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892 / A general-risk scale for preventing hospital adverse events

SPAIN
Classification of the PSP
Type of Patient Safety Practice Potentially Safe
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Assessment 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
 
Clinical safety management in nosocomial complications and prevention planning.
Description of the Patient Safety Practice
 
Most adverse events in the surgical procedures, and nosocomial, appear postoperative. This PSP is based on the introduction of an additional step in the traditional assistance in hospitals with medical-surgical shared care (co-management). It consists of supplementing the traditional postoperative assessment, generally based on a consultation with the Anaesthesia Service, with a nosocomial risk stratification method. A risk level is estimated for each case, which allows a classification of patients according to their estimated risk levels to suffer adverse events during the recovery period while hospitalized, and further an ultimate planification of adequate preventive meassures for each case, taking into account the total time of hospital admission. To sum up, our PSP starts off with a consultation with a member of the Internal Medicine team implicated in the shared care medical-surgical in the hospital. This consultation takes place at the same day as the Aneaesthesia preoperative consultation, and does not cause delays in preoperative times. This consultation consists of a structured interview upon which patients are ranked in the hospital information system within a scale based on three type of data: - Previous health status of the patient. - Degree of complexity of the surgical procedure. - Presence of risk factors for the appearance of adverse effects or complications during their hospital stay. The stratification of patients in three levels under this procedure, leads to an automatic plan for care and surveillance (more intensive for each level) within the hospital information system before entry, and during the whole hospitalization period. The surveillance intensity levels have been previously agreed among surgeons, internists and nursery responsible for the hospital ward monitoring and care, as well as by the hospital management. This PSP began implementation progressively throughout 2013 and we still do not have an outcome evaluation.
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
Institution level
Specific and measurable outcome for the reported practice were defined
No
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Not known
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
Not relevant
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
Clinical 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
Yes
Short description of the service users' level of involvement
User-led, where the service users control the development and implementation of the PSP
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
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
Staff or management did not recognise the need for change
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: José Feyjoo
Country: SPAIN
Organisation: Hospital Sanitas La Zarzuela, Madrid.
E-mail: feyjoo@terra.com
Phone: 0034629544468
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