Health Care Safety Management in Modern Health Care
01 May 2019-pp 18-31
TL;DR: A systematic review of the research devoted to the study of epidemiology, mechanisms of adverse events associated with the provision of medical care, as well as the principles of patient safety management found that cases of harm in the provisionof medical care (adverse events) are recorded in 10.6% of patients.
Abstract: The article is a systematic review of the research devoted to the study of epidemiology, mechanisms of adverse events associated with the provision of medical care, as well as the principles of patient safety management. The meta-analysis allowed to establish that cases of harm in the provision of medical care (adverse events) are recorded in 10.6% of patients. At the heart of the development of adverse events are systemic causes – latent threats, the management of which is the basis of the modern strategy of ensuring the safety of medical care.
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28 May 2020
TL;DR: The authors present an algorithm for implementation of a safety management system in a medical organization, including the construction of a new safety culture, an accounting system for recording of threats and incidents, and a model for managing medical care safety built into the operational system of the organization.
Abstract: The article describes a multifactorial model of adverse events related to the provision of medical care. It is shown that their origin is caused by the transformation of systemic causes (latent failures) acting at the level of medical organization, external microenvironment and macro-factors. Four types of global latent failures are described at the level of a medical organization related to: medical technology, work of medical personnel, work environment, and patient behavior. At the external microenvironment level, major latent threats are concentrated at the level of partners, suppliers and outsourcers. Among macro-factors influencing medical care safety especially important are the legal factors defining the status of medical errors and their consequences; economic model of state health care; financial provision of state guarantees and rationing of these volumes in regions and municipalities; availability of state medical care safety management programs; state regulation of medical activity; system of pre- and post-graduate medical education; system of labor regulation and remuneration of medical workers; society's attitude towards medical errors and its participation in the process of medical care safety management. The authors present an algorithm for implementation of a safety management system in a medical organization, including the construction of a new safety culture, an accounting system for recording of threats and incidents, a model for managing medical care safety built into the operational system of the organization.
10 citations
29 Jun 2021
TL;DR: In this paper, the authors have built a model of the risk management process in a medical organization, including the accounting subsystem, the risk analysis subsystem, and the risk processing subsystem.
Abstract: The paper discusses the main components of the modern system of risk management in medicine. Using the ISO 31000 standard of risk management and the ARIS integrated modeling environment, the authors have built a model of the risk management process in a medical organization, including the accounting subsystem, the risk analysis subsystem, and the risk processing subsystem. The concept of risk management proposed in the article is formulated on the basis of a system safety model, which assumes that adverse events related to the provision of medical care are based on systemic causes that under certain conditions turn into a hazard, and the latter is used to receive active threats and incidents. The risk management system is an executive block of the safety management system in a medical organization, which includes (in addition to risk management) an ideological block (a new safety culture) and an educational block (an organizational learning subsystem).
6 citations
13 Jul 2022
TL;DR: The results of the analysis of the application of sanitary and hygienic measures and scientific solutions of the XVIIIth to XIXth centuries confirm the need to use scientific, practical, and organizational experience in the introduction of new solutions to the modern system of medical care, including elements of hospital hygiene and patient safety.
Abstract: The article analyzes the problem of hygienic assessment of the conditions of the hospital environment and health-improving methods of treatment of patients of medical institutions at the stages of formation and development of healthcare in Russia in the XVIIIth and XIXth centuries. It has been established that in various historical periods, the problem of patient safety in medical organizations has always been the leading one in the management of people's health and the organization of healthcare as an agency that has been forming for several centuries. Organizational, legal, administrative, economic, and hygienic measures have been developed purposefully in the system of public health protection in Russia. This made it possible to improve the system of medical care on the basis of compliance with the provisions of hospital hygiene, such as the placement of patients in hospitals and compliance with the anti-epidemic regime. The systematization and analysis of the data from the Russian literature on the studied scientific problem were performed. Three leading directions of hospital hygiene development were established: organization of medical care, architectural and planning solutions, and therapeutic nutrition. The importance of developing the legislative framework of the listed areas at the state and departmental levels is shown. The results of the analysis of the application of sanitary and hygienic measures and scientific solutions of the XVIIIth to XIXth centuries confirm the need to use scientific, practical, and organizational experience in the introduction of new solutions to the modern system of medical care, including elements of hospital hygiene and patient safety. Proposals have been developed on the legality and prospects of using the historical experience of the development of preventive medicine and hygienic education of the XVIIIth and XIXth centuries, as well as the achievements of predecessors in the field of monitoring and accounting for the peculiarities of patient care and ensuring an anti-epidemic regime.