A Human Reliability approach to Clinical Risk Management (CRM): methodological and cultural issues

Safety in medicine is a rapidly developing field. The present paper deals with the identification and description of new human reliability methodological and cultural developments in medical sector, adapting the existing techniques which are well established in the industry sector and have potential applications in the Italian healthcare organisations. We carried out, in the first instance, a literature review to classify all techniques in current or recent use in an international and national context. We identified some guidelines, which are useful for the development of a new CRM methodology, based on Human Reliability Analysis (HRA). The gathered qualitative data were analysed by groups of experts, through structured focus group discussion, group interviews and with in-depth individual interviews. It is envisaged that this paper could act as a framework for other healthcare systems wishing to develop sustainable processes for managing the generation and application of HRA methods alongside hospitalisation processes.