Background: Long outpatient waiting time is a significant problem in Mainland China’s healthcare system. Long patient waiting time negatively affects actual care quality as well as patients’ perceptions of medical care. Aim: This study aims to understand the causes of long patient wait times in China’s outpatient care departments, and how those waits influence patients’ attitudes towards medical care. The rhythm of hospital patient flow will be explored in order to posit modest suggestions to resolve these issues. Objectives: The objectives of this study are to identify the causes of long waiting times in China’s outpatient care departments, to distinguish the specific bottleneck points in patient flow, and to characterize the relationship between waiting time length and the patients’ perceptions of medical care. Method: Two tertiary care hospitals in Mainland China were included as study sites. Macroergonomic methodologies were adopted to guide the data collection and analysis. The Systems Engineering Initiative for Patient Safety (SEIPS) model was specifically adopted to guide the study design and data analysis procedures. First, audio records were made of interviews with care providers from the two hospitals in order to document and discern the causes of long outpatient care waiting times. Second, a time study was carried out with patients visiting two outpatient departments at the two study sites in order to identify inefficiencies and bottleneck points in the patient flow. Third, a questionnaire survey was provided to the patients in order to understand the impact of lengthy wait times on their overall perceptions of medical care. The interview data was analyzed using content analysis methods, time study data was used to generate a patient flow model, and the questionnaire feedback was analyzed in tandem with the time study data using a linear regression analysis. Results: Sixty-three factors contributing to lengthy patient wait time were discerned from the interview data, concerning each of the five dimensions of the SEIPS model work system. Two patient flow diagrams were designed based on identified patient flow inefficiencies and bottlenecks. A majority (four-fifths and three-quarters, respectively, at the two study sites) of total patient visit time was spent on waiting for physician services and ancillary, non-medical activities. Serious bottlenecks in patient flow occurred while waiting for physician consultation, ultrasound examinations, and medical test result feedback. Patients’ evaluations of medical care quality dropped 0.04 points for each minute of consultation wait time, and 0.02 points for each minute of total visit duration and total waiting time. Conclusions: The causes of long patient wait times concern the physicians’ and patients’ characteristics, the organization and management of the hospital, the tasks, technology, and tools involved, and the hospital environment. Waiting for physician consultation, ultrasound examinations, and medical test result feedback cause the most patient flow problems. Long wait times have an adverse impact upon patients’ perceptions of medical care. The macroergonomic methodologies prove feasible and effective in evaluating health care systems. / published_or_final_version / Industrial and Manufacturing Systems Engineering / Master / Master of Philosophy

Purpose: There is a pressing need to enhance patient safety in the hospital environment. While there are many initiatives that focus on improving patient safety, few have studied engaging patients themselves to participate in patient safety efforts. This work was motived by the belief that patients can contribute valuable information to their care and when equipped with the right tools, can play a role in improving medication safety in the hospital. Methods: This research had three aims and used a mixed-methods approach to better understand the concept of engaging patients to improve medication safety. In order to gain insight into whether patients could beneficially contribute to the safety of their hospital care, my first aim was to understand current perspectives on the sharing of clinical information with patients while they were in the hospital. To accomplish this aim, I conducted surveys with clinicians and enrolled patients in a short field study in which they received full access to their clinical chart. In Aim 2, I conducted a study to establish that the Patient Activation Measure (PAM), a common measure of patient engagement in the outpatient setting, showed reliability and validity in the inpatient setting. Building on the knowledge from Aim 1 and using the PAM instrument from Aim 2, my third aim evaluated the impact of providing patients with access to a medication review tool while they were preparing to be admitted to the hospital. Aim 3 was achieved through a randomized controlled trial (RCT) involving 65 patients I recruited from the emergency department at Columbia University Medical Center. I also conducted a survey of admitting clinicians who had patients participate in the trial to identify the impact on clinician practices and to elicit feedback on their perceptions of the intervention. Results: My research findings suggest that increased patient information sharing in the inpatient setting is beneficial and desirable to patients, and generally acceptable to clinicians. The clinician survey from Aim 1 showed that most respondents were comfortable with the idea of providing patients with their clinical information. Some expressed reservations that patients might misunderstand information and become unnecessarily alarmed or offended. In the patient field study from Aim 1, patients reported perceiving the information they received as highly useful, even if they did not fully understand complex medical terms. My primary contribution in Aim 2 was to provide sound evidence that the Patient Activation Measure is a valid and reliable tool for use in the inpatient setting. Establishing the validity and reliability of the PAM instrument in inpatient setting was essential for conducting the RCT in Aim 3, and it will provide a foundation for future clinicians and research investigators to measure and understand hospital patients’ levels of engagement. The results from the RCT in Aim 3 did not support my primary hypothesis that clinicians who had patients participate in their medication review process using an informatics tool would make more changes to the home medication list than clinicians who had patients in the control group. However, the results did suggest that most hospital patients are knowledgeable, willing, and able to contribute useful and important information to the medication reconciliation process. Interestingly, the clinicians I surveyed seemed far less convinced that their patients would be able to beneficially participate in the medication reconciliation process due to low health literacy and other barriers. Nevertheless, the clinicians did seem to believe that in theory, at least, patient involvement in the medication reconciliation process could have positive impacts on their workflow and potentially save them time. Conclusion: The overall theme resulting from my research is that patients can be a valuable resource to improve patient safety in the hospital. Patients are generally knowledgeable and willing to more actively participate in their hospital care. By developing the structures and processes to facilitate greater patient engagement, hospitals can provide an extra layer of safety and error prevention, particularly with respect to the medications patients take at home. As with any medical treatment, active participation in patient safety efforts may not be possible for all patients. However, I believe that if the culture of a hospital encourages openness and transparency, and if patients are given the proper tools and information, the quality and safety of hospital care will improve.

