705 / From reporting to improvement actions: "the unwritten story of incident reporting"

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Reporting and learning systems
Implementation of Patient Safety initiatives / Activities There is no specified text here
Topic of the reported practice
Professional learning program on quality and safety
Aim and the benefit of the Patient Safety Practice
 
The use of incident reporting systems has international evidence of effectiveness to increase the safety of patients, professionals and organizations.
The Teaching Hospital of Parma (Italy) has planned and implemented an initiative “From Incident Reporting to improvement actions", in order to promote safety culture between professionals.
Description of the Patient Safety Practice
 
A new training program with Continuing Medical Education (CME) credits has been realized, through a structured methodology and an interactive small group work with expert supervision on "never written cases" reported by professionals. The project results are encouraging: after the initiative, professionals engaged in risk management, describe the immediate improvement actions undertaken or planned in the short to medium term, to increase safety in the processes of care and organization. http://buonepratiche.agenas.it/practicesdetail.aspx?id=3430
Evaluation tools: Process indicators - professionals involvement of professionals . The sample ( n = 174 ) is made up of nurses (59% ) , doctors (24 % ) , technical staff (13 % ) , biologists ( 1 % ) . 88% of respondents declared that Incident Reporting (IR) is a useful tool for risk management , while 6 % said that this is useful only in part. 41% of the participants declared , before the training, he had already compiled an IR directly within department or service , 57% had not had the opportunity to participate in its compilation and only 2% of the sample did not provide an answer. The reasons given by professionals who have not drawn in the IR were : lack of knowledge (15%) , lack of time (7%) , lack of confidence ( 2%), fear of disciplinary sanctions ( 2%), fear of criminal sanctions ( 1%).
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Hospital
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple specialities within the same setting
Involved health care staff
 
Physicians
Nurses
Pharmacists
Therapists
Technical support / technician
Clinical manager
Quality manager
Risk manager
Other or not relevant
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Patient representative(s)
Point of time in which service user or their reprasentatives' involvement takes place
During implementation of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
No
Short description of the service users' level of involvement
Consultation, such as asking for information
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/practicesdetail.aspx
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Sharing of progress information among involved staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Giovanna Campaniello, Antonella Dovani
Country: ITALY
Organisation: AZIENDA OSPEDALIERA DI PARMA
E-mail: gcampaniello@ao.pr.it
Phone: 0521702451
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