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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
CLINICAL RISK MANAGEMENT IN HEALTH SERVICE
Minerva Ortopedica e Traumatologica 2006 October;57(5):419-21
Promote the charitable quality running down on the process of management of the risk
Tessa L., Raciti I. M.
Direzione Sanitaria A.S.O. San Giovanni Battista, Torino
In our country and in the international context there is at present a renewed interest about security and the good quality of performances; in the sanitary field the subject of risk management for the patients is mainly considered as the management of the clinical risk and requires a strong integration demand between the quality and security systems. In the Italian system, a series of cultural and psychological reasons and above all the fear of medico-legal consequences lead to a strong resistance by professionals. Such resistances must be faced with an appropriate methodology which protects the professional but, above all, it is necessary to do our best to improve and modify the way to consider the mistake. Therefore, the sensibilization, the specific formation taking into consideration the criticisms of the professionals on these subjects represents the beginning of a program of risk management. The adverse events problems occurred to patients in the hospital have been in Italy till now only poorly treated, both from the point of view of the risk typology and of the techniques and tools of measurement. During the last decade, the criminal and civil actions in this field have increased and the phenomenon of the mistake in medicine is assuming no more negligible dimensions. In this context, there is now an increasing tight relation in the business systems among quality, security and management of the risk. The purpose of an approach to the clinical risk management is to help the operators improve the security and the total quality of cares. To such purpose, the process must be holistic, both with reference to the nature of the risk and to its management aspects; however, it is useful to focus a few specific aspects of the risk for the user. At the Azienda Sanitaria San Giovanni Battista in Turin, a project of prevention of the adverse events which can occur to patients following surgical intervention has been activated. The idea of developing a system of management of the clinical and charitable risk in this structure was due to the important organizational and legislative changes, the improvement of the good quality of the services and the remarkable increase of the insurance and managing costs.