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No description available.

Transparency in healthcare relates to formally reporting medical errors and disclosing bad outcomes to patients and families. Unfortunately, most physicians are not in the habit of communicating transparently, as many studies have shown the existence of a large medical error information gap. Research also shows that creating a culture of transparency would mutually support patient safety and risk management goals by concomitantly reducing medical errors and alleviating the malpractice crisis. Three predictor variables are used to represent the various dimensions of the context just described. Perfectionism represents the intrapersonal domain, socio-organizational climate represents the interpersonal and institutional domains, and medico-legal environment represents the societal domain. Chin and Benne’s normative re-educative strategy provides theoretical support for the notion that successful organizational change hinges upon addressing the structural and cultural barriers displayed by individuals and groups. The Physician Transparency Questionnaire was completed by 270 physicians who were drawn from a multi-site healthcare organization in Central Florida. Structural equation modeling was used to determine whether perfectionism, socio-organizational climate, and medico-legal environment significantly predict two transparency outcomes, namely, error reporting transparency and provider-patient transparency. Perfectionism and socio-organizational climate were found to be statistically significant predictors. Collectively, these variables accounted for nearly half of the variance in each transparency outcome. Within socio-organizational climate, policies had the greatest influence iv on transparency, followed by immunity and professional norms. Multiple group analysis showed that the covariance model developed in this study generalizes across gender, medical specialty, and occupation. In addition, group means comparisons tests revealed a number of interesting trends in error reporting and disclosure practices that provide insights about the behavioral and cognitive psychology behind transparent communication: 1) Physicians are more inclined to engage in provider-patient transparency compared to error reporting transparency, 2) physicians are more inclined to report serious errors compared to less serious errors, and 3) physicians are more inclined to express sympathy for bad outcomes than they are to apologize for a preventable error or be honest about the details surrounding bad outcomes. These results suggest that change efforts would need to be directed at medical education curricula and health provider organizations to ensure that current and future generations of physicians replace the pursuit for perfectionism with the pursuit for excellence. Also, a number of institutional changes are recommended, such as clearly communicating transparency policies and guidelines, promoting professional norms that encourage learning from mistakes rather than an aversion to error, and reassuring physicians that reporting and disclosure activities will not compromise their reputation. From the perspective of patient safety advocates and risk managers, the results are heartening because they emphasize a key principle in quality improvement - i.e., small changes can yield big results. From an ethical standpoint, this research suggests that healthcare organizations can inhibit (or facilitate) the emergence of professional virtues. Thus, although organizations cannot make a physician become virtuous, it is within their power to create conditions that encourage the physician to practice certain virtues. With respect to leadership styles, this research finds that v bottom-up, grassroots change efforts can elicit professional virtues, and that culture change in healthcare lies beyond the scope of the medico-legal system

