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A Journal on Forensic Medicine
Minerva Medicolegale 2010 July-December;130(3-4):145-54
New rules on reporting errors in health care
Dipartimento di Scienze Anatomiche, Istologiche, Medico-Legali e dell’Apparato Locomotore, Università di Roma “La Sapienza”, Roma, Italia
The author analyzes the applicative implications of the recent Decree of the Ministry of Labour, Health and Social Policy, dated December 11, 2009 , entitled “Establishment of information system for monitoring errors in health”. The monitoring of sentinel events is essential to contain the risk of damage to the assisted and to improve the quality and safety of care in the NHS. To avoid errors, we must first know them, which means be prepared to recognize, inventory, study and learn from them. To this end the Ministry of Health created Simes, belonging to the New Health Information System, which centrally collects reports submitted by the peripheral health facilities, through the regions. SIMES is delegated to the activation of the National Observatory of sentinel events, that have the task of analyzing and treating a specific bill that will be made available to all professionals. The success of the Decree will depend heavily on the compliance of Article 14 of the Code of Medical Ethics and it also depend on the spread of a culture of risk, and abandon the concept of error in any event guilty against the doctor who spoke in the individual case.