Model for comprehensive management of patient safety events at Lithuanian hospitals

Patients have the right to safe and quality health care (HC). They contact hospitals or other health care institutions (HCI) expecting help in restoring or strengthening health and do not expect to suffer any health damage or lose life. However, research shows that every tenth hospitalised patient suffers from adverse events (AE) resulting from shortcomings characteristic of a HC organisation or service provision. More than half of AE could have been prevented provided systematic prevention measures had been implemented. The prevalence of AE and their damage to patients, HC organisations, the entire HC sector and national economies remains unacceptably high. Implementation of actions to improve patient safety (PS) and ensure the provision of safer patient care has become the most important HC challenge of the 21st century. Notwithstanding the extensive international PS movement that has emerged during the last two decades and plenty of international and national initiatives aimed at improving PS, a substantial breakthrough in ensuring safe patient care still remains a goal to be achieved. The main cause of disappointment is failure to implement international and national level PS improvement initiatives at the local (health care organization and its departments) level. There is no managerial adaptation mechanism to customize international and national level PS practices thus adapting them for hospital needs, specifics and potential. The article presents and substantiates the comprehensive management model of PS events (Model) for hospitals and other HC organisations to use as a basis in developing and implementing comprehensive systems for PS management with the aim of more effectively expanding the scope of safe practices and implementing prevention of PS events as well as improving their management. The proposed Model consists of three structural blocks the integrated interaction of which is aimed at ensuring: (a) identification of the best international and national PS practice and its implementation at hospitals; (b) creation of conditions necessary to develop safe practice with the aim of ensuring and improving PS at hospitals; (c) detection, evaluation and development of safe practice; (d) comprehensive prevention and management of unsafe practice at hospitals thus ensuring and improving PS and contributing to the improvement of performance and achievement of the goals of the entire organisation. The article discusses structure and functions of the Model, its integration with other activities within the organization, interaction with other institutions and organizations that participate in ensuring PS at hospitals, including problems related to its implementation at different hospitals