Esse estudo tem por objetivo geral propor um mapa espacial de doses como ferramenta auxiliar na avaliação da necessidade de otimização de ambientes em serviços de medicina nuclear e, por objetivos específicos, avaliar as dosimetrias individuais dos trabalhadores; analisar a estrutura física dos serviços de medicina nuclear; avaliar as taxas de dose do ambiente. A pesquisa realizada se caracteriza como um estudo de caso, de natureza exploratória e explicativa, em três Serviços de Medicina Nuclear estabelecidos na região Noroeste do Estado do Paraná. Os resultados obtidos indicaram que as taxas de dose avaliadas e a dosimetria dos trabalhadores, em todas as dependências dos serviços pesquisados, respeitam os limites de doses anuais, mas algumas excedem os limites de investigações preconizados na norma NN-CNEN 3.01 (2014). Concluiu-se que o mapa espacial de dose é uma ferramenta importante para os serviços de medicina nuclear, pois facilita a visualização das áreas com maior concentração de radiação, bem como a revisão contínua de tais medidas e recursos para identificar quaisquer falhas e deficiências na sua aplicação, corrigi-las e evitar suas repetições, além de verificar regularmente se os objetivos de proteção radiológica estão sendo alcançados. / This study has as general aim to propose a spatial map of doses as an auxiliary tool in assessing the need for optimization of the workplace in nuclear medicine services. As specific aims, we assessed the workers individual dosimetry; we analyzed the facilities of the nuclear medicine services; and we evaluated environment exposure rates. The research is characterized as a case study, with an exploratory and explanatory nature. It was conducted in three Nuclear Medicine Services, all established in the Northwest of the Paraná State. Results indicated that the evaluated dose rates and workers dosimetry, in all the dependencies of the surveyed services, are within the limits of annual doses. However some exceeded the limits recommended in the standard CNEN-NN 3:01 (2014). It was concluded that the spatial map dose is an important tool for nuclear medicine services because it facilitates the visualization of areas with highest concentration of radiation, and also helps in the constant review of these measures and resources, aiding in the identification of any failures and shortcomings, providing resources to correct any issues and prevent their repetition. The spatial map dose is also important for the regular inspection, evaluating if the radiation protection objectives are being met.

Esse estudo tem por objetivo geral propor um mapa espacial de doses como ferramenta auxiliar na avaliação da necessidade de otimização de ambientes em serviços de medicina nuclear e, por objetivos específicos, avaliar as dosimetrias individuais dos trabalhadores; analisar a estrutura física dos serviços de medicina nuclear; avaliar as taxas de dose do ambiente. A pesquisa realizada se caracteriza como um estudo de caso, de natureza exploratória e explicativa, em três Serviços de Medicina Nuclear estabelecidos na região Noroeste do Estado do Paraná. Os resultados obtidos indicaram que as taxas de dose avaliadas e a dosimetria dos trabalhadores, em todas as dependências dos serviços pesquisados, respeitam os limites de doses anuais, mas algumas excedem os limites de investigações preconizados na norma NN-CNEN 3.01 (2014). Concluiu-se que o mapa espacial de dose é uma ferramenta importante para os serviços de medicina nuclear, pois facilita a visualização das áreas com maior concentração de radiação, bem como a revisão contínua de tais medidas e recursos para identificar quaisquer falhas e deficiências na sua aplicação, corrigi-las e evitar suas repetições, além de verificar regularmente se os objetivos de proteção radiológica estão sendo alcançados. / This study has as general aim to propose a spatial map of doses as an auxiliary tool in assessing the need for optimization of the workplace in nuclear medicine services. As specific aims, we assessed the workers individual dosimetry; we analyzed the facilities of the nuclear medicine services; and we evaluated environment exposure rates. The research is characterized as a case study, with an exploratory and explanatory nature. It was conducted in three Nuclear Medicine Services, all established in the Northwest of the Paraná State. Results indicated that the evaluated dose rates and workers dosimetry, in all the dependencies of the surveyed services, are within the limits of annual doses. However some exceeded the limits recommended in the standard CNEN-NN 3:01 (2014). It was concluded that the spatial map dose is an important tool for nuclear medicine services because it facilitates the visualization of areas with highest concentration of radiation, and also helps in the constant review of these measures and resources, aiding in the identification of any failures and shortcomings, providing resources to correct any issues and prevent their repetition. The spatial map dose is also important for the regular inspection, evaluating if the radiation protection objectives are being met.

