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13th International Conference on Health Promoting Hospitals (HPH) May 18-20, 2005 Dublin - Ireland ‘Active’ safety in the Tuscany Health Promoting Hospitals Network : From Training to Project F.Simonelli, L.Colonna, L.Tavanti, M.J. Caldés Pinilla, K.Majer Short introduction to the context: 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. LOCAL HEALTH UNIT LOCAL HOSPITAL UNIT 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 - The approach - The interpretation model - The work developed - The phases of the pathway training Key concepts : Safety: Is a relative concept, to define on the base of the levels of ‘passive safety’ and ‘active safety’ passive safety: the level of safety guaranteed by Acted by the observance of the the adoption of the rules rules active safety : Acted by the awareness and co- the level of passive safety increased operation of patients (and their through Health Promotion activities relatives), health professionals and community The approach END Active safety Awareness, Health literacy, Participation …. END Middle Situation Compensatory behaviour START END Passive safety observance of the rules Rules + Compensatory behaviour Global safety (?) + Empowerment The interpretation model Systemic vision: • CULTURAL ENVIRONMENTAL • PHYSICAL • LOGISTIC STANDARDS Organizational vision: • RE-ENGINEERING Integrated HPH PROCESSES • INNOVATION Planning Re-orientation of the Setting RE-DESIGN Professional vision: between: • PATIENTS • RELATIVES RELATIONSHIPS • OPERATORS • PARTNERS EMPOWERMENT • COMMUNITY 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 safety concept The phases of the training pathway 1. Study of initiatives made by Tuscany Hospitals RE-ORIENTATION Active safety PROJECT Active safety Analysis Grid (selective) SAFETY ON THE (Hospital Setting and safety) ‘SETTING’ LEVEL SAFETY ON THE ‘RELATIONSHIP’ (Relationship and Hospital Safety) LEVEL SAFETY ON THE (Safety in the diagnosis and therapeutic process. Risk ‘PROCESS’ LEVEL management) 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: • 1st requirement: EMPOWERMENT • Others requirements: FATTIBILITY TRASFERIBILITY POTENZIALE ATTRATTIVO COERENCE WITH THE REGIONAL POLITICAL ADRESS Level of development of the local projects/experiences Experience 1. 100% EMPOWERMENT! Experience 2. 100% 33% Experience 3. 100% 100% 33% Experience 4. 100% passive safety Middle Situation Experience 5. 100% 66% active safety Experience 6. 66% passive Active Middle safety Situation safety 3. Re-elaboration of this experiences and their synthesis in a shared integrated project based on the active safety concept The results of this analysis and elaboration was the identification of the following five arguments: • Prevention of pressure sores • Prevention of falls • Treatment with central intravenous catheter (CVC) • Safety in the antiballistic therapy • Prevention of the latex allergies Progress made after the end of the training pathway (December, 2004) For each sub-project: • constitution of a thematic Working Group (inter-corporate, inter- disciplinary character) • elaboration of the timetable 2005 with the following goals: - definition of a set of standards, both on the passive and the active safety level - assessment of their feasibility - individuation of specific good practices.
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