Critical issues that put healthcare professions at risk

Patient safety is one of the factors determining the quality of care and therefore is one of the priority objectives that the National Health Service sets itself. It is therefore essential to prevent any clinical risks that doctors may encounter while carrying out their work. Providing the information necessary to increase the awareness of healthcare professionals regarding issues related to patient safety and translating these acquisitions into daily professional practice has therefore become a primary objective.

But what specifically is meant by clinical risk?

“Clinical risk” is defined as the possibility that a patient suffers involuntary damage or discomfort, attributable to healthcare, which causes an extension of the period of hospitalization, a worsening of health conditions or, in the worst case, death.

Most accidents in complex organizations are generated by the interaction between the different components of the system: technological, human and organizational.

In healthcare there are two types of risk: a «business» risk intrinsic to the technologies, to the production mechanisms of the healthcare organization and proportional to the complexity of the system and a risk defined as «pure risk», which is not related to the complexity of the production system and depends on the chain of situations that favor the onset of an adverse event, it is not predictable or quantifiable.

In the healthcare sector there are many i factors that contribute to defining the «degree of risk» of the system, which can be schematically grouped into the following classes:

• Structural/technological factors:
  • design and maintenance of the healthcare building and systems;
  • safety and logistics of environments;
  • operation, maintenance, renewal of equipment and instruments;
  • infrastructures, networks, digitalisation, automation.
• Organizational/managerial factors and working conditions:
  • organizational structure (roles, responsibilities, distribution of work);
  • human resources policy and management;
  • workload and shifts (which contribute to determining fatigue and stress);
  • organizational communication system;
  • ergonomic aspects (workstation, monitor, noise, light);
  • policies to promote patient safety.
• Human factors:
  • individual characteristics (perception, attention, memory, ability to make decisions, perception of responsibility, mental and physical conditions, psychomotor skills) and professional competence;
  • interpersonal and group dynamics and consequent level of cooperation.
• User characteristics:
  • epidemiology and socio-cultural aspects (ethnicity, socioeconomic environment, complexity and co-presence of acute and chronic pathologies, etc.);
  • social network.
• External factors:
  • regulations and legal obligations;
  • financial constraints;
  • socio-economic-cultural context.

The commitment to promoting patient safety involves, in various capacities and with different responsibilities, all the subjects of the «health system». However, risk prevention is not always sufficient to avoid damage and danger. For this reason, starting from 15 August 2014, insurance is compulsory for all doctors registered in the Register, whether they practice their profession as employees or as freelancers, consultants or collaborators of any hospital facility. Furthermore, since 2017, the Gelli-Bianco Law requires any healthcare professional to take out a professional liability insurance policy, therefore including all healthcare facilities. Lokky through the Lokky Doctors’ Liability Policy protects doctors and healthcare workers and their profession from any claims for compensation made by patients following any errors committed during the performance of their profession. This coverage protects the professional up to a maximum of €5 million. It is also possible to choose and include additional guarantees such as Unlimited Retroactivity and Unlimited Posthumous coverage.