Background. In recent decades, the concept of error in healthcare has evolved, shifting from a punitive approach, focused on individual responsibility, to a systemic perspective, aimed to learning and continuous improvement in the quality of care. Although clinical risk is widely studied in the medical field, literature remains limited about rehabilitation, and specifically around speech and language therapy. However, the complexity of speech therapy interventions does not exempt this practice from risks that can compromise the effectiveness of treatment. Considering these findings, the present study aims to analyse the presence of clinical risk in speech and language therapy by identifying the most frequent errors, exploring the level of training on the subject, and analysing the possible relationship between the frequency of errors and professional variables. Materials and Methods. The research was conducted through a cross-sectional, descriptive observational study, using a questionnaire turned to speech and language therapists practicing in the Marche Region. The questionnaire, divided into two sections, collected socio-demographic and professional information and investigated the frequency of 15 types of errors, occurring in professional practice. The collected data were analysed using descriptive statistics (percentages and frequencies). The study was conducted among 75 speech and language therapists working in various settings, including hospitals, private accredited facilities, local health units and private practice. Results. The main findings of the study point out the presence of clinical risk in speech and language therapy practice, considered as a set of potential critical issues rather than severe adverse events. The majority of the speech therapists involved reported occasionally encountering errorsrelated to: the definition of clinical goals (78.7%), the collection of anamnestic information (77,3%), the application of rehabilitative criteria (65,3%), the estimation of patient expectation, needs and wishes (64%), the selection and execution of therapeutic manoeuvres (57,3%), the updating or transcription of data in clinical records (56%), the measurement of outcomes (54,7%) and the assessment of the patient's main problem (53,3%). Furthermore, it has emerged that 57% of participants had attended at least one training course on clinical risk; however, the majority reported limited participation, with 47% attending only one course and 40% attending 2-3 courses. In conclusion, the differences observed in the distribution of errors, particularly in relation to years of service, suggest that clinical risk may be influenced by professional experience. Conclusions. The study confirms the presence of clinical risk in speech and language therapy, whose management should be considered as an integral part of clinical practice, not only in terms of error prevention but also as a strategic lever for improving the quality of care. The vulnerabilities identified in the phases of assessment, treatment planning and clinical documentation, management highlight the necessity of targeted interventions: strengthening skills in Evidence-Based Practice (EBP), adopting standardized tools, promoting multidisciplinary teamwork, improving clinical documentation management and implementing structured training programs on risk management. Overall, the data collected provide relevant insights to guide future research on clinical risk in speech and language therapy.
Background. Negli ultimi decenni, il concetto di errore in campo sanitario si è evoluto, passando da un approccio punitivo centrato sulla responsabilità individuale a una visione sistemica, orientata all’apprendimento e al miglioramento della qualità assistenziale. Sebbene il rischio clinico sia ampiamente studiato in ambito medico, la letteratura rimane limitata per quanto riguarda la riabilitazione, e in particolare la logopedia. Tuttavia, la complessità degli interventi logopedici non esenta questa pratica da rischi che possono compromettere l’efficacia delle cure. Alla luce di quanto emerso, il presente studio si propone di analizzare la presenza del rischio clinico in logopedia, identificando gli errori più frequenti, esplorando il livello di formazione in materia e analizzando la possibile relazione tra la frequenza degli errori e le variabili professionali. Materiali e Metodi. La ricerca è stata condotta mediante uno studio osservazionale descrittivo trasversale, attraverso la somministrazione di un questionario ai logopedisti operanti nella Regione Marche. Il questionario, articolato in due sezioni, ha raccolto informazioni sociodemografiche e professionali ed ha indagato la frequenza di 15 tipologie di errore che si verificano nella pratica professionale. I dati raccolti sono stati analizzati mediante statistica descrittiva (percentuale e frequenza). Il campione oggetto dello studio è composto da 75 logopedisti, operanti in contesti ospedalieri, strutture private convenzionate, presidi ASL, libera professione. Risultati. I risultati principali dello studio evidenziano la presenza del rischio clinico nella pratica logopedica, inteso come un insieme di criticità potenziali piuttosto che come eventi avversi gravi. La maggior parte dei logopedisti coinvolti riferisce di riscontrare come eventi che si verificano occasionalmente errori