Risk Management as a Part of Quality Management System. MRI Private Clinic. Russia

Transcription

1 Risk Management as a Part of Quality Management System. MRI Private Clinic. Russia Poster No.: C-0078 Congress: ECR 2014 Type: Scientific Exhibit Authors: M. Yastrebova 1, A. K. Karpenko 1, T. Trofimova 2 ; 1 Saint- Petersburg/RU, 2 St. Petersburg/RU Keywords: Quality assurance, Audit and standards, MR, Management DOI: /ecr2014/C-0078 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 15

2 Aims and objectives The structured approach to reduce risk levels till possible minimum for patients and personnel during MRI examinations on all steps of patient management in MRI department, using all the principles of the Quality Management System. When the staff acts in a very high professional way, it shows, that: - Quality of the department is manageble; - The risk of incident in the department is very low; - The risk of the insufficient result is very low; - The aim of the company is the constant improvement. So, using the structured approach and eight principles of the quality management system, we considerably improve the quality of the medical service, and lead the company to it`s success. The risk management system, installed in the MRI department ensures the safety of the patient, safety of the personnel and the quality of the diagnostics. Page 2 of 15

3 Images for this section: Fig. 1: Principles of the Quality Management System MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Page 3 of 15

4 Methods and materials According to Quality Management System (QMS), which was certified in our clinic 2010, next step was to specify risk levels on the steps of patient management during MRI examination and assess, whether all standard operational procedures (SOP) were optimized: patient registration; examination time; examination protocols for each region, consisting of high quality standards in order to quantify risk rating from lower to catastrofic. The process maps were arranged for all medical, organizational, financial, support and other processes. Main procedures that were quantified: special access system into department; special regulation of critical situations; quality of equipment with 5-year maintenance contract with producer; personnel training on regularly bases according to own and world experience; SOP for regulation of acute cases with patients, risks in quality of examination and main risk in doctors reports. In order to develop the risk management system all possible risks were identified, described, ranged with colors. Than tools of their management were chosen, risk -strategy was elaborated, so possible negative consequences for patient of stuff health, or financial state of department were minimized. Page 4 of 15

5 Images for this section: Fig. 5: Risk Management System in MRI Department MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Fig. 6: The Processes Mapping Page 5 of 15

6 MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Fig. 7: Example of the Risk Assessment. Risk Zone - Confidenciality MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Fig. 8: Risks Partition Page 6 of 15

7 MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Page 7 of 15

8 Results All processes in daily work are monitored by the shift personell, consisting of medical and nonmedical personell, with purpose to correct risk management system, as quality management system purpose is constant improvement. Three risk factors were extracted: radiologist`s factor, equipment factor and patient factor. In different risk zones the identified risks were ranged with colors. Separately SOPs were divided into operating zones and for every staff specialization were renewed: registration staff, technicians, doctors and engineers. Once SOPs have been implemented, any time when team members had an unclear situation SOPs are used for decision making. The Implementation of SOPs has reduced any possible risks in daily routine: equality of images quality, performed by different people, precise knowledge about needed time for examination, better possibility for planning, no risks with metal and other risk MRI devices in procedure room. Special SOP was made for contrast enhancement procedures: indications, dosage, standards of postcontrast image analysis, allergy management. SOPs for maintenance of team work between departments helped to safe necessary time for emergency work, that also reduces risks. Quality self control and audits system were elaborated and implemented. Quality management system according to ISO 9001:2008 is in process of integration with risk management system, certification of integrated QMS is planned for Maximum possible quantity of risks are identified, ranged, tools to manage them are chosen. More examinations monthly, high patient liability, high financial results, that allowed to open the second and the third affiliates. Page 8 of 15

9 Images for this section: Fig. 3: Results of the Risk Management Implementation MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Fig. 9: Medical and Engineering Staff Cooperation Page 9 of 15

10 MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Page 10 of 15

11 Conclusion Organization of risk management system and precise follow up during last year showed the high effectiveness in private MRI- clinic. Not correct procedures or standards can be followed up by health damage of patient, not efficient examination result, financial losses of clinic. Regularly audits and feedbacks from staff help us to improve our risk management system. To our opinion, risk management system is helpful, and obviously obligatory in radiological clinic. Page 11 of 15

12 Images for this section: Fig. 4: Loyality of our patients MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Fig. 10: Summary Page 12 of 15

13 MRI, Scandinavia Clinic, NMC-Tomography Ltd - Saint-Petersburg/RU Page 13 of 15

14 Personal information Marina Yastrebova, Ph.D., MRI Dept. of "Scandinavia Clinic", Saint-Petersburg, certified QMS Auditor, Alla Karpenko, Asst.Prof.M.D.,Ph.D, Head of MRI department, Tatyana Trofimova, Prof., M.D., Chief Doctor of "Scandinavia clinic", Saint-Petersburg, Page 14 of 15

15 References 1. ISO 9001:2008 Quality Management System. Requirements. 2. ESR IV Risk Management in Radiology in Europe 3. EN Dienstleistungen in der Gesundheitsversorgung - Qualitaetsmanagementsysteme - Anforderungen nach EN ISO 9001: IWA 1:2005 "Quality management systems - Guidelines for processes improvements in health service organizations" 5. Lawrence S. Lau, MBBS, Maria R.Perez, MD, Kimberly E. Applegate, MD, MS, Madan M. Rehani, PhD, Hans G. Ringertz, MD, PhD, Robert George, ARMIT, Dip Pract Man, Global Quality Imaging: Emerging Issues, J Am Coll Radiol 2011;8: American College of Radiology Frank James Lexa, MD, MBA, Tushar Mehta, MPPM, PhD, Abraham Seidmann, PhD, Managerial Accounting Applications in Radiology, J Am Coll Radiol 2005;2: American College of Radiology Page 15 of 15