The clinical risk management. A case study

Titolo Rivista MANAGEMENT CONTROL
Autori/Curatori Antonio Fusco, Grazia Dicuonzo, Vittorio Dell’Atti, Nii Amoo
Anno di pubblicazione 2017 Fascicolo 2017/3
Lingua Inglese Numero pagine 22 P. 31-52 Dimensione file 267 KB
DOI 10.3280/MACO2017-003003
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più clicca qui

Qui sotto puoi vedere in anteprima la prima pagina di questo articolo.

Se questo articolo ti interessa, lo puoi acquistare (e scaricare in formato pdf) seguendo le facili indicazioni per acquistare il download credit. Acquista Download Credits per scaricare questo Articolo in formato PDF

Anteprima articolo

FrancoAngeli è membro della Publishers International Linking Association, Inc (PILA)associazione indipendente e non profit per facilitare (attraverso i servizi tecnologici implementati da CrossRef.org) l’accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche

The continuous increase in healthcare costs as regards GDP and the public expenditure reflects, on the one side, the growth of health demand due to the change in the global epidemiological landscape and, on the other side, a progressive rise in health costs, significantly influencing the sustainability of the world health system. The legislative measures adopted by many countries, primarily aiming at containing the public expenditure, have drawn the attention of academics and practitioners. The interest is focused on risk management because nowadays this process is considered necessary in healthcare public companies. The reason is that it allows, on the one hand, to reduce waste and, consequently, costs, and, on the other hand, to improve the results and the assistance quality offered. In this context, the aim of the study is twofold: i) to examine the clinical risk management in healthcare organizations; ii) to verify, through a case study, in which way the adoption of innovative managerial models, such as the lean management, can improve performance and reduce the clinical risks caused by adverse events; this, to improve the clinical risk management. For this purpose, we analyze the lean management model implemented in "Morgagni Pierantoni Hospital Unit" of Forlì. The results show a positive impact of lean management model on clinical processes in terms of improvement of performance and higher security of assistance services.

Parole chiave:Clinical risk management, lean management, health care organization, clinical processes, clinical risk, case study.

