1244 / Tracer as a tool to assess quality of care

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
Patient safety culture / Patient safety climate
There is no specified text here There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
The aim of the program was to map the processes shown to be particularly critical in the hospital. In particular, the following areas have been identified: Patient identification, Communication of critical values, Informed consent, Safety of surgical patient, Patient falls, Pain, Nutrition, Trasport of patient, Good use of blood, Confidentially information of patient.
Description of the Patient Safety Practice
 
In 2013, the University Hospital of Udine, starting from the previous experiences with the Joint Commission International, has launched a program for the monitoring of certain themes focused on treatment and patient care. It has been used the tracer methodology that is "an evaluation system to measure the quality of care and services provided by a health care organization from the perspective of the patient, through his experience". The traces, therefore, provide a way to evaluate a health care system and its procedures. The program was coordinated by the Accreditation, Clinical Risk Management and Performance Assessment Unit. The tracer was made in the period between July and September 2013. It has been involved a team of various professionals who participated to a specific course. Each observer was given a checklist specific to the subject matter of tracer. It has been prepared a set of 11 checklist with YES or NO as possible answer with a field for eventual comments. Each checklist was characterized by a series of items. Totally, 89 items were checked. Observers collected information by consulting documents, direct observation in the ward and interview to staff or patient. The data were collected and processed through the Excel program (Microsoft office 2007).
During the observation period 115 tracer were made and 26 wards have been visited(65%). A total of 27 health workers have been involved, including two ward directors, five doctors, nine medical residents, a biologist, eight nurses and two laboratory technicians. Each tracer was carried out according to a schedule and it required about an hour for each health professional. The results showed that the subjects who achieved a good compliance (= 80%) were: patient identification, communication of critical values, expression of informed consent, patient safety surgery, pain, good use of the blood. While the areas in need of improvement actions were: patient falls (56%), nutrition (34%), internal transport (60%), confidentially information of patient (43%). Part of these data have been supported by the existence of data in the institution and regional databases.
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
No
A measurement after full implementation of the reported practice was obtained
No
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
There is no specified text here
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
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
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Involved health care staff
 
Physicians
Nurses
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(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
Collaboration, such as co-designing a Patient Safety Practice or active partnership in implementation
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=5067
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
Specially trained staff
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
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Adriana Moccia
Country: ITALY
Organisation: AZIENDA OSPEDALIERO-UNIVERSITARIA UDINE
E-mail: adriamoccia@aoud.sanita.fvg.it
Phone: There is no specified text here
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