Search Results (4)

(1) Background: Identifying hospital-related critical, and excellent, areas represents the main goal of this paper, in both a national and local setting. Information was collected and organized for an internal company’s reports, regarding civil litigation that has been affecting the hospital, to relate the obtained results with the phenomenon of medical malpractice on a national scale. This is for the development of targeted improvement strategies, and for investing available resources in a proficient way. (2) Methods: In the present study, data from claims management in Umberto I General Hospital, Agostino Gemelli University Hospital Foundation and Campus Bio-Medico University Hospital Foundation, from 2013 to 2020 were collected. A total of 2098 files were examined, and a set of 13 outcome indicators in the assessment of “quality of care” was proposed. (3) Results: From the total number, only 779 records (37.1%) were attributable to the categories indexable for the present analysis. This data highlights how, following a correct and rigorous categorization of hospital events, it is possible to analyze these medico-legal aspects using a small number of indicators. Furthermore, it is important to consider how a consistent percentage of remaining events was difficult to index, and was also of poor scientific interest. (4) Conclusions: The proposed indicators do not require standards to be compared to, but provide a useful instrument for comparative purposes. In fact, in addition to comparative assessment between different business realities distributed throughout the territory, the use of outcome indicators allows for a longitudinal analysis evaluating the performance of an individual structure over time. Full article

Incident reporting is an important method to identify risks because learning from the reports is crucial in developing and implementing effective improvements. A medical malpractice claims analysis is an important tool in any case. Both incident reports and claims show cases of damage caused to patients, despite incident reporting comprising near misses, cases where no event occurred and no-harm events. We therefore compare the two worlds to assess whether they are similar or definitively different. From 1 January 2014 to 31 December 2021, the claims database of Policlinico Universitario A. Gemelli IRCCS collected 843 claims. From 1 January 2020 to 31 December 2021, the incident-reporting database collected 1919 events. In order to compare the two, we used IBNR calculation, usually adopted by the insurance industry to determine loss to a company and to evaluate the real number of adverse events that occurred. Indeed, the number of reported adverse events almost overlapped with the total number of events, which is indicative that incurred-but-not-reported events are practically irrelevant. The distribution of damage events reported as claims in the period from 1 January 2020 to 31 December 2021 and related to incidents that occurred in the months of the same period, grouped by quarter, was then compared with the distribution of damage events reported as adverse events and sentinel events in the same period, grouped by quarter. The analysis of the claims database showed that the claims trend is slightly decreasing. However, the analysis of the reports database showed that, in the period 2020–2021, the reports trend was increasing. In our study, the comparison of the two, malpractice claims and incident reporting, documented many differences and weak areas of overlap. Nevertheless, this contribution represents the first attempt to compare the two and new studies focusing on single types of adverse events are, therefore, desirable. Full article

This study aimed to assess current perceptions of heat stress, heat strain, acclimatisation and recovery practices in wildland fire suppression. A total of 1459 wildfire and structural firefighters, all involved in wildland fire suppression, completed an 18-question survey. Most participants (81.3%) reported heat strain as one of the main risks faced during wildland firefighting. Thermal strain is considered an important risk for health and safety in wildland firefighting. The best-valued heat strain mitigation strategies were those traditionally recommended in wildland fire suppression: (i) an adequate work/rest ratio (79.0%), (ii) acclimatisation (71.6%), (iii) enhancing body ventilation by opening protective clothing or removing helmets or gloves (63.5%), and (iv) drinking water and food supplementation (52.1%). Despite these results, only 22% of the participants reported carrying out acclimatisation in the workplace. The vast majority of the respondents (87.4%) consider active cooling strategies (i.e., ice slurry ingestion, ice vests, etc.) impractical in combating heat strain during wildfire suppression. We identified a gap between knowledge about heat strain, its mitigation strategies and the level of actual implementation of these practices in the workplace. Our results highlight the need to improve heat strain management and implement operational directives for acclimatisation and active cooling interventions. Full article

Every year worldwide some extraordinary wildfires occur, overwhelming suppression capabilities, causing substantial damages, and often resulting in fatalities. Given their increasing frequency, there is a debate about how to address these wildfires with significant social impacts, but there is no agreement upon terminology to describe them. The concept of extreme wildfire event (EWE) has emerged to bring some coherence on this kind of events. It is increasingly used, often as a synonym of other terms related to wildfires of high intensity and size, but its definition remains elusive. The goal of this paper is to go beyond drawing on distinct disciplinary perspectives to develop a holistic view of EWE as a social-ecological phenomenon. Based on literature review and using a transdisciplinary approach, this paper proposes a definition of EWE as a process and an outcome. Considering the lack of a consistent “scale of gravity” to leverage extreme wildfire events such as in natural hazards (e.g., tornados, hurricanes and earthquakes) we present a proposal of wildfire classification with seven categories based on measurable fire spread and behavior parameters and suppression difficulty. The categories 5 to 7 are labeled as EWE. Full article