  1. Agnoletti V., Buccioli M., Padovani E., Corso R., Perger P., Piraccini E., Orelli R. L., Maitan S., Dell’Amore D., Garcea D., Vicini C., Montella M. T., Gambale G. (2013), Operating room data management: improving efficiency and safety in a surgical block, BMC Surgery. DOI: 10.1186/1471-2482-13-7
  2. Armeni P., Costa F., Sommariva S. (2015), Il confronto dei sistemi sanitari in una prospettiva internazionale, Cergas Bocconi (a cura di), Rapporto OASI, Milano, Egea.
  3. Armeni P., Costa F., Furnari S. (2016), Il confronto dei sistemi sanitari in una prospettiva internazionale, Cergas Bocconi (a cura di), Rapporto OASI, Milano, Egea.
  4. Barbagallo S., Corradi L., de Goyet J., Iannucci M., Porro I., Rosso N., Tanfani E., Testi A. (2015), Optimization and planning of operating theatre activities: an original definition of pathways and process modelling, BMC Medical Informatics and Decision Making, 15, 38, pp. 1-16. Doi 10.1186/s12911-015-0161-7.
  5. Barnas K. (2011), ThedaCare’s business performance system: Sustaining continuous daily improvement through hospital management in a lean environment, Joint Commission Journal on Quality and Patient Safety, 37, 9, pp. 387-399.
  6. Barresi G. (2013), Il rischio clinico nelle aziende ospedaliere. Strumenti di analisi e profili di gestione, Milano, FrancoAngeli.
  7. Bertini U. (1987), Introduzione allo studio dei rischi nell’economia aziendale, Milano, Giuffrè.
  8. Boscolo P.R., Canobbio M., Ciani O. (2012), Hospital-based HTA: quale valore per la valutazione delle tecnologie nelle aziende sanitarie italiane?, Management control, 2, special issue, pp. 55-69. DOI: 10.3280/MACO2012-SU2004
  9. Brandao de Souza L. (2009), Trends and approaches in lean healthcare, Leadership in Health Services, 22, 2, pp. 121-139, DOI: 10.1108/17511870910953788
  10. Briner M., Kessler O., Pfeiffer Y., Wehner T., Manser T. (2010), Assessing hospitals’ clinical risk management: Development of a monitoring instrument, BMC Health Services Research, 10, 337, pp. 1-11, DOI: 10.1186/1472-6963-10-337
  11. Brusoni M., Trinchero E. (2008), Soluzioni aziendali e competenze emergenti per la gestione del rischio e della sicurezza, in Anessi Pessina E., Cantù E. (a cura di), L’aziendalizzazione della sanità in Italia, Rapporto OASI, Milano, Egea.
  12. Brusoni M., Trinchero E., Marazzi L., Partenza I. (2012), Gestione, ritenzione e assicurazione del rischio: alla ricerca di una prospettiva integrata, in Anessi Pessina E., Cantù E., Ferré F. e Ricci A. (a cura di), L’aziendalizzazione della sanità in Italia, Rapporto OASI, Milano, Egea.
  13. Buccioli M., Agnoletti V., Padovani E., Perger P. (2014), E-HCM: Resources reduction & demand increase, cover the gap by a managerial approach powered by an IT solutions, Stud Health Technol Inform., 205, pp. 945-949.
  14. Burgess N., Radnor Z. (2011), Evaluating Lean in healthcare, International Journal of Health Care Quality Assurance, 26, 3, pp. 220-235, DOI: 10.1108/09526861311311418
  15. Centauri F., Marsilio M., Villa S. (2016), Condizioni organizzative per l’implementazione delle logiche lean in sanità, in Lean healthcare: il caso dell'AOU senese: storia di una strategia vincente, Milano, FrancoAngeli.
  16. Crema M., Verbano C. (2015), How to combine lean and safety management in health care processes: A case from Spain, Safety Science, 79, pp. 63-71.
  17. D’Arcy S.P., Brogan C.J. (2001), Enterprise Risk Management, Journal of Risk Management of Korea, 12, 1, pp. 1-24.
  18. Del Bene L., Ceccarelli R. (2016), Il contributo del Sistema Informativo alla gestione logistica dei materiali. Un caso studio nel settore sanitario, Management Control, 1, pp. 149-172. DOI: 10.3280/MACO2016-001009
  19. Dexter F., Traub R.D., Macario A. (2003), How to Release Allocated Operating Room Time to Increase Efficiency: Predicting Which Surgical Service Will Have the Most Underutilized Operating Room Time, Anesthesia & Analgesia, 96, pp. 507-512, DOI: 10.1213/01.ANE.0000042450.45778.AB
  20. Dezzani F. (1971), Rischi e politiche di impresa, Giuffrè, Milano.
  21. Eisenhardt K. M., Graebner M. E. (2007), Theory building from cases: opportunities and challenges, Academy of Management Journal, 50, 1, pp. 25-32.
  22. Fillingham D. (2007), Can Lean save lives?, Leadership in Health Services, 20, 4, pp. 231-241, DOI: 10.1108/17511870710829346
  23. Fillingham D. (2008), Lean Healthcare: Improving the Patient’s Experience, Chichester, Kingsham Press.
  24. Floreani A. (2004), Enterprise Risk Management. I rischi aziendali e il processo di risk management, Milano, Isu, Università Cattolica.
  25. Foropon C., Landry S., McLachlin R. (2013), La démarche lean au cœur des établissements de santé, Gestions Hospitalières, 528, aug-sept, pp. 410-413.
  26. Furman C., Caplan R. (2007), Applyng the Toyota Production System: using a patient safety alert system to reduce error, Joint Commission Journal on Quality and Patient Safety, 33, 7, pp. 376-386.
