058 - Risk evaluation
Autor(s): A. Tinivella, P. Rizzotti
Issue: RIMeL - IJLaM, Vol. 2, N. 3-S1, 2006 (MAF Servizi srl ed.)
Page(s): 58-61
In recent years among Western Healthcare Organisations, a new methodology has been established to better address risk management issues. The responsibility for medical diagnosis and treatment is entrusted to skillful healthcare providers. Nevertheless, however competent these healthcare providers are, there is still a likelihood of errors occuring such as misdiagnosis leading to critical patient safety issues. Therefore, today, the theory is that a more holistic approach to risk management will improve clinical practice, enhance the growth of a more patient-oriented therapy (rather than disease-oriented therapy) and reduce overall costs. As a consequence these savings can be redirected to produce safer and more efficient health facilities and services. According to this new risk management approach, which has been proposed by the Scientific Community, the responsibility for patient safety issues relies on implementing a system adapted to the whole structure as opposed to one distinct element. This methodology will only be successful if it operates within a culture which encourages openness and transparancy. In other words, it relies on medical staff taking responsibility for their mistakes and working together with their team to improve procedures in order to prevent the same errors occuring in the future. The aim is prevention and protection. The ideal methodology should be both predictive (ie it should detect signs that the system is beginning to fail before the accident occurs) and reactive (ie. it should be able to examine the accident after it happened). To this end, FMEA (Failure Mode and Effect Analysis) has been intro duced. This means a systematic method to proactive evaluate system and product vulnerabilities and it is also a multidisciplinary team-based approach to error prevention. A holistic risk management approach needs to address a number of deficiencies which can occur throughout the health care service at all different levels from stages of preventative medicine to after-care services. Such unsatisfactory care is often the result of inattention to details or procedures, failure to provide access to care, faulty systems, a lack of support, or poor communication leading to patients feeling neglected or humiliated without access to the correct information. At each stage, one error can lead to a series of unforseen errors which affect patient safety. Improvements will only happen if medical staff understand how to reduce the risks, consider possible risks on a daily basis, take responsibility for their mistakes and work together to make improvements as a team. A quality approach needs to be achieved and that will only happen if change comes from within.