Increasing the options for reducing adverse events: Results from a modified Delphi technique

Table 5 Other hospital regulation

Proposals	Effect [1 = v.high 6 = negative] mean (std dev)	Implement (months)	Impact (months)	Total (years)
5.1 Regulation should require a defined minimum complement of qualified staff in situ (or in close proximity) following defined procedures in all public and private hospitals, where the required minimum is determined by patient safety during the high-risk period of recuperation.	2.00 (.79)	12	9	1.8
5.2 All hospitals should have in place a risk management system that ensures personnel can initiate action to prevent and/or reduce the impact of risks. Whistle-blower procedures should be formalised to guarantee anonymity and/or protection for whistle blowers.	1.82 (.73)	8	10	1.5
5.3 All hospitals should have trained, specialized risk management staff.	2.24 (.75)	9	11	1.7
5.4 All hospital staff should be trained in risk management, so that all staff assume 'ownership' of safety and quality issues.^a	2.00 (.94)	12	11	1.9
5.5 All hospitals should have in place an equipment replacement program and dedicated funding should be made available annually to replace unsafe equipment. This funding should not be part of the overall budget.	2.19 (.91)	11	31	3.5
5.6 All university hospitals should have medical education departments for (a) education, (b) credentialing and (c) simulation.	1.94 (.57)	31	19	4.2

a There is some scope for disagreement about what this might mean in practice. For example, the Victorian Department of Human Services believes 'that all staff should be aware of RCA processes (Root Cause Analysis) but need not be fully trained in conducting a RCA'.