551 / Hip replacement diagnostic and therapeutic pathway

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Surgical / Invasive procedures
Deep venous thrombosis There is no specified text here
Topic of the reported practice
Clinical guidelines or pathways
Aim and the benefit of the Patient Safety Practice
 
To check the possibility of including items proposed by the Italian Registry of the Orthopaedic Prosthetic Implants (RIPO) in the macro-management model of care of Hip Replacement. In VCO Orthopaedics Departments most implants are cementless, used at both femoral and acetabular level. Only in special cases cemented or hybrid and custom made protheses or anatomical implants are used.
Description of the Patient Safety Practice
 
Based on the accreditation requirements of the Piedmont Region, a clinical audit was conducted. This revision allowed identification of critical points, organizational redundancies, wasted resources, shortcomings and the resulting corrective actions. Corrective Actions: a set of indicators was identified and evidence based standards were adopted. Several procedures were defined, including: patient identification, surgical site and side, pain assessment and management, management and removal of catheters and drainage, prevention of thromboembolism and nosocomial infections. Some results: - Surgical site identification in accordance with the procedure/ total clinical records: from 11% to 58%; - Deep venous thrombosis prophylaxis in accordance with the protocol / total clinical records: 100% confirmed; - Short-term antibiotic prophylaxis (peri-operative) according to protocol / total clinical records:from 34% to 73%; - N. of patients who underwent count of gauze according to procedure/tot. n. of patients operated: from 36% to 100%; - N. of patients who underwent reoperation within 15 days after the first intervention/total n. of interventions: 0; - N. of patients with analgesic treatment post-operative according to the Hospital Without Pain Committee protocol: from 11% to 89%
Attachment of relevant written information and/or photos, as appropriate
103_WP4_Results_Hip replacement.pdf
There is no specified text here
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
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
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
Yes
Specification of implementation in another health care setting(s)
Hospital
Successful implementation's level  of this Patient Safety Practice across settings
No, not known or not relevant
Involved health care staff
 
Physicians
Nurses
Health care assistants
Pharmacists
Therapists
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
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient representative(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
http://buonepratiche.agenas.it/practicesdetail.aspx
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
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
Sharing of progress information among involved 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
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: Margherita Bianchi
Country: ITALY
Organisation: Ospedali Riuniti ASL 14 Piemonte
E-mail: margherita.bianchi@aslvco.it
Phone: There is no specified text here
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