Risk management and healthcare safety: Ten years of experience at the Vienna General Hospital

Abstract

We should use the word "Health Care Safety" instead of "Patient Safety," because in cases of malpractice the people who are in charge of treatment of patients can be "second victims." The typical damage case occurs to an above-average employee in a risk-prone discipline after working in the job for 20 years often between Friday afternoon and Sunday more often in the months of January, March or July due to a preceding communication error and a missing assertiveness of a person who is involved in the case. Very often, health professionals do not know how to react in case of malpractice or emergency from a legal point of view. The patient or his family contact a lawyer immediately, but who helps the health professionals to cope with the case? The Vienna General Hospital (VGH) is one of the biggest in the world. In 1999, the project "Risk Management" was initiated by the Legal Department. The aim at this time was: "Minus 50% concerning cases and more than 50% less costs in the next ten years (2000-2010)." In 2010, the aim was reached and the positive trend is still continuing, but how did it work? The VGH in cooperation with the Vienna Insurance Group created a complete new form of quick help in case of emergency: the so-called "Legal Emergency Kit." It represents a handy plastic case on which a paragraph is stamped. A special checklist tells what to do in case of legal emergency. The legal practitioner of the VGH can be called at any time via mobile phone. The malpractice cases are analysed in a retrospective damage analysis, which helps to avoid errors and damages in the future.

What good is access to unsafe care? A developing dilemma

“…8 Marzi showed a decline in lawsuits at one of the largest hospitals in Europe, but it is difficult to know if the reduction in litigation was due to the tools they adopted. 9 Piggot described a novel handoff tool, but it is uncertain if it will reduce errors and harm and be useful in other settings. 10…”

“…8 Marzi showed a decline in lawsuits at one of the largest hospitals in Europe, but it is difficult to know if the reduction in litigation was due to the tools they adopted. 9 Piggot described a novel handoff tool, but it is uncertain if it will reduce errors and harm and be useful in other settings. 10 In a previous issue, Guzman described the death of a 27-year-old woman due to a non-sterile episiotomyprecisely the situation bemoaned by Dr. Chan-and the state of water, sanitation, and hygiene services in healthcare facilities across Rwanda.…”