Informal risk assessment strategies in health care staff: an unrecognized source of resilience?

Abstract

RationaleRecent reports indicate that approximately 10% of in-patients in UK hospitals are involved in an adverse event (these reports also state that 50% of these events are preventable). This is indeed a worrying finding, and indicates the need to look at how these incidents are handled or indeed, what is done to minimize their occurrence. The Department of Health, via the National Patient Safety Agency (NPSA) published a guide which is aimed at encouraging accurate reporting, learning from past events and changing the attitudes of key stakeholders (healthcare managers, frontline staf etc) towards risk taking and risk management. Aims and objectives Our aim was to compare informally-learned and used risk assessment strategies volunteered by staff with the 'how to do it' guide published by the NPSA. We have compared each step of the NPSA guide with our empirical data relating to that activity. Methods We interviewed forty-eight healthcare professionals (doctors from several specialties; nurses from a variety of settings; and an array of allied healthcare professionals). We used semi-structured interviews in order to discuss participants' views on their everyday working life, working relationships and patient safety. Results Our results indicate that healthcare professionals develop their own unique way to approach the issue of patient safety and risk, based on their professional raining, seniority and role within the hospital. They did share the conviction that frontline and support staff need to have immediate and easy access to information about past adverse events. They see this as a powerful tool in minimizing the reoccurrence of the same errors/problems, as well as a vehicle to improve staff morale by feeling valued and having their opinion heard. Conclusions We believe that patient safety and welfare can benefit from the adoption of a more flexible and person-centred approach to how risk assessments are carried out. Enriching formal guidelines such as the 'Risk Assessment made easy' document with successful techniques and strategies which healthcare staff have informally developed has the potential to not only improve patient safety (since it will be based on the accumulated experience and knowledge of such staff) but also foster higher levels of self esteem amongst healthcare professionals. bs_bs_banner ISSN 1365-2753 Journal of Evaluation in Clinical Practice

Barriers and facilitators to incident reporting in mental healthcare settings: A qualitative study

“…Whilst there have been calls to develop more sophisticated infrastructures for investigation, learning and sharing to promote system-wide improvement (Macrae, 2016), it appears that the necessary changes are yet to be honed and implemented fully within [xxxxx] Trust. Similarly, in this study all participants described lack of time as a significant barrier to incident reporting, reinforcing findings from previous studies (Albolino et al, 2010;Arfanis & Smith, 2011;Backstrom, Mjorndal, Dahlqvist, & Nordkvist-Olsson, 2000;Elder et al, 2007). In particular, participants described limited availability of time and resource to work with complicated systems and were particularly frustrated with duplication between RiO (the electronic patient record for mental healthcare) and the in-house reporting system.…”

“…The majority of barriers stemmed from organisational policies and procedures surrounding the reporting of/learning from incidents. For example, there was a strong belief that incident reports should be used to drive improvement in practice, which is consistent with previous research (Arfanis & Smith, 2011;Elder, Graham, Brandt, & Hickner, 2007;Waters, Hall, Brown, Espezel, & Palmer, 2012). Whilst there have been calls to develop more sophisticated infrastructures for investigation, learning and sharing to promote system-wide improvement (Macrae, 2016), it appears that the necessary changes are yet to be honed and implemented fully within [xxxxx] Trust.…”

The Indicators of Nurse's Perspective in Health Management System and Hospital Safety in Gombong Region Hospitals, Indonesia

“…Arfanis and Smith explained that effective training helps create a feel of belonging in personnel which therefore will increases their responsiveness to protection in the workplace (Arfanis & Smith, 2012). In an intervention observe by Wang et al aimed at evaluating the impact of a education program on occupational risk prevention, the results confirmed an increase in the level of awareness of the subjects and an increase in their performance regarding risk prevention.…”

Enhancing patient safety in the operating theatre: from the perspective of experienced operating theatre nurses

“…The importance of incidence reporting has been widely identified as a means towards increasing patient safety as well as the importance of support from managers, continuous education, feedback and open communication regarding adverse events and incidents, without casting blame or searching for scapegoats . The OTNs in the present study felt that incident reporting seemed ineffective as a means to improve patient safety and conveyed a feeling that the processing of the information gained from incident reports was inadequate, along with a considerable feeling of uncertainty as to when or who should report incidents or adverse events.…”