1125 / "Open disclosure": Communication and support in adverse event

ITALY
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Identification of risk and harm
Human factors There is no specified text here
Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
Ensure a transparent, timely, accurate and complete communication between health professionals and citizens.
Description of the Patient Safety Practice
 
Since 2000 we have been defining procedures for managing claims that include an upstream selection of cases of technical-professional interest with the cooperation between corporate management and the clinical specialists in the formulation of the answer. Subsequently, we defined a procedure for handling the reported cases trying, where possible, to have a direct dialogue with the person harmed; patients or relatives have always been allowed to ask for an external opinion and a copy of health records was also made available in short time. In 2011 protocols “Managing and communicating adverse events” and “Corporate path for the support of patients and their relatives and of the operators involved in adverse events” were formalized. The corporate path provides 1) the psychological support, the cultural mediation for patient and his relatives and possible additional diagnostic-therapeutic investigations (for free) for foreign users 2) the support of the competent physician who may advise healthcare professionals toward psychological counseling as well as the consulting of the legal department or of the forensic specialists. In 2014 the following procedure was developed: in case of death and subsequent diagnostic examination it involves a conversation between a doctor or the hospital directorate and the relatives of the deceased for the delivery of the related report containing the data antomopathological to respond quickly to question and doubts of the family.
An example of "open disclosure" and of structured support was the experience we have undertaken since 2011, following the withdrawal from the market of a group of metal-on-metal hip implants. We have then been recalling 92 patients (for a total of 108 implants/prosthesis; 16 of them were bilateral). The path involved several departments (orthopedic, laboratory, radiology, cardiology, hospital directorate, forensics, clinical risk , legal department) in an integrated fashion.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
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There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Mental health care
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple specialities across different health care settings
Involved health care staff
 
Physicians
Nurses
Health care assistants
Clinical manager
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient organisation(s)
Point of time in which service user or their reprasentatives' involvement takes place
During the application of the Patient Safety Practice
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
No
Short description of the service users' level of involvement
Not known
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/questionnaire.aspx?id=4627
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Other
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Luca Giacometti - Claudia Giuliani
Country: ITALY
Organisation: ASS5 BASSA FRIULANA
E-mail: luca.giacometti@ass5.sanita.fvg.it
Phone: There is no specified text here
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