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Process support for risk mitigation: a case study of variability and resilience in vascular surgery
Berit Brattheim1, Arild Faxvaag, Andreas Seim
1Department of Radiography, Sør-Trøndelag University College, HiST, MTFS, O Kyrresegt 9, NO-7489 Trondheim, Norway. berit.j.brattheim@ntnu.no
BMJ Quality & Safety
|February 18, 2011
Summary
Process variations in surgical care often stem from risk mitigation efforts. Designing IT support to enhance system resilience and manage risks is crucial for improving patient safety and preventing care breakdowns.
Area of Science:
- Healthcare Management
- Surgical Process Analysis
- Information Technology in Healthcare
Background:
- Surgical care processes involve multiple institutions and professionals, leading to inherent variability.
- Understanding the sources of this process variation is key for optimizing care delivery and IT support design.
Purpose of the Study:
- To explore characteristics and sources of process variability in surgical care.
- To inform the design of effective information technology (IT) support for surgical processes.
Main Methods:
- A case study approach was used within the Abdominal Aortic Aneurysm (AAA) surveillance program across three Norwegian hospitals.
- Data were collected through observational studies of patient-surgeon encounters and semistructured interviews with patients and healthcare personnel.
Main Results:
- Four dimensions of process variation were identified, classified as intended or unintended.
- Care processes are largely characterized by systematic risk analysis and mitigation.
- Variations arise from both clinical aims/patient preferences and system resilience limitations.
Conclusions:
- Process variation is partly driven by systematic risk mitigation strategies.
- IT support should be designed to foster resilience, manage risks, and prevent patient dropouts.
- Enhancing system resilience through IT can improve patient safety in surgical care pathways.
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