‘‘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.