riguardanti: definizione degli obiettivi clinici (78,7%), raccolta delle informazioni anamnestiche (77,3%), applicazione di criteri riabilitativi (65,3%), stima delle aspettative, delle attese e dei desideri del paziente (64%), scelta/esecuzione di una manovra terapeutica (57,3%), aggiornamento o trascrizione di dati nella cartella clinica (56%), misurazione degli outcome (54,7%), valutazione del problema principale del paziente (53,3%). È emerso inoltre che il 57% dei partecipanti ha frequentato almeno un corso di formazione sul rischio clinico; tuttavia, la maggioranza riferisce una partecipazione limitata a uno (47%) o a 2-3 corsi (40%). Infine, le differenze osservate nella distribuzione degli errori, in relazione soprattutto agli anni di servizio suggeriscono come il rischio clinico possa essere influenzato dall’esperienza. Conclusioni. Lo studio conferma la presenza del rischio clinico in logopedia, la cui gestione dovrebbe essere considerata parte integrante della pratica clinica, non solo in termini di prevenzione dell’errore, ma come leva strategica per il miglioramento della qualità assistenziale. Le vulnerabilità emerse nelle fasi di valutazione, pianificazione del trattamento e gestione della documentazione clinica rendono prioritari alcuni interventi mirati: il rafforzamento delle competenze in Evidence-Based Practice (EBP), l’adozione di strumenti standardizzati, la promozione del lavoro multidisciplinare, il miglioramento della gestione della documentazione clinica e l’implementazione di percorsi formativi strutturati. In conclusione, i dati raccolti offrono spunti rilevanti per orientare future ricerche sul rischio clinico in logopedia.
Rischio clinico in logopedia: studio osservazionale rivolto ai logopedisti della Regione Marche
IANUA', CHIARA
2024/2025
Abstract
Background. In recent decades, the concept of error in healthcare has evolved, shifting from a punitive approach, focused on individual responsibility, to a systemic perspective, aimed to learning and continuous improvement in the quality of care. Although clinical risk is widely studied in the medical field, literature remains limited about rehabilitation, and specifically around speech and language therapy. However, the complexity of speech therapy interventions does not exempt this practice from risks that can compromise the effectiveness of treatment. Considering these findings, the present study aims to analyse the presence of clinical risk in speech and language therapy by identifying the most frequent errors, exploring the level of training on the subject, and analysing the possible relationship between the frequency of errors and professional variables. Materials and Methods. The research was conducted through a cross-sectional, descriptive observational study, using a questionnaire turned to speech and language therapists practicing in the Marche Region. The questionnaire, divided into two sections, collected socio-demographic and professional information and investigated the frequency of 15 types of errors, occurring in professional practice. The collected data were analysed using descriptive statistics (percentages and frequencies). The study was conducted among 75 speech and language therapists working in various settings, including hospitals, private accredited facilities, local health units and private practice. Results. The main findings of the study point out the presence of clinical risk in speech and language therapy practice, considered as a set of potential critical issues rather than severe adverse events. The majority of the speech therapists involved reported occasionally encountering errorsrelated to: the definition of clinical goals (78.7%), the collection of anamnestic information (77,3%), the application of rehabilitative criteria (65,3%), the estimation of patient expectation, needs and wishes (64%), the selection and execution of therapeutic manoeuvres (57,3%), the updating or transcription of data in clinical records (56%), the measurement of outcomes (54,7%) and the assessment of the patient's main problem (53,3%). Furthermore, it has emerged that 57% of participants had attended at least one training course on clinical risk; however, the majority reported limited participation, with 47% attending only one course and 40% attending 2-3 courses. In conclusion, the differences observed in the distribution of errors, particularly in relation to years of service, suggest that clinical risk may be influenced by professional experience. Conclusions. The study confirms the presence of clinical risk in speech and language therapy, whose management should be considered as an integral part of clinical practice, not only in terms of error prevention but also as a strategic lever for improving the quality of care. The vulnerabilities identified in the phases of assessment, treatment planning and clinical documentation, management highlight the necessity of targeted interventions: strengthening skills in Evidence-Based Practice (EBP), adopting standardized tools, promoting multidisciplinary teamwork, improving clinical documentation management and implementing structured training programs on risk management. Overall, the data collected provide relevant insights to guide future research on clinical risk in speech and language therapy.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/26226