Clinical risk management

Journal title RIVISTA SPERIMENTALE DI FRENIATRIA
Author/s Pietro Ragni, Roberto Grilli
Publishing Year 2015 Issue 2015/3
Language Italian Pages 14 P. 117-130 File size 2187 KB
DOI 10.3280/RSF2015-003008
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The issue of reducing avoidable harm to patients, in a health care organisation, can be addressed either through a perspective based on clinical risk, or through an approach focusing on safety. The two methods are different, but not mutually exclusive. The first focuses on risk and studies the linear and predictable relationships among the different components of a productive process. It consents the identification of errors and of their causes, and helps to describe the degree of vulnerability of a system. Finally, it implements preventive actions which reduce the probability of error and contain the risk of harm to the patient. The second approach examines safety, rather than risk. It focuses on the patient and less on the organisation. It thus studies, not only current or potential errors, but also care delivery processes which might expose a patient to a "unnecessary" risk (e.g. inappropriate care).This approach not only prevents errors, but also enhances the quality of care (i.e. clinical effectiveness) by taking into consideration the patient’s preferences.

Keywords: Clinical risk management, safety, complex systems.

  1. [1] Ministero della salute. Glossario
  2. [2] Kohn LT, Corrigan JM, Donaldson MS. To err is human. Building a Safer Health System. Washington, DC: Institute Of Medicine, National Academy Press; 1999.
  3. [3] Ministero della salute. Risk Management in sanità. Il problema degli errori. Roma: Ministero della Salute; marzo 2004.
  4. [4] Vincent C. Patient safety, La sicurezza del paziente. Roma: Esse Editrice; 2007.
  5. [5] Consiglio dell’Unione Europea. Raccomandazione 9 giugno 2009 sulla sicurezza dei pazienti, comprese la prevenzione e il controllo delle infezioni associate all’assistenza sanitaria (2009/C 151/01).
  6. [6] Dekker S. Sicurezza e pensiero sistemico. Milano: Hirelia Edizioni; 2012.
  7. [7] Parlamento Europeo. P8-TA- PROV 2015(0197). Un’assistenza sanitaria più sicura in Europa. Risoluzione del Parlamento Europeo del 19 maggio 2015 su un’assistenza sanitaria più sicura in Europa: Migliorare la sicurezza del paziente e combattere la resistenza antimicrobica. (2014/2207 INI).
  8. [8] Funtowicz SO, Ravetz JR. Science for the post-normal age. Futures 1993; 25 (7): 739-755.
  9. [9] Cillers P. Complexity and postmodernism: understanding complex systems. London: Routledge; 1998.
  10. [10] Panà A, Amato S. Il rischio clinico. Metodologie e strumenti organizzativi gestionali. Roma: Esseditrice; 2007.
  11. [11] Caminati A, Di Denia P, Mazzoni R. Risk Management. Manuale teorico pratico per le professioni dell’assistenza. Roma: Carocci Faber; 2007.
  12. [12] Ministero della salute. Sicurezza dei pazienti e gestione del rischio clinico. Roma: Biblioteca La professione; (anno non indicato).
  13. [13] Decreto Ministero della salute 11 dicembre 2009. Istituzione del sistema informativo per il monitoraggio degli errori in sanità. GU Serie Generale n. 8 12.1.2010
  14. [14] Federazione Nazionale degli Ordini dei Medici Chirurghi e Odontoiatri. Codice di Deontologia Medica. Roma; 2014
  15. [15] Ministero della salute. Safety Walk Round – Manuale. Roma: aprile 2012
  16. [16] Royal College of General Practicioners. Significant Event Audit.
  17. [17] Ministero della salute. L’audit clinico. Roma; maggio 2011.
  18. [18] Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AHS, Dellinger P, et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. New England Journal of Medicine 2009; 360:491-499.
  19. [19] Cook R, Rasmussen J. Going solid: a model of system dynamics and consequences for patient safety. Quality and Safety Health Care 2005; 14:130–4.
  20. [20] Rydenfält C, Ek Å, Larsson PA. Safety checklist compliance and a false sense of safety: new directions for research. British Medical Journal Quality and Safety 2014; 23:183–6.
  21. [21] Anthes E. The trouble with Checklists. Nature 2015; 523, 516-8.
  22. [22] Greenhalgh T, Howick J, Maskrey N. Evidence based medicine: a movement in crisis? British Medical Journal 2014; 348: 3725. DOI: 10.1136/bmj.g372
  23. [23] Malherbe JF. Sette richieste filosofiche alla bioetica. I quaderni dell’Hospice Madonna dell’Uliveto. Albinea; 2011.
  24. [24] Cosmacini G. L’arte lunga, Storia della medicina dall’antichità a oggi. Bari: Laterza; 2009.

Pietro Ragni, Roberto Grilli, La gestione del rischio clinico in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2015, pp 117-130, DOI: 10.3280/RSF2015-003008