Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA)
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 8 August 2016
Abstract
Purpose
The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time.
Design/methodology/approach
A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development.
Findings
The self-assessment tool – Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations.
Practical implications
This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders.
Originality/value
The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries.
Keywords
Acknowledgements
The tool development was made possible by the contribution of the entire CARMINA team including: Tamara Zerman (Azienda Unità Locale Socio Sanitaria n.20, Verona), Andrea Cambieri (Policlinico Universitario “Agostino Gemelli,” Rome), Antonella Campo (Azienda Sanitaria Provinciale di Caltanissetta), Salvatore Paolo Cantaro (Azienda Ospedaliero-Universitaria “Policlinico Vittorio Emanuele,” Catania), Anna Laura Costa (University of Pisa), Lodovico Marazzi (Catholic University of the Sacred Heart, Rome), Adriano Marcolongo (Friuli Venezia Giulia Region), Diana Pascu (Azienda Unità Locale Socio Sanitaria n.20, Verona), Oliviero Rinaldi (European Institute of Oncology, Milan), Gabriele Romano (University of Verona), David Zanardo (Azienda Unità Locale Socio Sanitaria n.17, Monselice). This project was realized with Italian Ministry of Health – CCM financial support. The authors thank Dr Charles D. Shaw for creating the acronym CARMINA and for his support, suggestions and comments.
Citation
Tricarico, P., Tardivo, S., Sotgiu, G., Moretti, F., Poletti, P., Fiore, A., Monturano, M., Mura, I., Privitera, G. and Brusaferro, S. (2016), "Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA)", International Journal of Health Care Quality Assurance, Vol. 29 No. 7, pp. 744-758. https://doi.org/10.1108/IJHCQA-11-2015-0140
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited