HealthManagement, Volume 16 - Issue 3, 2016

In recent years patient safety and risk management have ‏become important topics of debate at different levels of ‏healthcare throughout Europe so that where there is one, ‏the other is also found.


In this article we will bring these topics together, putting ‏them in the context of the Input-Management-Processes- ‏Outcomes (IMPO ) model, and also introducing them to the ‏IMPO -Conference taking place on November 17 in Düsseldorf.


The main question is: are patient safety and risk management ‏bound to each other as two sides of a coin or are they counterweights ‏in the balance health care management seeks?


‏For years, patient safety has been an important topic on ‏the agenda of the European Union. It is estimated that 8 to ‏12 percent of patients admitted to hospital in the EU suffer ‏from adverse events. A high proportion of these are avoidable ‏and have their roots in systematic issues. In 2009 the ‏Council of the European Union adopted a series of recommendations ‏regarding measures designed to improve patient ‏safety, complemented with recent initiatives such as the ‏directive 2011/24/EU on the application of patients’ rights in ‏cross-border healthcare. Because patient safety is (mostly) ‏an area of national competence, action at European level ‏has focused on a collaborative approach and exchange of ‏best practice, for example through EU-funded projects and ‏expert groups.


The World Health Organization (WHO ) is very active in this ‏field as patient safety is the foremost attribute of quality ‏of care. Patient safety can be considered as a goal (or an ‏outcome) in terms of zero-level patient harm as well as a ‏practice, meaning processes and structures that aim to make ‏healthcare safer. To make this more concrete, WHO developed ‏a Conceptual Framework for the international classification ‏for patient safety (ICPS ) and is now working intensively ‏together with the EU on a minimal information model for ‏patient safety incidents. The WHO Surgical Safety Checklist ‏is a well-known example to put patient safety into practice.


Another definition used by WHO describes patient safety as ‏“the reduction of risk of unnecessary harm associated with ‏healthcare to an acceptable minimum”. While this definition ‏once more links patient safety with unnecessary harm, it ‏refers also to an acceptable minimum, which indicates that ‏it should be measurable and hopefully manageable.


Hospitals have gone through a long evolution with quality ‏leading to safety management. Now with the financial crisis, ‏risk management is at the forefront.


Looking to the practice, risk managers conduct an in-depth ‏investigation in case of an adverse event to assess the ‏liability exposure of the organisation and to help mitigate ‏any future loss that may arise. They are also responsible for ‏identifying and assessing high-risk areas that could cause ‏harm to patients, visitors, and employees and for implementing ‏programmes to avert risks.


As a result, processes will be improved and expertise or ‏assets will be acquired where needed; regulations and legislation ‏will be more closely followed. To ensure this, a range ‏of risk management processes are required as an interface ‏between processes and management.


On the other hand, patient safety is mostly part of quality ‏management in hospitals. Quality management professionals ‏focus on best possible outcomes in patient care and often ‏ensure that the organisation meets accreditation and other ‏regulatory requirements. Their focus is not necessarily about ‏but primarily to improve the quality of patient care. With ‏patient safety we also put the patient back in the centre. ‏Considering that the risks are with the processes and the ‏patients are the input while the outcome is to be considered ‏in terms of safety, both topics can be projected on the ‏IMPO -model.


Many solutions ensuring patient safety are putting incident ‏management in the centre to reduce the risks. In order ‏to keep the risk to an acceptable minimum it is important ‏to be able to analyse and assess the risk so that appropriate ‏actions can be taken.


Patient safety within a healthcare organisation like a ‏hospital is a challenge as hospitals are high reliability organisations, ‏complex adaptive systems where cultures have an ‏impact. Healthcare managers have an important role in ‏ensuring a high level of patient safety practice in order to ‏reduce unnecessary harm. ‏


During the biggest health fair of Europe, Medica, the Krankenhaustag ‏presents the most up-to-date themes dominating ‏discussions not only in Germany but also in Europe. On ‏November 17 2016 the conference, co-organised by the European ‏Association of Hospital Managers, will present different ‏views on patient safety and risk management. Also on the ‏agenda will be healthcare managers’ role, necessary competencies ‏and experience in the context of individual healthcare ‏systems as well as in the broader context of Europe. ‏For further information, go to the EAHM website: ‏