Sikkerhet i helse som et samfunnsanliggende

1. Sikkerhet i helse som et samfunnsanliggende Lillestrøm, 31. oktober 2007 Sven Mollekleiv Det Norske Veritas

2. New risk reality • Companies today are operating in an increasingly more complex and demanding risk environment • Society at large is gradually adopting a “zero tolerance” for failure • More detailed reporting and demands for transparency • Stricter regulatory requirements • More watchdogs Version

3. Climate Change Impacts Version

4. Environment = Business • “Responsible investing: Bottom line is more than making a profit” • “Commentators agree that taking a longer-term view is not altruistic, but about ensuring the best outcome for investors” 9. October 2006 ”The Stern review is not only a counsel of hope, it is a necessary call for action” - Financial Times Leader, 31. October 2006 Version

5. Tsunami Catastrophe Version

6. Version

7. Enron Version

8. Version

9. Version

10. Version

11. The New Risk Reality Version

12. Stakeholders’ growing importance Local community NGOs Company Shareholders Own employees Customers Authorities Investors Suppliers/ business partners Version

13. HC Issues Patient safety makes it to the headlines • Never has so many patient been treated • Never has the spending been so high • Never has the quality been so good • Still 10.000’s are dying of errors in hospitals • Patient safety on the agenda “world wide” Version

14. What we deliver…. • Climate Change & Managing greenhouse gas emissions • Environmental services & emergency response • Management systems & Risk Based Certification™ • Sustainability reporting • Corporate responsibility assessment • Corporate governance assessment • Fraud & corruption resistance assessment • Social Accountability (SA 8000). • isrs7 - environment, health safety and quality in the workplace. Version

15. DNV - sertifisering av styringssystemer • Kvalitetsstyring ISO 9001 • Miljøstyring ISO 14001/EMAS • HMS - Sikkert arbeidsmiljø OHSAS 18001 • Matvaresikkerhet BRC, ISO 22001 • Medisinsk utstyr ISO 13485:2003 • Informasjonssikkerhet ISO/IEC 27001 • IT Drift ISO/IEC 20001 • Guide for softwareutvikling TickIt • eBusiness Management System EB trust • Bedrifters samfunnsansvar CSR/SA 8000 Version

16. DNV services • NOW: gaining “Hospital Assessors” position • Alternative Accreditation in the US • Hospital Assessment and rating in the UK • Hospital certification (ISO, OHSAS) in various countries • NOW: Risk Management • Existing Risk management - UK • Involve IQM – quality off information is crucial as hospitals move to electronic medical records systems • Future (depends greatly on achieving recognition as an Accreditation Organization of Hospitals) • Bio Risk • Public Health • Fraud and Corruption (Insurance?) Version

17. Klinikk Stokkan AS • Selle Rehabiliteringssenter • Aleris Ungplan • Laerdal Medical • Hand-Pro AS • Fresenius Kabi Norge AS • Actavis Norway, Avdeling Norgesplaster • Snøgg AS • Roche Diagnostics Norge AS • Vingmed AS • Diacor AS • FMC Biopolymer AS Nova Matrix • SonoWand AS • Larvik kommune Referanser - systemsertifisering • Rikshospitalet – radiumhospitalet HF avd for Sterilforsyning • Ullevål Universitetssykehus, Mikrobiologisk avd. og Blodbank • Akershus Universitetssykehus Blodbank • Sykehuset Asker og Bærum HF, Blodbank og Nukleærmedisinsk seksjon • St. Olavs Hospital HF, Blodbank • Helse Nord-Trøndelag HF, psykiatrisk klinikk Version

18. Sikkerhetskultur i helsevesenet The National Coalition on Health Care beskriver et ”paradigmeskifte” i synet på pasientsikkerhet i USA: Fra Til • Her er alt bra! Her er det uendelige muligheter for feil • Feil oppstår sjelden Feil oppstår ofte • Si så lite som mulig Fortell alt du vet • Gi meg navnet på den som gjorde det! Finn frem til root cause • Straff den som varsler Belønn den som varsler • Lag flere rutiner og prosedyrer Gjør systemet enklere Version

19. Sertifisering bidrar til • Oversikt, styring og kontroll med prosessene • Fokus, motivasjon og inspirasjon • Forpliktelse av ledelsen • Uavhengig vurdering – perspektiv utenfra • Hjelp til organisasjonen (kvalitet/ miljø/ sikkerhet…) • Forbedret konkurranseevne • Bedret styring av leverandørene • Pålitelighet. Standarden er ofte definert som beste praksis, og bidrar til å sikre pålitelige og konsistente tjenester/produkter. Version

20. Laboratory Biorisk Version

21. Laboratory biorisk management - current situation • Few internationally recognized standards • Poor awareness and adoption of formal systems to manage biorisk • Oversight varies according to geography Ebola, smallpox, Lassa fever 50 BSL4 Level of control TB, prions, HIV, anthrax 16,500 BSL3 Salmonella, influenza, 250,000 BSL2 • International exchange and collaboration increasingly difficult • Limited transparency towards external stakeholders Version

22. Guidance, operation, reporting International declarations and conventions UDHR, ILO, OECD, UN Global Compact, etc. National legislation Vision, objective, strategy Optimise predictability Minimise uncertainty Version

23. Competency chart DNV staff around the world Our people – a vital resource • People are the core of DNV • 85 different nationalities Version