1. © Joint Commission International Joint Commission International Carlo Ramponi, Joint Commission International, European Office, via Ripamonti 44, Milano Risk Management in Ospedale tra Governance e Assicurazioni Cineas, Milano 21 giugno 2012

2. © Joint Commission International 2  A government or non-government agency grants recognition to health care institutions which meet certain standards that require continuous improvement in structures, processes, and outcomes  Usually a voluntary process Accreditation – A Definition

3. © Joint Commission International Potential Return on Investment 1.Greater clarity to leadership structure and quality oversight 2.More efficient, cost effective work processes 3.Better preventive maintenance program – longer life of biomedical equipment 4.Improved care – fewer complications 5.More satisfied staff – better retention and lower recruitment and training costs 6.Better safety management, and risk reduction – reduced liability exposure 7.Special recognition from payment sources and insurance companies 8.Better reputation -- increased number of new patients

4. © Joint Commission International AOP COP ACC PCI QPS MCI SQE FMS GLD PFRPFE FUNCTIONS MMU ASC IPSG

5. © Joint Commission International The Systemic Approach MMU COP FMS QPS ASC PFR PFE PCI IPSG GLD SQE MCI ACC AOP

6. © Joint Commission International International Patient Safety Goals since 2007 1.Identify Patients Correctly 2.Improve Effective Communications 3.Improve the Safety of High-Alert, High Risk Medications 4.Eliminate Wrong-side, Wrong-patient, Wrong- procedure Surgery 5.Reduce the Risk of Health Care-acquired Infections 6.Reduce the Risk of Patient Harm Resulting from Falls

7. © Joint Commission International Type of Sentinel Events: TJC USA database 7

8. © Joint Commission International Sentinel Events Outcomes 8

9. © Joint Commission International Most Frequently Identified Root Causes

10. © Joint Commission International 10 International Library of Measures The International Perspective  Ongoing self-evaluation as a mandatory requirement for accreditation recognition  5 out of 11 clinical measures drawn from ILM  International Comparison based on ILM collected by JCI from JCI accredited hospitals  ILM development based on JCI accredited hospitals suggestions and international experience  The Adverse Events International data-base.

11. © Joint Commission International Thank you For more information: On JCR products and services www.jcrinc.com +1630-268-7400 On JCI accreditation and advisory services www.jointcommissioninternational.org +1630-268-4800 Carlo Ramponi, MD JCI Europe cramponi@jcrinc.com +393477295364