Risk assessment towards patient safety in health care facilities.

Background: Medical care is not a harmless practice. It involves intrinsic risks for those who receive it. Risk assessment in health care has been a common practice for several decades; however, evaluation for comprehensive risk management in health care facilities is a more recent practice. This paper proposes that patient safety results from measures at different levels: public health, health care facilities and clinical practice. In each of these, it is possible to assess and manage risks towards improvements in patient safety in order to reduce both incidents and related adverse events.

Methods: We designed a method to assess risk in terms of hospital patient safety based on theoretical models used in public administration, health systems in industrialized countries and the General System Theory. We evaluated risk in a general hospital of 170 beds with four basic services and 16 medical and surgical specialties. The evaluation was conducted by an external body with the participation of local managers and staff.

Results: The evaluation revealed that the structural and outcome components had a moderate risk, with overall scores of 73.3% and 70.0%, respectively. The process component had a high risk, with an overall score of 41.6%.

Conclusions: The methodology proved to be a useful tool for the assessment of risks and risk management strategies related to medical care. Available information at the hospital facilitated implementation of the method.