  27. Gobo G. (2004), Generalizzare da un solo caso, Rassegna Italiana di Sociologia, 2004, 1, pp. 103-129.
  28. Haute Autorité de Santé (2012), La sécurité des patients. Mettre en oeuvre la gestion des risques associés aux soins en établissement de santé. Des concepts à la pratique; --www.has-sante.fr.
  29. Institute of Medicine (1999), To Err is Human Building a Safer Health System, Washington, USA, National Academy Press.
  30. Knight F. (1921), Risk, uncertainty and profit, Chicago, Chicago University Press.
  31. Longo F., Cantù E. (2013), Dove sta andando il SSN: evidenze dal Rapporto OASI 2013, Cergas Bocconi (a cura di), Rapporto OASI, Milano, Egea.
  32. Marchi L. (2014), Nuove prospettive di valutazione delle performance nelle aziende di servizi, Management Control, 1, pp. 5-8. DOI: 10.3280/MACO2014-001001
  33. Mariani L., Tieghi M., Gigli S. (2016), The efficacy of performance management system in healthcare. A literature review and research perspectives, Management Control, 3, pp. 97-116. DOI: 10.3280/MACO2016-003006
  34. Mazzocato P. (2012), Unpacking process improvement: in-depth studies of how lean and clinical pathways contribute to the timeliness of care, Medical Management Centre Department of learning, informatics, management and ethics, Stockholm, Svezia, Karolinska Institutet.
  35. Mehr R., Hedges B. (1963, ed. 2012), Risk Management in the Business Enterprise, White-fish, USA, Literary Licensing.
  36. Nolan T. W. (2000), System changes to improve patient safety, BMJ, 320, pp. 771-773.
  37. Nuti S., Seghieri C., Vainieri M., Zett S. (2012), Assessment and Improvement of the Italian Healthcare System: First Evidence from a Pilot National Performance Evaluation System, Journal of Healthcare Management, 57, 3, pp. 182-198.
  38. Padovani E., Orelli R. (2012), Management Control for Improved Operating Room Performance in Healthcare Services, Management Control Journal Workshop, Pisa 2 February.
  39. Padovani E., Orelli R., Young D. (2014), Implementing change in a hospital management accounting system, Public Management Review, 16, 8, pp. 1184-1204.
  40. Perger P., Buccioli M., Agnoletti V., Padovani E., Gambale G. (2013), 'E-HCM’ Project: Cost Calculation Model for Surgical Procedures, in IFMBE Proceedings, 41, Springer.
  41. Radnor Z. (2010), Review of Business Process Improvement Methodologies in Public Services, London, Advanced Institute of Management Research.
  42. Radnor Z. (2011), Implementing Lean in Health Care: Making the link between the approach, readiness and sustainability, International Journal of Industrial Engineering and Management, 2, 1, pp. 1-12.
  43. Radnor Z., Bucci, G. (2007), Evaluation of Pacesetter, Lean, Senior Leadership and Operational Management within HMRC Processing, London, HMRC.
  44. Radnor Z., Walley P., Stephens A., Bucci G. (2006), Evaluation of the Lean Approach to Business Management and its Use in the Public Sector, Scottish Executive Social Re-search.
  45. Sassi S. (1940), Il sistema dei rischi di impresa, Milano, Vallardi.
  46. Spear S. J. (2004), Learning to lead at Toyota, Harvard Business Review, 82, 5, May, pp. 78-86.
  47. Spear S., Bowen H.K. (1999), Decoding the DNA of the Toyota Production System, Harvard Business Review, 77, 5, Sept-Oct, pp. 96-106.
  48. Spear, S.J. (2005), Fixing health care from the inside, today, Harvard Business Review, 83, 9, September, pp. 78-91.
  49. Toussaint J. (2009), Writing The New Playbook For U.S. Health Care: Lessons From Wisconsin, Health Affairs, 28, 5, pp. 1343-1350.
  50. Toussaint J., Gerard R.A. (2010), On the Mend, Lean Enterprise Institute, Inc., Cambridge.
  51. Villa S., Stagni M.G., Lega F. (2007), Aspetti concettuali ed operativi della logistica nelle aziende sanitarie: il caso del Presidio ospedaliero di Forlì, Mecosan, 61, pp. 139-170.
  52. Womack J.P., Jones D.T. (1997), Lean Thinking. Come creare valore e bandire gli sprechi, Milano, Guerini e Associatio.
  53. Yin R. K. (1994), Case study research: design and methods, Thousand Oaks, California, Sage Publications.
  54. Yin R. K. (2005), Lo studio di casi nella ricerca scientifica, Ed. Italiana, Roma, Armando Editore.
  55. Young P., Tomski M. (2002), An introduction to risk management, Physical Medicine and Rehabilitation Clinics of North America, 13, 2, pp. 225-246.

  • Considerations regarding the attitude of medical staff towards administrative risks within the Pathology Department Aurora Maria Popa, Bianca Andreea Lazar, Liviu Onoriu Marian, Ovidiu Simion Cotoi, Septimiu Voidăzan, in Acta Marisiensis - Seria Medica /2024 pp.157
    DOI: 10.2478/amma-2024-0023
  • Il cambiamento dei sistemi di controllo manageriale e il processo di successione nelle imprese familiari. Quali possibili relazioni? Francesca Maria Cesaroni, Annalisa Sentuti, in MANAGEMENT CONTROL 1/2019 pp.17
    DOI: 10.3280/MACO2019-001002

Antonio Fusco, Grazia Dicuonzo, Vittorio Dell’Atti, Nii Amoo, The clinical risk management. A case study in "MANAGEMENT CONTROL" 3/2017, pp 31-52, DOI: 10.3280/MACO2017-003003