Research


I first became aware of KLAS when I gave a keynote at the Healthcare Information Management Systems Society (HIMSS)
Annual Conference in Orlando, this past February. KLAS Research, based in Orem, Utah, has an extremely important mission statement; “Our mission is to improve healthcare technology delivery by honestly, accurately, and impartially measuring vendor performance for our provider partners”.

KLAS is an independent research firm based in Orem, Utah; established in 1996. KLAS is similar to Consumer Reports, only for Healthcare IT. They conduct over 30,000 interviews per year with healthcare providers to gain qualitative and quantitative data on over 1,000 healthcare IT products within 100+ healthcare IT market segments. They maintain an active database of rankings, performance scores, alerts and blogs to provide vendor transparency to providers on existing technologies.

Similarly, a very key part of The Emily Jerry Foundation’s mission statement is “identifying technology and best practices that are proven to minimize the human error component of medicine.” This is where I saw that both of our organization’s core goals and objectives are in perfect alignment, in striving to always be an active part of the solution to improving healthcare.

I was contacted by the KLAS team, a few months ago, as they were in the process of beginning research on a comprehensive study covering intravenous (IV) compounding technologies that are currently available from various manufacturers. It is absolutely imperative that this vital “life saving” technology be evaluated objectively in an unbiased manner. This is precisely what KLAS does and exactly why The Emily Jerry Foundation is looking forward to establishing a very long, mutually beneficial, relationship between our organizations!

Learn more at klasresearch.com

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Announcing The Emily Jerry Foundation’s “Patient Safety Express” Educational Program

On the Road to Saving 440,000 Lives a Year!

Click on the image above to view a larger version.

On March 1st of 2006, Emily’s mother and I had to make the most difficult decision of our lives, which was to take our precious 2-year old girl, Emily, off of life support after a preventable medical error.   In horrible, unimaginable situations like this, we all respond differently. However, as any father would be, I was completely and totally devastated emotionally. Even with that thought in mind, I still never questioned the existence of God. From that horrific day forward, I knew in my heart that He had to have a plan, I just had absolutely no idea, nor was I ever meant to even comprehend at that point, what exactly God’s plan was for my beautiful little girl’s short life here on earth.   

As I frequently mention in many of my speaking engagements and lectures, as Emily’s father looking back over the past eight years, I have really come to believe that Emily’s short life was truly meant to save thousands from the same fate.  In retrospect, I am also convinced that Emily’s life was actually meant to be the catalyst for all the positive change in attitudes and opinions on preventable medical errors and how the medical community responds and learns from them. This is precisely why I have always strived with my advocacy efforts, as well as, the programming of The Emily Jerry Foundation to be an active part of the overall “solution” to preventable medical errors, which by recent estimates are claiming more than 440,000 lives every year and are now sadly the third leading cause of death in the United States.

I am extremely pleased to say that the special Guardian Angel logo for the foundation, designed with Emily’s likeness, is very quickly becoming the “Gerber Baby” of patient safety. Most everyone in medicine and pharmacy recognizes it. More importantly to me, they really seem to comprehend the fact that it stands for all of this positive change that is, in fact, occurring in the underlying “culture of medicine” and how it’s being practiced, both here in the United States and abroad.  In these ways, Emily lives on, and is truly responsible for saving many lives. My goal is to keep the momentum going forward and continue to inspire those in the medical field to never settle for “good enough” when it comes to patient safety.

When I first established The Emily Jerry Foundation, under these distinct premises, my primary motivation was to begin getting out and speaking to as many caregivers around the nation as possible. I wanted to share with them Emily’s story and the extremely important lessons that have been learned since her passing. My feeling was that the caregivers, hospital administrators, boards of trustees for medical facilities, etc., were the ones who could really impact the changes I was praying for, more quickly than anyone else. 

Over the past three years, I have been blessed with the opportunity to speak before tens of thousands of people, all who play an integral part in patient safety in our healthcare system. I have already given more than 75 lectures, keynotes speeches, and presentations on patient safety and ways to reduce preventable medical errors at hospitals and medical conferences around the nation. It is extremely important to keep this wave of enthusiasm for our very important cause moving forward. This is precisely why I believe so strongly that The Emily Jerry Foundation needs to continue to reach and convey our vital messages to as many caregivers and healthcare administrators across the nation, as quickly and effectively, as possible.  

According to the American Hospital Association (AHA), we currently have 5, 723 registered hospitals in the United States today. I know it’s a completely unrealistic goal to expect to be able to book the speaking engagements and patient safety symposiums, which have proven very effective over the past few years, at each and every single medical facility in our nation. This is exactly why we have developed The Emily Jerry Foundation’s new “Patient Safety Express” Educational Program, to effectively and efficiently reach, as many of these hospitals, as possible.

