Clinical risk is an avoidable increase in the probability of harm occurring to a patient
Clinical Risk Management (CRM) is an approach to improving the quality and safety of healthcare by:
placing special emphasis on identifying circumstances that put patients at risk of harm acting to prevent or control those risks
CRM helps the hospital: to maintain and improve quality of services improve patient safety reduce frequency of litigation help maintain trust in profession prevent staff lose
Medical Error
It is the failure of a planned action to be completed as intended (i.e. error of execution e.g. error of drug dose calculation) or the use of wrong plan to achieve an aim (I.e. error of planning e.g. wrong lab result leading to wrong management)
Medical errors have the potential for physical, emotional and financial burden on the patient.
Types of Medical Errors
1) Diagnostic errors: e.g. use of outdated tests resulting in false diagnosis
2) Treatment errors e.g. giving intramuscular injection instead of intravenous, error in performance of procedure, error in drug dose
3) Prevention errors e.g. failure to provide prophylactic treatment such as heparin for embolism, patient not informed of post-surgical care
4) Other e.g. communication failure, equipment failure
Misdiagnosis contributes to 40% of errors, medication errors contribute 28% and medical procedure errors contribute 22%
Most errors take place in ICU and A&E because there are many procedures taking place thus the risk of errors is high, the staff are working under stress due to heavy workload, patients are fully dependent as they may unconscious, stressed
Differentiation of adverse outcomes
A. Near miss: this is when an error results in a close call because only by chance no patient injury was produced e.g. doctor prescribed penicillin to a patient with penicillin allergy but the pharmacist just happened to ask the patient if he had any allergies
B. Adverse event: an injury