title: Clinical risk in rehabilitation: an exploratory investigation in Campania region.
abstract: BACKGROUND
  Clinical risk management is a comprehensive programme that encompasses all the measures implemented to improve the quality of the healthcare service and ensure patient safety, which is based on learning through error. This process is intended to bring about ongoing improvements in clinical practice, starting with risk identification, before moving on to risk assessment and analysis, in order to reduce risks where possible. When clinical risk management is applied in rehabilitation, the first step involves identifying errors by assessing adverse events, which are considered to indicate the existing risk. Our work aims to explore the characteristics of the clinical risk in rehabilitation so as to learn more about its extent, its components, and its implications for the user.
  
  
  METHODS
  Our study involved numerous workers operating in four different branches of rehabilitation - speech therapy, physiotherapy, psychomotor education and occupational therapy - at forty-nine private rehabilitation centres in the province of Naples, an area that has not been studied before. A questionnaire was drafted regarding the main errors committed in the rehabilitation sector. It was then distributed and collected in again, after which the results were analysed and outcomes measured. Out of a total of 556 questionnaires distributed, 493 were returned (88.6% response rate.).
  
  
  RESULTS
  The study revealed that for all the rehabilitation branches considered, the macro-category of errors linked to technical and professional aspects accounted for the highest percentage of the total errors (39%). In this study, the most frequent errors linked to technical and professional aspects were: wrong dose errors, treatment planning errors and functional assessment errors.
  
  
  CONCLUSIONS
  There is an evident need to take action in order to manage the clinical risk in rehabilitation: to promote a concept of errors as opportunities for learning and improvement; to maintain the focus on both individual responsibility and on any systemic failings; to share fundamental values such as transparency, collaboration between workers, communication with patients, and a commitment to ongoing improvements in healthcare quality.
authors.affiliation: Department of Public Health, School of Medicine and Surgery, "Federico II" University of Naples, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Corrado
authors.affiliation: Department of Public Health, School of Medicine and Surgery, "Federico II" University of Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Di Meglio
authors.affiliation: Department of Public Health, School of Medicine and Surgery, "Federico II" University of Naples, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Montuori
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012047:Rehabilitation Centers / Q000458:organization & administration* / Q000592:standards; D018570:Risk Assessment / Q000379:methods; D012308:Risk Management / Q000379:methods; D011795:Surveys and Questionnaires
keywords: Clinical risk; Errors; Management; Rehabilitation