Objective: The purpose of this research is to track and reduce risks so as to prevent errors within the process of health care. The aim is to design an organizational information model using error prevention methods for risk assessment. Method: In order to assess the risk of errors, the Health Care Failure Mode and Effect Analysis is used. To determine the causes of the errors, the Root Cause Analysis is used. Results: Results of the process analysis following corrective measures shows that the risk assessment of individual lahko uporablja v namen opredelitve dejavnikov za nastanek napak, izgradnjo baze znanj za učenje iz napak ter za kontinuirano verifikacijo in prilagajanje organizacije spremembam v okolju s ciljem preprečevanja napak. Ključne besede: zdravstvo, varnost bolnika, napake, informacijsko-komunikacijska tehnologijaThere is significant attention in scientific journals and other relevant sources given to the empirical study of methods of analysis for risk assessment in the industry. In health care, it is possible to trace some of this research and analysis in the international environment (11-13). To date, there have been no studies conducted in Slovenia as presented in the paper. The purpose of our research is to reduce risks and hence prevent errors in the process of the delivery of health care. The aim is to design an organizational information model using error prevention methods for risk assessment in a clinical setting. The model is based on selected indicators of quality nursing care, resulting from world-known theoretical and practical models combined with experience in Slovenian health care. This article presents the use of HFMEA in combination with other methods, techniques and tools for risk assessment model developing. The new organizational information model and software solution designed to prevent errors within the process of health care is described. The article concludes with a discussion of implications from this study for both health care providers and health policy officials involved in outcomebased, quality improvement initiatives. METHODSThe risk assessment model was developed by combination of four methods: the Health care Failure Mode and Effect Analysis (HFMEA) in order to assess the risk of errors; the Root Cause Analysis (RCA) in order to determine the causes of the errors: the Method of Structured Analysis for the analysis of work processes and information system design; Dynamic systems development method (DSDM) for the development of software prototype. HFMEA is a method designed to identify the possibility of deviations from the planned process, to assess the risks associated with these variations and to identify and implement corrective actions to address these. The HFMEA driven transformation process is aimed at reducing the risk of errors. In planning corrective actions, it is necessary first to focus on events that show the occurrence of a high frequency of errors and the high severity of the damage. Evaluation of HFMEA works best at the level of sub process...

Health documentation is a prerequisite for good and sustainable health and social care. It is especially important for patient involvement and their empowerment. A transition from paper to e-documentation together with the electronic patient record should be based on thorough knowledge of the current state of documentation and its usages. The main objective of this paper was to analyse which documents and work methods of documenting processes within nursing are being used within different environments. Furthermore, what are the main reasons for their discrepancies from theoretical approaches and best practices. The analysis is based on a survey carried out on all three levels of healthcare. The survey questionnaire consisted of 12 questions to which responded 286 nursing teams from community health centres, hospitals and retirement homes in Slovenia. The results point to diversity in documenting as well as lack of interoperability. This is reflected in a great number of different documents. All phases of the nursing process were being documented in only 31.8 % of cases. The main reasons for this can be attributed to work organisation, different definitions of data-set requirements and inadequate knowledge by nurses. Survey results pointed out a need for the renewal of nursing documentation towards a more uniform system based on contemporary health technologies.

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Rationale: Palbociclib (PAL) is a first-in-class selective inhibitor of the cyclin-dependent kinases 4 (CDK4) and CDK6 and is indicated for the treatment of hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) in combination with fulvestrant (FUL) in postmenopausal women. Antrodia cinnamomea (AC), a well-known Chinese folk medicine in Taiwan, possesses numerous biological capabilities, most notably an anti-tumor effect. However, the clinical use of AC as complementary medicine combined with adjuvant therapy is unexplored. In this case report, we evaluated AC combined with PAL plus FUL to reduce the tumor burden in an MBC patient. Patient concerns: A Slovenian woman diagnosed with relapsed bone metastases of breast cancer (BC) was unable to undergo surgery and refused radiation therapy due to fear of side effects; she also feared the side effects of adjuvants. However, she was eager to live with a high quality of life. Diagnosis: Stage IV, HR-positive/HER2-negative BC with relapse of bone metastases. Interventions: After diagnosis of relapse of bone metastases, she received adjuvant with PAL plus FUL. Additionally, she chose to take AC orally (10 g/d). Outcomes: The pain was mostly relieved, and the side effects of adjuvant therapy reduced. Magnetic resonance imaging revealed reduction of tumor size at the fifth month of adjuvant therapy plus AC. After 14 months of adjuvant therapy plus AC, the tumors at the thoracic vertebrae T1 and T3 were found to have shrunk from 35.2 and 12.0 mm to 28.1 and 9.9 mm, respectively. Remarkably, no further metastases were observed. Lessons: According to the circulating tumor cells (CTCs) test data, AC had better anti-tumor efficacy on active tumor cells than PAL plus FUL. Thus, AC could be an effective complementary medicine for adjuvant therapy in patients with HR-positive/HER2-negative MBC. Interestingly, continued elevation of carcinoma antigen 15-3 and lactate dehydrogenase levels but decreasing levels of alkaline phosphatase were observed, which may be indicative of the potent efficacy of treatment resulting in massive tumor cell death. The CTCs test may be a sensitive approach to monitor the progression of BC and subsequently evaluate the efficiency of therapy.

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