1199 / Computerization of SOS.net checklist for surgical safety

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
Identification of risk and harm
Implementation of Patient Safety initiatives / Activities There is no specified text here
Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
Since 2010, the Rizzoli Orthopaedic Institute of Bologna has joined the project of the Emilia-Romagna Region called "SOS.net project: Network for safe operating theaters", adopting the regional checklist for surgical safety in hard copy from three surgical units. Over the years, the adoption of the checklist has been extended to all surgical units, thanks to the computerization: we have been starting a process of computerization of operating rooms, which also included the introduction/editing tools for the management of clinical risk in the operating room.
This change has allowed not only to integrate the moment of verification, thanks to the surgical safety checklist, with the detection of deviations from the expected standard, but also to be able to have specific reports in real time.
Description of the Patient Safety Practice
 
Since the early months of 2010, the Health and Social Agency of the Emilia Romagna region has set up a multidisciplinary working group, with the aim of adapting the ministerial document "Safety Manual in the operating room: recommendations and checklists" to the regional context and developed the" Recommendations for safety in the operating room", spread to health districts of Emilia Romagna in March 2010. In parallel, the same agency initiated the "SOS.net project: Network for safe operating theaters", with the aim of making surgical procedures safer, through the application of surgical safety checklist in the operating rooms of health facilities of its territory. Among the various activities undertaken, the Agency made available to companies participating in the project a dedicated database for the registration of the checklists and the non-conformity recorded. In the same period, the Rizzoli Orthopaedic Institute joined the Project and then started the process of computerization of operating rooms. It was decided to computerize the surgical safety checklist, along with other useful tools for patient safety, in order to facilitate the time to test, carried out by the checklist, with that of non-compliance through a single screen filled in the operating room via touchscreen, thus improving compliance to the use of the tool. Some results: in 2013, compliance with the checklist was 78.5%, in 2014 it was 39.3%, in the first half of 2015 it was 45.9%, in September 2015 it was 92.4%. The detection of deviations from the standard (non-compliance) is analyzed periodically by the medical department and the results are sent to the respective departments. There have been meetings between the direction and the health units involved in the analysis of results.
Attachment of relevant written information and/or photos, as appropriate
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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
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
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
Rolli M, Di Denia P, Accarisi S, Sassoli V, Facchini F, Cavallini C, Lorini V, Porcu E, Tedesco D. L’informatizzazione del Blocco Operatorio all’IRCCS “Istituto Ortopedico Rizzoli” di Bologna. e-Health 2014; 29
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
Not relevant
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
Clinical support
Technical support / technician
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=5313
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.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Staff and management recognised the need for change
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
Not relevant
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
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Contact information
 
Name: Patrizio Di Denia
Country: ITALY
Organisation: Istituti Ortopedici RIZZOLI - Bologna, Ufficio Risk Management
E-mail: patrizio.didenia@ior.it
Phone: There is no specified text here
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