954 / Analysis of preoperative pathway of patients waiting for orthopaedic elective surgery

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
Analysis of risk and harm
Assessment of risk and harm There is no specified text here
Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
Since the publication of the "To err is human" report by the Institute of Medicine in 2000, health systems have been paying increasing attention to patient safety as a fundamental prerequisite of healthcare, together with appropriateness and effectiveness. Among the improvement activities carried out by the Santa Maria Degli Angeli Hospital, there is the analysis , through the implementation of the Failure Mode and Effect Analysis (FMEA) of the preoperative pathway of patients waiting for orthopaedic elective surgery. The main aim of the practice is about analyzing the processes in preoperative pathway so to identify failures and to carry out improvement actions.
Description of the Patient Safety Practice
 
By carrying out a Failure Mode and Effect Analysis (FMEA) on the pathway of patients waiting for elective orthopaedic surgery, we identified the problems and proposed the solutions below: - Completeness of information to be given to patients: 4 booklets were produced and distributed; - Proper storage of medical records: dedicated space for admission folders created; - Proper information management through computer-based systems: ad-hoc staff training provided; - Proper management of medical records: updating of hospitalization forms with new information, monitoring of medical documentation, information to care workers through reports, publication of "Quaderni della Qualita" (Notebooks of Quality) and making data available on the restricted area of the website, continuous monitoring to increase and maintain compliance; - Reduction of waiting times: number of places increased for more in-depth tests on pre-hospitalized patients; - Proper management of surgical records; - Sharing of the tasks between ward staff and surgical staff.
http://buonepratiche.agenas.it/practicesdetail.aspx?id=3722
Attachment of relevant written information and/or photos, as appropriate
201403070428012103_WP4_102_WP4_AOPN%20DESCRIPTION[1].pdf
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Unit or ward 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
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Administrative support (secretary, clerk, receptionist etc.)
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
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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/practicesedit.aspx?id=2912
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
Regular data feed back to 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
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Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Nicola Delli Quadri - Alessandra Santarossa
Country: ITALY
Organisation: Azienda Ospedaliera Santa Maria degli Angeli - Pordenone
E-mail: nicola.delliquadri@aopn.fvg.it
Phone: 0039 - 0434399744
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