A risk-based integrated management for patient safety and quality in healthcare services
Quality of health care services and patient safety has become a matter of interest to healthcare professionals, researchers and governments all over the world. The aim of this paper is to show the implementation of the risk-based integrated management for
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National Center for Minimal Access Surgery Havana, Cuba Biomaterials Center, University of Havana, Habana, Cuba 3 Center of Medical Biophysics, Santiago de Cuba, 4 Public Health Fac., High Polytechnic School of Chimborazo, Ecuador 2
Abstract—Quality of health care services and patient safety has become a matter of interest to healthcare professionals, researchers and governments all over the world. The aim of this paper is to show the implementation of the risk-based integrated management for safety and quality at the National Center for Minimal Access Surgery in Havana, Cuba. Based on the structure, responsibilities and documents established for the health care service quality, thorough studies on patient safety and the risk-based thinking led to the development of an integrated system. This approach shifts the quality and safety management from reactively assessment of complications and incidents to proactive evaluation of the potential risks. Reporting of errors, injuries and complications can play an important role in the continuous health service improvement and as learning opportunities, may avoid future harm to patients. Keywords— risk management, quality management, patient safety, healthcare services. I. INTRODUCTION
Errors and injuries are common and often very serious in the delivery of health care. For this reason hospitals have created several offices and committees for managing service quality and patient safety. However, in many healthcare institutions these structures work independently without the understanding that safety is just one of the dimensions of the quality of health care, together with access, timeliness, efficacy, efficiency, appropriate measures and acceptability [1]. In the context of patient safety, errors are defined as a failure of a planned action to be completed as intended (error of execution) or the use of a wrong plan to achieve an aim (error of planning) [2]. Errors may manifest by doing the wrong thing (commission) or by failing to do the right thing (omission), at either the planning or execution phase [3]. To have a valid, reliable, and meaningful error rate an accurate data has to be compiled. However, in the best situations, the rate of reporting or identifying medical errors in the review of the records may not reflect the true rate. In fact, engaging health care professionals and staff about reporting errors, reducing risk and improving the safety and quality is a crucial but difficult task [4].
To manage all dimensions of the health care quality, a risk-based approach may be adopted, focused on identifying the underlying hazards in the health care service that lead to risky situations and finally to errors and injuries [2]. Off course, the appreciation of risks has to be based on the available data about the occurrence and consequences of errors and injuries. Reports about injuries and errors are one of the sources of risk identification. Other potential sources of risk identification include the published literature [5], medical device recalls, consulting experts an
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