Process Control Charts in Falls Prevention: The Experience of the Local Healthcare Authority of Romagna, Italy
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ORIGINAL PAPER
Process Control Charts in Falls Prevention: The Experience of the Local Healthcare Authority of Romagna, Italy Michele Scagliarini 1
&
Nunzia Boccaforno 2 & Roberto Donati 2 & Marco Vandi 2 & Elisa Ponti 2 & Simona Nanni 2
Received: 14 September 2019 / Accepted: 29 April 2020 # IUPESM and Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Patient safety is a great concern of healthcare institutions and the correct reporting and management of adverse events is a key element for supporting safety improvement efforts. Patient falls are the most frequent adverse event in hospitals and often cause serious patient outcomes. In this work, we describe the experience of the Local Healthcare Authority of Romagna, Italy that, within the framework of a quality and safety improvement programme, designed, developed and implemented a desktop application for monitoring inpatient falls. A multidisciplinary team created a software tool based on R, an open source software for statistical computing that, appropriately combined with the existing hospital information system, is used to obtain Shewhart ucontrol charts for monitoring the monthly fall rates. The tool had been implemented in twenty nine hospital units. The results indicate that the proposed application gave a valuable contribution in the safety improvement activities. Its usefulness extended beyond the “safety problem” as it also enabled hospital managers to identify a number of critical issues in data collection. As a result, where necessary, improvement actions had been implemented. Furthermore, the use of open source software led to a considerable cost reduction and facilitated customization of the software tool. Keywords Adverse events . Control charts . Desktop application . Hospital information system . Patient safety
1 Introduction Healthcare organizations are continuously engaged in increasing or maintaining high levels of quality and safety of care. * Michele Scagliarini [email protected] Nunzia Boccaforno [email protected] Roberto Donati [email protected] Marco Vandi [email protected] Elisa Ponti [email protected] Simona Nanni [email protected] 1
Department of Statistical Sciences, University of Bologna, Italy, Via delle Belle Arti, 41, 40126 Bologna, Italy
2
Azienda Unità Sanitaria Locale della Romagna, Viale Settembrini 2, 47923 Rimini, Italy
Among the many activities carried out to sustain these programs, the correct reporting and management of adverse events is a key element for supporting all improvement efforts. In order to ensure patient safety, evidence-based systems are implemented and the monitoring of adverse events constitutes one of an array of methods used by hospital management teams in the pursuit of safety [1]. Patient falls are one of the most frequent adverse events in healthcare institutions [2]. A patient fall often causes serious consequences which include an increase in the period of hospitalization and a reduction in the quality of l
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