Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers

Sendlhofer, Gerald; Brunner, Gernot; Tax, Christa; Falzberger, Gebhard; Smolle, Josef; Leitgeb, Karina; Kober, Brigitte; Kamolz, Lars‐Peter

doi:10.1007/s00508-014-0620-7

Cited by 32 publications

(52 citation statements)

References 23 publications

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“…Since 2009, the University Hospital Graz initiated comprehensive patient safety initiatives [6,18], however, employees perceived patient safety climate prior implementation of patient safety initiatives were not performed so far. In contrast to many European countries where the use of the HSOPSC became mandatory, the Austrian government did not recommend the survey so far.…”

Section: Discussionmentioning

confidence: 99%

“…For example, on a national level, the Austrian Federal Ministry of Health released a model for a distinct patient safety strategy and defined five intervention fields based on the capacity building concept and comprises i) policy development measures, ii) organization development, iii) personnel development measures, iv) monitoring measures and v) measures to raise public awareness [5]. Within the organizational level, clinical risk management and critical incident reporting systems accompanied with open communication and teamwork are some components to create a patient safety culture within an organization [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Patient safety culture within a university hospital: feasibility trial

2015

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Background: Developing a patient safety culture is an evolving process for organizations. An accepted tool to assess the patient safety culture is the Hospital Survey on Patient Safety Culture (HSOPSC). Recently, the HSOPSC was translated into German. It was the primary aim of this short report to assess the reliability of the German HSOPSC within a university hospital in Austria. Findings: The German version of the survey was adjusted to local circumstances. Finally, the survey contained 48 questions using the five-point Likert response scale of agreement. The online survey was sent out to 6317 employees. A total of 415 employees took part in the online survey (6.6 %). The majority (n = 299, 72.0 %) had been employees without an executive function. 70 (16.9 %) physician, 229 (55.2 %) nurses, 47 (11.3 %) medical technical assistants and 69 (16.6 %) administrative employees answered to the survey. The dimension that received the highest positive score was "manager expectations and actions promoting safety" (3.90 ± 0.84 SD). Within outcome measures "patient safety in general" showed the lowest score (2.34 ± 0.71 SD).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient safety culture within a university hospital: feasibility trial

2015

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“…Classificar adequadamente não somente o paciente quanto a sua gravidade na porta de entrada do hospital (setor de emergência) mas também de acordo com as suas necessidades assistenciais é de grande relevância para o planejamento terapêutico e necessita de um claro entendimento dos profissionais sobre essa classificação [19]. O setor de emergência do HNSC já possui experiência em sistema de classificação de risco (a classificação de Manchester está implantada no setor) e as equipes de internação já classificam a gravidade dos pacientes pelo índice de comorbidades de Charlson, o que facilitou a introdução de sistema que visa a classificação e ordenamento interno dos pacientes [20][21][22][23].…”

Section: Discussionunclassified

Avaliação de intervenções de Gestão da Clínica na qualificação do cuidado e na oferta de leitos em um hospital público de grande porte

Anschau

Webster

Roessler

et al. 2017

Sci Med

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*** Evaluation of clinical governance interventions on qualification of care and supply of beds in a large public hospital ***AIMS: To describe the results achieved in hospital performance indicators and supply of beds, with the strategy of incorporating clinical management into the care process of the backup unit of the Nossa Senhora da Conceição Hospital.METHODS: The study was carried out in the backup unit of the Nossa Senhora da Conceição Hospital, in Porto Alegre, Rio Grande do Sul, Brazil. The backup unit is an inpatient hospital with beds intended for hospital emergency patients characterized by short stay (less than 10 days of hospitalization) and in the study period it had 27 beds. As clinic management tools we implemented multidisciplinary reference teams and multidisciplinary rounds, established a Kanban system to monitor mean length of stay, and introduced the unique therapeutic project at the hospital entrance (emergency room) and management of beds by the Internal Regulation Center. We monitored the hospital indicators number of hospitalizations, mean length of stay, resolvability, mortality rate and turnover rate over a period of 12 months (2016, after implementation of the strategy) and made comparisons with the same period of the previous year. RESULTS: After the introduction of Clinic Management, there was an increase in the number of hospitalizations from 1395 to 1537/year. There were 1240 discharges to home (an average of 104 a month), showing an increase of 101.9% in relation to the previous period. There was also a decrease in the number of internal transfers (between the back unit and other sectors of the hospital), an increase in the turnover rate from 51.6 to 56.9, decrease in the mean stay time of 7.2 days to 6.6 days and a significant decrease in the mortality rate from 3.5 to 0.7 (p <0.05).CONCLUSIONS: The implementation of clinical management in the context of care work in the hospital's backup bed unit fostered improvements in care processes, as well as ensuring greater supply of beds to users.

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“…In 2009, the University Hospital Graz, a 1,500-bed tertiary university hospital and the second largest in Austria, began implementing comprehensive patient safety tools through the systematic introduction of clinical risk management into routine hospital procedures [13]. In 2012, the Styrian Public Health Fund started the province-wide campaign "Clean Hands" based on an initiative by the Word Health Organization (WHO) and guidelines of the German national HH campaign to increase healthcare professional awareness of the importance of HH through alcoholbased hand rub (ABHR).…”

Section: Introductionmentioning

confidence: 99%

Hand hygiene behavior in a tertiary university hospital: differences between surgical and nonsurgical departments

et al. 2015

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Background: Health care-associated infections are a major patient safety issue worldwide. Hand hygiene (HH) campaigns have started all over the world to increase awareness and decrease HH barriers. The aim of this study was to assess healthcare professionals' HH-knowledge, HH-barriers as well HH-environmental factors in general and especially in surgical and nonsurgical departments within a tertiary university hospital. Methods: In order to achieve our primary goal, five phases were implemented: i) environmental audit, ii) baseline survey, iii) HH-campaign, iv) follow-up survey and v) alcohol-based hand rub consumption. Results: The environmental audits showed that 443 HH-dispensers were missing. A total of 1,340 questionnaires were returned (baseline: 855; follow-up: 485). Eight HH-barriers were addressed in the baseline survey, 2 of which became significantly reduced during the HH-campaign. HH-environment improved and was followed by a significant increase in compliance with respect to the five moments for HH. Progress in the surgical departments was more evident than in nonsurgical departments. The average procurement of alcohol-based hand rub rose from 105 to 108 mL per patient day in intensive care units and from 26 to 31 mL per patient day in wards. Conclusion: HH-motivation can be addressed with comprehensive HH-campaigns; however, positive role models are needed to attract all healthcare professionals to take part. The necessity of physicians taking part in HH-campaign is the key to the future success of HH-campaigns.

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Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers

Cited by 32 publications

References 23 publications

Patient safety culture within a university hospital: feasibility trial

Patient safety culture within a university hospital: feasibility trial

Avaliação de intervenções de Gestão da Clínica na qualificação do cuidado e na oferta de leitos em um hospital público de grande porte

Hand hygiene behavior in a tertiary university hospital: differences between surgical and nonsurgical departments

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