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‘‘Active’ safety in the Tuscany Health Promoting Hospitals Network :Active’ safety in the Tuscany Health Promoting Hospitals Network :
From Training to Project From Training to Project
F.Simonelli, L.Colonna, L.Tavanti, M.J. Caldés Pinilla, K.MajerF.Simonelli, L.Colonna, L.Tavanti, M.J. Caldés Pinilla, K.Majer
13th International Conference on Health Promoting Hospitals (HPH)May 18-20, 2005Dublin - Ireland
Short introduction to the context:
LOCAL HEALTH UNIT
LOCAL HOSPITAL UNIT
The HPH Network of Tuscany is co-ordinated by the A. Meyer University Children’s Hospital, involving all the 16 Local Health and Hospital Units of the Region.
The HPH Safety Project involves: 2 Local University Hospital Units (Florence and Pisa)
and 2 Local Health Units (Arezzo and Siena)
The “Safety” project:
- Key concepts - Key concepts
- The approach- The approach
- The interpretation model- The interpretation model
- The work developed- The work developed
- The phases of the pathway training- The phases of the pathway training
SSaaffeettyy:: Is a relative concept, to define on the base of the levels of
‘‘passive safety’ passive safety’ andand ‘activeactive safety’safety’
passive safety:passive safety:
the level of safety guaranteed by the adoption of the rules
Key concepts :
active safetyactive safety : :
the level of passive safety increased through Health Promotion activities
Acted by the awareness and Acted by the awareness and co-operation of patients (and co-operation of patients (and their relatives), health their relatives), health professionals and communityprofessionals and community
Acted by the observance of the Acted by the observance of the rulesrules
Compensatory
behaviour
START END
Rules
Passive safetyPassive safety
observance of the rulesobservance of the rules
END
+
The approach
+Empowerment
END Active safetyActive safety Awareness, Health literacy, Participation ….
Ex p
e cte
d va
l ue
Middle SituationCompensatory behaviour
GGlloobbaall s saaffeetty y (?)(?)
HPH
ENVIRONMENTAL • CULTURAL• PHYSICAL• LOGISTIC
PROCESSES • RE-ENGINEERING • INNOVATION
between:• PATIENTS• RELATIVES• OPERATORS• PARTNERS• COMMUNITY
RELATIONSHIPS
Re-orientation of the Setting
The interpretation model
Integrated Planning
Systemic vision:
STANDARDS
Professional vision:
EMPOWERMENT
Organizational vision:
RE-DESIGN
HE
AL
TH
GA
IN
The work developed
A specific training programme composed by five seminars for operators participating to this project
Tree phases of the training programme
1. Study of initiatives made by Tuscan hospitals on the safety issue
2. Analyses of this experiences, ‘choosing’ those in the health promotion field
3. Re-elaboration of this experiences and their synthesis in a shared project based on the active safetyactive safety concept
1. Study of initiatives made by Tuscany Hospitals
SAFETY ON THE ‘PROCESS’ LEVEL
SAFETY ON THE ‘RELATIONSHIP’
LEVEL
SAFETY ON THE ‘SETTING’
LEVEL
PROJECT
Active safetyActive safety
Analysis Grid (selective)
Active safetyActive safety
(Safety in the diagnosis and therapeutic process. Risk management)
(Relationship and Hospital Safety)
(Hospital Setting and safety)
RE-ORIENTATION
The phases of the training pathwayThe phases of the training pathway
2. Analyses of this experiences, ‘choosing’ those in the Health Promotion field
For this analysis the participants have been using a specific grid
made themselves whit the help of the teaching and tutors
Criteria for the selection:
• 11stst requirement requirement: EMPOWERMENTEMPOWERMENT
• Others requirements:Others requirements:
FATTIBILITYFATTIBILITY
TRASFERIBILITYTRASFERIBILITY
POTENZIALE ATTRATTIVO POTENZIALE ATTRATTIVO
COERENCE WITH THE REGIONAL POLITICAL ADRESSCOERENCE WITH THE REGIONAL POLITICAL ADRESS
Experience 1.
Experience 2.
Experience 3.
Experience 4.
Experience 5.
Experience 6.
passive passive safetysafety
Middle Situation
Active Active safetysafety
100%
100%
100%
100%
66%
100%
100%
66%
33%
33%
passive safetypassive safety
Middle Situation
Level of development of the local projects/experiences
active safetyactive safety
EMPOWERMENT!
3. Re-elaboration of this experiences and their synthesis in a shared integrated project based on the active safetyactive safety concept
The results of this analysis and elaboration was the identification of
the following five arguments:
• Prevention of pressure soresPrevention of pressure sores
• Prevention of fallsPrevention of falls
• Treatment with central intravenous catheter (CVC)Treatment with central intravenous catheter (CVC)
• Safety in the antiballistic therapySafety in the antiballistic therapy
• Prevention of the latex allergiesPrevention of the latex allergies
Progress made after the end of the training pathway (December, 2004)
For each sub-project:For each sub-project:
• constitution of a thematic Working Group (inter-corporate, constitution of a thematic Working Group (inter-corporate,
inter- disciplinary character) inter- disciplinary character)
• elaboration of the timetable 2005 with the following goals:elaboration of the timetable 2005 with the following goals:
- definition of a set of standards, both on the passive - definition of a set of standards, both on the passive
and the active safety level and the active safety level
- assessment of their feasibility - assessment of their feasibility
- individuation of specific good practices.- individuation of specific good practices.