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Purpose To improve the performance both in terms of patient safety and quality of treatments, this research studies one of the most delicate processes of health organizations, that is to say, the clinical risk management in maternal and child pathway. This paper aims to analyze the accidents that occurred in a complex health facility through the standard mapping of this pathway included in the CartoRisk, i.e. a risk assessment tool for the a priori analysis. Design/methodology/approach The research uses the case study methodology, as it explores a complex process in which a lot of variables and actors are involved. It analyzes the accidents occurred in the largest health facility at national and European level. Findings After a presentation of the regulatory framework and the studied health organization, the research analyzes the accidents occurred in maternal and child pathway from 2014 to 2018. It showed the main risks according to the standard mapping of the maternal and child pathway. Furthermore, it identified 11 new risks mainly associated with physiologic birth and Caesarean birth. Originality/value This study presents the regulatory framework, the health facility and the accidents of a health organization. Moreover, besides the accident analysis, the research integrates further risks into the standard mapping adopted to carry out this study and proposes a risk management approach. Therefore, the value of the research for operators will consist of the integration of the standard mapping used for a priori analysis to be reused in the hospitals where they work, while for researchers it will represent a deep knowledge of a real case.

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