My plan is simple. If we can raise enough funds and donations to either purchase or lease a coach tour bus, similar to the one pictured above this article, I am going to make a personal commitment to our cause to live on the road for 12 to 18 months at a time, going to as many hospitals and patient safety functions around the country as humanly possible. Typically, I am only able to conduct roughly two to four speaking engagements and patient safety events per month via commercial airlines. With the “Patient Safety Express”, I will be able to more efficiently cover the entire United States visiting three to five hospitals per week. My very realistic goal then, subsequently, becomes approximately 156 to 260 hospitals and functions per year!

Please join me in this fight by donating toward this very important educational program and our vital “life saving” cause at emilyjerryfoundation.org/donate. If you would like to discuss corporate sponsorship for this program, please contact me directly at chris@emilyjerryfoundation.org.

Thank You in Advance for your Support!
~Chris Jerry, Patient Safety Advocate

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Part 2 of Emily’s Story Featured on Mark Graban’s LeanBlog.org


As I posted last month, I was incredibly thankful to be interviewed for Part 1 of Emily’s Story on Mark Graban’s LeanBlog.org. If you are new to the site or missed that episode, click here to listen to Part 1.

Mark recently released Part 2 of our conversation which covers many topics including: overhauling systems vs. blaming individuals, pushing for a comprehensive national Pharmacy Tech policy, Public forgiveness of Eric Cropp, and much more! Click here to listen to Part 2 of my interview on the LeanBlog.org Podcast.

Mark’s blog is a great place to learn innovative information about best practices in medicine so please share with your network. As always thanks for your continued support!

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The Third Leading Cause of Death in America – PREVENTABLE Medical Errors


Most of the public is completely unaware of this fact and many people in the medical community, who are cognizant, are in complete denial!

On March 1st 2006, five days after my beautiful daughter Emily’s second birthday, my wife and I had to make the worst decision of our entire lives, to take our little girl off of life support. That horrific day will always remain permanently burned into my memory and it haunts me every single day. It was only by the Grace of God and His new little angel Emily that truly saved me from myself in the years that followed this unimaginable tragedy.

It was also on that day, that I knew in my heart that my life had drastically changed forever. I absolutely understood that there was no way to bring my sweet Emily back, however, I also knew that I could find out exactly what happened to her and, subsequently, find ways to ensure that other babies, children, and their families, didn’t suffer a similar fate. I still continue to have, and have always had, the utmost respect for modern day science and medicine. After all, it was modern day medicine and the advances that have been made in research and development of new leading edge treatment methods that had actually cured my Emily of an extremely life threatening, horrible, tumor that, just 10 or 15 years prior would have proven to be fatal for any patient with that particular diagnosis.

Shortly after Emily’s heartbreaking death from a horrible medication error, I immediately began researching preventable medical error, desperately trying to educate myself on why these tragedies occur at such an astonishing number in the United States and globally, each and every year. To me, as well as many others, these annual numbers of deaths that had been reported in historic studies like “To Err is Human” in 1999, by the Institute of Medicine (IOM), were completely unacceptable and did not have to happen in the first place. Again, in my opinion, they are called preventable medical errors for a reason. They really are preventable! When the IOM first introduced this landmark study in 1999, they tried as best as they could to very accurately assess the number of deaths that occur every year in America. The number that they were able to quantify, at that time, was over 100,000 lives each and every year. I was completely shocked to learn that this many people died every year just like Emily did!

In the years following this initial IOM report, through the use of what are called “global trigger tools”, SBAR (Situation, Background, Assessment, and Recommendation) tools, etc., the new numbers of estimated deaths in the United States from preventable medical errors, began to climb substantially and double to over 200,000 lives lost every year in America.

I began to think to myself that either number was horrific and senseless. There were so many questions that I had. I started to wonder why the total number of deaths had doubled? Were there really twice as many people dying from preventable medical error a decade after the IOM’s report, or was the core of the problem in the accuracy of the reporting? If this was the case, was the real number of deaths that occur annually in the United States even larger than the 200,000 that was being used? Then I began to ponder the question, that in 2006, when Emily died, would she have been included in those numbers? If not, her short life wouldn’t have even amounted to an accurate statistic. Was that what everyone was telling me? As her father, my biggest fear was that my little Emily would have been completely forgotten and her short life wouldn’t have even been counted, as if she had never even been born. What about all of the other lives that had been lost so tragically from preventable medical error? All because we as a society and the medical community had no way of accurately counting the real number of lives lost to preventable medical errors. As you can probably already tell, this whole notion has never sat very well with me. As I’m sure you will agree, this is definitely not the way we should be honoring our loved ones, especially after their lives had ended so abruptly and unexpectedly!

