Model-Based Risk Assessment to Clinical Risk Management Policies

摘要

Errors and adverse events occur even under the most efficient circumstances. On the one hand, clinical errors reduce patient's safety level and can even sometimes cause patient's death; on the other hand, weak management of clinical risks harms staff and hospital's reputation and can be quite costly for the health system of any country. That is why a clinical risk management system, as a systematic tool for minimizing errors and preventing systematic errors, plays an important role. According to World Health Organization statistics, medical errors are the eighth cause of death worldwide. Consequently, due to the significance of patient safety in the health system, the present study focuses on the identification and simulation of the factors influencing the occurrence of clinical errors using system dynamics approach. System dynamics provides a quantitative mathematical model which makes it possible to generate different scenarios and then, simulate the results of the implementation them on the model. The purpose of simulating clinical risk management is to identify policies that help prevent and minimize clinical errors. In Iran's health system, despite the growth of technology and health infrastructure, medical errors have an increasing trend, and this has become one of the major challenges of policymakers in healthcare section. The results showed that development and improvement of the performance indicators defined in the Ministry of Health and Medical Education, e.g. increasing human resources, improving equipment and facilities, increasing the number of healthcare-associated graduates, increasing the number of hospital beds, and so forth will not reduce the level of clinical errors. For this reason, here different policies regarding electronic health records, patient safety culture, and clinical governance have been implemented on the model and their simulation results have been examined. While all three policies have played a significant role in reducing the errors, the results of the policy related to patient safety culture has the greatest impact on clinical errors.