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

2. Accreditation – A Definition • 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 voluntaryprocess

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

4. FUNCTIONS PCI ASC MMU QPS GLD IPSG PFE PFR COP ACC MCI FMS AOP SQE

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

6. International Patient Safety Goalssince 2007 • Identify Patients Correctly • Improve Effective Communications • Improve the Safety of High-Alert, High Risk Medications • Eliminate Wrong-side, Wrong-patient, Wrong-procedure Surgery • Reduce the Risk of Health Care-acquired Infections • Reduce the Risk of Patient Harm Resulting from Falls

7. Type of Sentinel Events: TJC USA database

8. Sentinel Events Outcomes

9. Most Frequently Identified Root Causes

10. International Library of MeasuresThe 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. 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