A retired NASA scientist by the name of John James, who heartbreakingly lost his 19-year old son to multiple preventable medical errors as a result of cardiologist’s mistakes at two separate medical facilities in Houston, also dedicated the remainder of his life’s work to honoring his son’s life by improving hospital safety and founding an organization called Patient Safety America. Flash-forward to September of 2013, John authored a comprehensive study that had its conclusion published in the Journal of Patient Safety called “A New Evidence-based Estimate of Patient Harms Associated with Hospital Care” (September 2013 – Volume 9 – Issue 3 – p 122–128). This ground breaking study put the new number at 440,000 lives lost in America every year due to preventable medical error, making preventable medical error the third leading cause of death, aside from heart disease and cancer!

Shortly after this important study was released, I began presenting and discussing it’s validity in virtually all of my presentations with some of our nation’s brightest minds in medicine. I was really hoping and praying that the “experts” in the medical community would be able to tell me that it wasn’t really true. I became obsessed with requesting anyone who would take the time, including a few people associated with the IOM, to review this study in an effort to find any possible flaws. To date, absolutely no one has been able to find any. In fact, the feedback I have received has been quite the contrary. A number of respected people in medicine have said, that in their professional opinion, they believe the annual number of deaths in our nation most likely exceeds 440,000!

As utterly shocking as these numbers are, my biggest fear now is the very “human” conditioned response to problems that appear so incredibly overwhelming, hopeless, and unfixable. It’s very common for virtually anyone to go through a stage of complete denial with respect to the real situation and problem at hand. With this thought in mind, I am genuinely hoping and praying that we as a society, as well as, the medical community, patient safety oriented organization, and fellow advocates like myself, can get past this denial stage, as quickly as possible and truly begin fixing the problems associated with “human error”, internal systems, processes, and protocols, in medicine that are leading to hundreds of thousands of lives lost every year in America. With real hope, forgiveness, compassion, and collaboration, I truly believe we can get to zero deaths from preventable medical errors during my lifetime!

Recent media reports on deaths associated with preventable medical errors:


http://www.consumerreports.org/cro/magazine/2014/05/survive-your-hospital-stay/index.htm?fb_action_ids=10204438159658317&fb_action_types=og.likes&fb_source=aggregation&fb_aggregation_id=288381481237582


http://www.forbes.com/sites/leahbinder/2013/09/23/stunning-news-on-preventable-deaths-in-hospitals/


http://www.npr.org/blogs/health/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals?utm_campaign=storyshare&utm_source


http://m.healthcareitnews.com/news/deaths-by-medical-mistakes-hit-records

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  • Nate & Katherine

    A Letter to My Children

    Dear Nate & Katherine,

    I truly love and miss, both of you, more than you will ever know! I am so incredibly sorry that you both have had to endure the loss of your baby sister, the death of your uncle, and the breakup of your family in such a short period of time. You both were the absolute best big brother and sister ever and I know how much you both must still hurt and miss her! I genuinely hope and pray that you find some comfort and that you both always know in your heart that little Emily is still watching over all of us!

    Click Here to Read the Full Letter...

  • Our mission

    The Emily Jerry Foundation is determined to help make our nation’s, world renowned, medical facilities safer for everyone, beginning with our babies and children. We are accomplishing this very important objective by focusing on increasing public awareness of key patient safety related issues and identifying technology and best practices that are proven to minimize the “human error” component of medicine. Through our ongoing efforts The Emily Jerry Foundation is working hard to save lives every day.


    Thank You So Very Much for Your Support! ~Chris Jerry

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    Contact us

    We'd love to hear your stories and comments. Together we can save lives.

    chris@emilyjerryfoundation.org


    Advocacy Heals U


    Internet Radio Show Co-hosted by Joni Aldrich and Chris Jerry of the Emily Jerry Foundation

    Through my work as an advocate, I never really knew the profound healing that would occur on a personal level, as Emily’s father. It’s this type of healing process that can occur, for anyone who has experienced or is going through a life-changing crisis, that cohost Joni Aldrich (www.jonialdrich.com) and I, discuss on our weekly show called ADVOCACY HEALS U. Please join us every Tuesday at 2:00pm EST and find out how to be an advocate for positive change and how it can, subsequently, heal and inspire you too! Over any web enabled device, you can listen to the show by either going to www.W4CS.com or www.W4WN.com. If you happen to miss a show it will be rebroadcast each Saturday at 3:00pm EST. All our shows are archived on iHeartRadio.com. Click on the button below to scroll through the archives.