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Cagliano AC, Grimaldi S, Rafele C. A structured approach to analyse logistics risks in the blood transfusion process. J Healthc Risk Manag 2021; 41:18-30. [PMID: 33434405 DOI: 10.1002/jhrm.21458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/12/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Blood transfusion is a critical health care process due to the nature of the products handled and the complexity driven by the strong interdependence among the sub-processes involved. Most of the errors causing adverse events originate during the blood logistics activities. Several literature contributions apply risk management to the transfusion process but often in a fragmented and reactive way. Moreover, few of them focus on logistics risks and assess the effectiveness of risk responses through operational key performance indicators (KPIs). The present paper applies a comprehensive and structured approach to proactively identify and analyse logistics risks as well as define responses to improve blood bag traceability, focusing on hospital wards. The implementation of such actions is monitored by specific KPIs whose measurement enables an improved communication flow among actors allowing to uncover residual risks. Future research will extend the application to further blood transfusion settings and supply chain echelons. The outcomes of this work might assist practitioners in improving policy making about blood supply chains. As a matter of fact, they allow a better understanding of the associated material and informational flows and the related risks, which supports setting effective strategies to either prevent adverse events or mitigate their effects.
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Affiliation(s)
- Anna Corinna Cagliano
- Department of Management and Production Engineering, Politecnico di Torino, Torino, Italy
| | - Sabrina Grimaldi
- Department of Management and Production Engineering, Politecnico di Torino, Torino, Italy
| | - Carlo Rafele
- Department of Management and Production Engineering, Politecnico di Torino, Torino, Italy
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Yarrow E, Pagan V. 'Reflections on frontline medical work during Covid-19, and the embodiment of risk'. GENDER WORK AND ORGANIZATION 2020; 28:89-100. [PMID: 32837018 PMCID: PMC7361443 DOI: 10.1111/gwao.12505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 11/18/2022]
Abstract
Drawing on the voice of a woman NHS front‐line doctor during the current COVID‐19 pandemic, we explore her lived experience of the embodiment of risk in the crisis. We explore her struggles and difficulties, giving her voice and mobilizing our writing to listen to these experiences, reflecting on them as a way of living our own feminist lives. Her story illustrates that the current crisis is not only a crisis of health, but a crisis for feminism. Through telling her story, we cast light upon the embodied amplification of inequalities, paternalistic discourses around risk and lived experience of exposure to risk of contracting a deadly virus. We explore her work on the NHS front line, providing a conceptual framework of the multi‐level facets of the embodiment of risk, through lived experiences of risk and observations of the inequality of risk in the context of the COVID‐19 pandemic in the UK.
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Su WTK, Lehto MR, Degnan DD, Yih Y, Duffy VG, DeLaurentis P. Healthcare Professionals Risk Assessments for Alert Overrides in High-Risk IV Infusions Using Simulated Scenarios. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:1342-1354. [PMID: 32339316 DOI: 10.1111/risa.13489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 03/02/2020] [Accepted: 03/18/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to use healthcare professionals' assessments to calculate expected risk of intravenous (IV) infusion harm for simulated high-risk medications that exceed soft limits and to investigate the impact of relevant risk factors. We designed 30 infusion scenarios for four high-risk medications, propofol, morphine, insulin, and heparin, infused in adult intensive care unit (AICU) and adult medical and surgical care unit (AMSU). A total of 20 pharmacists and 5 nurses provided their assessed expected risk of harm in each scenario. Descriptive statistics, analysis of variance with least square mean, and post hoc test were conducted to test the effects of field limit type, soft (SoftMax), and hard maximum drug limit types (HardMax), and care area-medication combination on risk of harm. The results showed that overdosing scenarios with continuous and bolus dose limit types were assessed with significantly higher risks than those of bolus dose rate type. An overdose infusion in AICU over a large SoftMax was assessed to be of higher risk than over a small one, but not in AMSU. For overdose infusions with three levels of drug amount, greater drug amount in AICU and AMSU was assessed to have higher risk, except insignificant risk difference between the infusions with higher and moderate drug amount in AMSU. This study obtained expected risk for simulated high-risk IV infusions and found that different field limit and SoftMax types can affect expected risk based on healthcare professionals' perspectives. The findings will be regarded as benchmarks for validating risk quantification models in future research.
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Affiliation(s)
- Wan-Ting K Su
- Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Detroit, MI, USA
| | - Mark R Lehto
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA
| | - Dan D Degnan
- Professional Programs Laboratory, Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, IN, USA
- Regenstrief Center for Healthcare Engineering, Purdue University, Gerald D. and Edna E. Mann Hall, West Lafayette, IN, USA
| | - Yuehwern Yih
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA
- Regenstrief Center for Healthcare Engineering, Purdue University, Gerald D. and Edna E. Mann Hall, West Lafayette, IN, USA
| | - Vincent G Duffy
- School of Industrial Engineering, Purdue University, West Lafayette, IN, USA
| | - Poching DeLaurentis
- Regenstrief Center for Healthcare Engineering, Purdue University, Gerald D. and Edna E. Mann Hall, West Lafayette, IN, USA
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Ead H. Patient Safety Consultants-Adding to Patient Care or Overhead Costs? J Perianesth Nurs 2019; 32:267-268. [PMID: 28527559 DOI: 10.1016/j.jopan.2017.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 01/19/2017] [Indexed: 11/13/2022]
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