383 / Create a multidisciplinary unit to manage the risks relating to patient safety

SPAIN
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
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
In the Integral Control Panel 2006-08 of the Foundation Hospital Calahorra (FHC), retires as strategic aims those related to the safety of the hospitalized patient. In the year 2006, workgroups are created to identify safety areas: falls, pressure ulcers, adverse reactions to medicines, infection of central and peripheral route , blood transfusion and hemotherapy, and newly born. Of every area there was done a modal analysis of reasons and effects (MARE). One of the areas of improvement detected was the need to create a Functional Specific Unit of Management of Risks as for Security in the FHC, which was allowing an integrated management of all the areas.
In the year 2009, the Ministry of Health and Social Politics of the Government of Spain approved and financed its creation. It is evident, both in Spain and in other countries, which to carry out a suitable management of risks inside the sanitary environment, to create a safety culture, to detect and to avoid the adverse events that the sanitary practice generates, to promote and to improve the not punitive notification , there is necessary an integrated boarding that allows a sanitary excellent and sure attention for the patients. In our organizational model for processes, these matrix structures ensue from special value, and fit to the perfection when the quality is orientated towards the patient.
In addition, there need persons and teams awkward and formed and trained as for safety, with a clear commitment in the constant improvement, making turn all his your effort in obtaining a sure Hospital thanks to the actions undertaken to obtain the aims, involving patients, professionals, relatives, institutions and sanitary policies in the unique alliance.

General aim: Guarantee a sanitary sure, excellent attention and of maximum quality to the patient hospitalized of the Foundation Hospital Calahorra

Specific aims :
1. To promote the not punitive culture of the management of the mistake in safety topics , and the incorporation of routines of management of risks among our professionals by means of the training and learning
2. System of anonymous notification of adverse events
3. Participants do both professionals and users and institutional local organizations of the above mentioned aims and its fulfillment.
4. To identify and to develop specific areas of management of safety risks:
    - Elder abuse
    - Falls
    - Phlebitis of venous route
    - Sores for Pressure
    - Mistakes in medication and adverse reactions for medicines
    - Intimacy of the patients
    - Infection nosocomial
    - Patients' unequivocal identification
    - Security in hemotransfusión
Description of the Patient Safety Practice
 
I target 1. To promote the not punitive culture of management of the mistake in safety topics and the incorporation of routines of management of risks between(among) our professionals across a suitable formation(training).
Activities: 1) Conference of Security of the Patient in the FHC on April 2010, and January, 2011, and April 2012; 2) Formation in safety topics and responsibility to all the professionals of the hospital. Workshops twice-monthl Kaizen; 3) To continue with the design of records of adverse not wished events that guarantee the anonymity and favor the wilfulness at the moment of being declared on the part of the professionals, 4) they make all the professionals and patients participants.
Instruments: 1) Meeting teams to design records, to agree on them and to validate them so much for the UFEGRS-FHC, Qualit coordinator of the FHC, Commission of Quality and Hospital Readers, 2) To continue realizing security surveys to patients and professionals on opportunities of improvement and suggestions as for safety topics, 3) Informatics support that could generate us overturned of information for valuation and putting in march of actions of improvement

2. They make users and relatives participants
Activities: 1) To give information about safety to all the hospitalized patients; 2) Surveys to patients and professionals; 3) To issue reports of the above mentioned results and to spread them.
Instruments: 1) To have surveys formalized and agreed both by the direction(address) of the center and by the members of the Functional Specific Unit as for safety, 2) Media of local communication and hospital intranet for the diffusion of the results obtained in the surveys and of the actions(shares) of improvement to develop that have been generated of the same ones; 3) Social networks.

3. To identify and to develop specific areas of management of safety risks
Activities:
In relation the safety area "FALLEN DOWN": 1) Nursing Procedure of prevention of falls, as well as the Informed Consent for Physical Subordination; 2) Informative diptych; 3) To avoid water excess in the floor; 4) To check all the measures and external devices of safety as rails, etc. Existing both in common zones of the Hospital and in every room with the aim(lens) to put and/ó to improve the existing thing; 5) Form of Communication of Falls registered of the clinical electronic history, in order to establish preventive suitable measures and to avoid the Fall.
In relation to the safety area "HOSPITAL ESCAPE" : 1) One is employed at the elaboration of the Nursing procedure at the prevention and performance before an escape; 2) Likewise in the elaboration, consensus and validation of a Communication form and action after an escape
In relation to the safety area “ Newborn child and breast-fed baby ”: 1) The priority action is to improvement the training of the personnel as for the programs of notification of infantile mistreatment (it will be realized in the days of Security of the Patient that will be carried out in May, 2010), 2) The unequivocal identification of the newborn.
In relation to the safety area “ PHARMACOLOGICAL TREATMENTS ”: 1) Record of Adverse Not wished Events; 2) Electronic prescription and Alerts; 3) To identify medicines of high risk; 4) Information of the medicine in the moment of the hospitable discharge
In relation to the safety area “ TREATMENTS WITH HEMODERIVADOS: 1) Procedure of hemoterapia.

Instruments: Technology(Skill) of Modal Analysis of Failures and yours Effects

4. To stimulate and to spread the Functional Specific Unit of Management of Risks as for Security in the FHC.
Activities: 1) To continue with programmed activities leading the safety areas defined in 2009 and the new areas of safety detected in 2010; 2) To give diffusion of the activities programmed so much to promote the participation as(like) to report of the results and actions(shares) of improvement.
Instruments: 1) Team Meetings according to established chronology; 2) Informatic support, hospitable Intranet updated with the above mentioned news

5. Patients' identification
Activities: Bracelet for identification of every patient in the moment of the hospitalization
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, partly
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
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
XXVIII Congress of the Spanish Society for Quality Healthcare, La Coruna (Spain) 2010
XXXI National Congress of the Spanish Society of Internal Medicine, Oviedo 2010
XXXII National Congress of the Spanish Society of Internal Medicine, Gran Canaria 2011
Hospitals National Congress, Madrid 2011
Clinical Management Workshop, Calahorra 2011
Autumn Day, SEMES, Teruel 2012
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Home care
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
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 evaluation of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Consultation, such as asking for information
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
Patient Safety Conference, held in Calahorra (La Rioja, Spain) years 2010.2011, 2012
Local radio programs in 2011 and 2012 in Onda Cero, Calahorra
Local newspapers and magazines.
Diptychs of information delivered to patients and hospital users.
Medical Journal:http://www.diariomedico.com/2011/04/26/area-profesional/gestion/calahorra-implicar-personal-seguridad
Blog SobreviviRRHHe!: Http://sobrevivirrhhe.blogspot.com/.../ii-jornadas-seguridad-paciente-fhc.html
Page with all presentations slideshare: www.slideshare.net / segpacfhc
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
Involvement of service users did not happen
Lack of incentive
No motivation among staff
Not sufficient human resources available
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: Jesús Castiella
Country: SPAIN
Organisation: Fundación Hospital Calahorra, La Rioja
E-mail: jcastiella@riojasalud.es
Phone: There is no specified text here
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