The clinical risk management as a tool to improve the quality and appropriateness of health services, in recent years has proved to conquer a central position in the politics of Clinical Governance. The main reason behind this rise is the need to contain the increasing litigation in the Jield of medical liability through instruments able to assess the risk profile oj health services and in the meantime to get toolsJor prevention / correction of critical issues. Another reason is the introduction of high insurance deductibles (sometimesgreater than One million euros) and the retirement oj many insurance companies in the market of medical malpractice that hasforced many hospitals (somewhere even entire Regions) lo activate schemes for self-management of claims. In this context an essential role is played by the legal medical examiner oj the hospital; therefore, it is mandatory to guarantee the acquisition of theoretical and practical principlesjrom the beginning of the professional training in legal medicine. This should led up to a highest co-operation among the professionals involved in the clinical risk management and, consequently, to an improvement of the effectiveness and efficiency of the whole health system. 1 his paper shows the state of the art of the Italian professional training in legal medicine with regard to the Jield of clinical risk management through the analysis of the main existing rules and a survey distributed to 29 Italian Schools of Specialization of Legal Medicine. Our results have demonstrated a lack of attention of ministerial training plans to the issue of clinical risk management, especially in terms oj practical activities; we have also noticed a heterogeneous pattern in the survey. According to these results, the A uthors suggest to insert specific formative objectives in the ministerial training plans that should be rewritten in order to conform them to the reduction from S to 4 training years in many medical specialties provided by the laws n. 128/2013 andn. 114/2014.
The professional training oe residents in legal medicine in clinical risk management state of the art and proposals for the new ministerail training plan
Bonsignore, Alessandro;Tettamanti, Camilla;
2014-01-01
Abstract
The clinical risk management as a tool to improve the quality and appropriateness of health services, in recent years has proved to conquer a central position in the politics of Clinical Governance. The main reason behind this rise is the need to contain the increasing litigation in the Jield of medical liability through instruments able to assess the risk profile oj health services and in the meantime to get toolsJor prevention / correction of critical issues. Another reason is the introduction of high insurance deductibles (sometimesgreater than One million euros) and the retirement oj many insurance companies in the market of medical malpractice that hasforced many hospitals (somewhere even entire Regions) lo activate schemes for self-management of claims. In this context an essential role is played by the legal medical examiner oj the hospital; therefore, it is mandatory to guarantee the acquisition of theoretical and practical principlesjrom the beginning of the professional training in legal medicine. This should led up to a highest co-operation among the professionals involved in the clinical risk management and, consequently, to an improvement of the effectiveness and efficiency of the whole health system. 1 his paper shows the state of the art of the Italian professional training in legal medicine with regard to the Jield of clinical risk management through the analysis of the main existing rules and a survey distributed to 29 Italian Schools of Specialization of Legal Medicine. Our results have demonstrated a lack of attention of ministerial training plans to the issue of clinical risk management, especially in terms oj practical activities; we have also noticed a heterogeneous pattern in the survey. According to these results, the A uthors suggest to insert specific formative objectives in the ministerial training plans that should be rewritten in order to conform them to the reduction from S to 4 training years in many medical specialties provided by the laws n. 128/2013 andn. 114/2014.
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