1142 / Clinical risk assessment at the Local Health Trust of Sassari

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Analysis of risk and harm
Assessment of risk and harm There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
The main goal of the project is to identify the most appropriate methodology for the identification of the most frequent / more damaging errors and define associated risks that could occur within the clinical processes of Sassari Health Authority. The project is therefore a first milestone for the implementation of risk prevention / containment in Sassari Health Authority. Key words: methodology risk assessment Bottom-up approach clinical process prospective approach.
Description of the Patient Safety Practice
 
The identification process included: 1) The analysis of the methods of risk assessment proposed in the literature and in particular those based on: a. data base analysis; b. good practice benchmarking and implementation level in Healthcare Organizations; c. professionals consultation/interview; 2)The application of the methodology in the Local Health Trust of Sassari, which revealed that the professionals consultation (based to bottom-up approach), integrated with the other two, is the best answer in the context. Indeed, sharing information with the Clinical Risk Management Unit, the active involvement of operators who daily "live" the healthcare process allows a realistic analysis, bringing themselves to "rethink" on their practice with the aim of continuous quality and safety improvement.
The method is based on the pro-active analysis technique, in particular : - FMEA (Failure Mode and Effect Analysis) to prospectively qualitative risk assessment in the pathway, identifying process potential failure points / errors for each step of the process and related causes. - FMECA (Failure Mode and Effect and Criticality Analysis) to prospectively quantitative risk assessment in the pathway, calculating the risk priority number (RPN) of each failure point based on the severity of the failure, the frequency of occurrence, and the likelihood of detecting the failure. The results of the analysis are summarized in the “Risk assessment worksheet” (FMEA/FMECA Form worksheet) that determines quantitative and qualitative value of risk related to activities for each step of the process, highlighting failures. Based on the FMEA Form worksheet's data, Priority Master List is built to put in descending order "failure modes" of process respect to RPN related. Analysis Results indicators (Intermediate Results): - N° failures for Phase - Type of failures for Phase - Level of risk (RPN) for activities The final results of the project (results of the application of the risk assessment method to the processes), were evaluated in terms of validity, effectiveness, compliance level and reproducibility of the instrument used. Project results indicators (Final Results): - N° examined processes / Total processes in the Operative Units - Degree of compliance of the actors involved - Team management level - Level of ability to transfer / learning "Process Management" concepts - Tool management skills - Tool utilization level.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
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
There is no specified text here
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
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Health care assistants
Pharmacists
Therapists
Technical support / technician
Administrative support (secretary, clerk, receptionist etc.)
Clinical manager
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
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=5002
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
No management support
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: Rosamaria Marchi
Country: ITALY
Organisation: ASL1 SASSARI
E-mail: rmarchi@aslsassari.it
Phone: There is no specified text here
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