Em 2013, foi implantado no Brasil o Programa Nacional de Segurança do Paciente (PNSP), que através da Resolução RDC No 36, prevê que as instituições de saúde brasileiras devem apresentar um Plano de Segurança do Paciente (PSP) para as situações que possam proporcionar a ocorrência de eventos adversos (EAs), ou seja, lesão ou dano não intencional causado ao paciente pela intervenção assistencial e não pela doença base. O PSP é um documento com embasamento científico que aponta as situações de risco e descreve estratégias e ações definidas pelo serviço de saúde para a gestão do risco com objetivo de prevenção e redução dos EA em todas as fases da assistência. O implante de eletrodos para estimulação encefálica profunda (EEP) é um procedimento realizado rotineiramente no Hospital Marcelino Champagnat (HMC), localizado na cidade de Curitiba – PR, para melhorar a sintomatologia e a qualidade de vida de pacientes portadores de determinados distúrbios neurológicos crônicos. A confiabilidade e a precisão do posicionamento dos eletrodos cerebrais após a implantação de sistemas de EEP é de suma importância para a eficácia do método, sendo a Imagem por Ressonância Magnética (IRM) pós-operatória, atualmente, o padrão ouro para documentação do correto posicionamento dos eletrodos. Entretanto, a interação do sistema de EEP com o campo de radiofrequência do equipamento de IRM pode constituir uma fonte de EAs, uma vez que possibilita a indução de correntes elétricas com potencial de causar lesões térmicas ao paciente em locais de alta resistência. As recomendações de segurança dos fabricantes para a maioria dos sistemas de EEP implantados são bastante restritivas e resultam em longos tempos de exame ou em imagens de baixa qualidade, fatores que dificultam a prática em muitos centros. Estudos in vitro revelam que o aquecimento excessivo ocorre sob determinadas configurações, enquanto outras não oferecem risco fisiológico ao paciente. Estudos clínicos com base em vasta experiência sustentam a evidência de que é possível realizar exames pós-operatórios de forma satisfatória e sem a ocorrência de EAs utilizando parâmetros menos restritivos que aqueles determinados pelos fabricantes, desde que alguns padrões de segurança sejam cuidadosamente seguidos. Dessa forma, o presente trabalho propõe a elaboração de um PSP para a situação específica de pacientes com sistemas de EEP submetidos à exames de IRM no HMC, com base nas recomendações de segurança do fabricante e na revisão sistemática da literatura. De acordo com a base de dados consultada, um total de 26 artigos científicos foram considerados relevantes e permitiram identificar as possíveis fontes de risco de forma a evitá-las, colaborando com a conclusão satisfatória do PSP. Além de suprir a demanda local, o presente trabalho visou também promover a cultura de segurança do paciente e despertar a atenção para a necessidade de interposição de barreiras às diversas oportunidades de EAs que os setores de radiologia podem oferecer. A metodologia aqui proposta pode servir, ainda, de base para que outros centros de diagnóstico por imagem componham seus próprios PSPs. / In 2013, the National Program Patient Safety (PNSP) was implemented in Brazil through Resolution RDC 36, providing that the Brazilian health institutions must have a Patient Safety Plan (PSP) for situations that may lead to adverse events (AEs), which are unintentional injury or damage caused to the patient by the health care intervention and not by the primary disease. The PSP is a document with scientific basis that points to hazardous situations and describes strategies and actions defined by the health service for risk management in order to prevent and reduce AEs in all phases of patient care. Implantation of Deep Brain Stimulation (DBS) devices is considered a routine procedure at the Hospital Marcelino Champagnat (HMC), located in Curitiba – PR, and it consists in a practice widely used to improve symptoms and quality of life of patients with certain chronic neurological disorders.The reliability and accuracy of the final brain positioning of the leads, after the DBS implantation are of paramount importance to assure efficacy. Currently, post-operative Magnetic Resonance Imaging (MRI) is the gold standard for the documentation of the correct lead positioning. However, the interaction between the DBS system and the MRI radiofrequency field could represent an important source of adverse events (EAs) since it allows electric currents induction with potential to cause local thermal injuries on high resistance sites. The safety recommendations from the DBS system manufacturers for most of the already deployed systems are quite restrictive resulting in long examination times or low quality images, which compromises the practice in many centers. Thus, the present work proposes the development of a PSP based on the manufacturer's safety recommendations and a systematic review of the literature to the specific situation of patients with DBS systems undergoing MRI scans at the HMC. We found a total of 26 papers, that were considered relevant and allowed us to identify the potential sources of risk in order to avoid them, collaborating to the successful elaboration of the PSP. Besides supplying local demand, this work also aims to promote patient safety and draw attention to the need of interposing barriers in order to avoid significant AEs situations that a radiology department may be presented with. Moreover, the methodology proposed here can serve as a basis for other imaging centers to compose their own PSPs.

O Cateter Central de Inserção Periférica (PICC) constitui-se de dispositivo intravenoso, instalado através de uma veia periférica, que avança até a veia cava adquirindo características de cateter central. Neste sentido, o presente estudo teve como objetivo geral: identificar as condições de viabilidade para a definição de padrões e protocolos que possibilitem a utilização do PICC em pacientes adultos e pediátricos. E como objetivos específicos: analisar o desempenho da primeira e terceira geração de PICC em pacientes da oncohematologia comparando com a literatura internacional; detectar pontos sensíveis no contexto do uso do PICC para a proposição de protocolo; propor instrumento para a coleta e investigação de relevância de dados e variáveis; e propor protocolo de utilização do PICC para pacientes pediátricos e adultos. Trata-se de estudo descritivo exploratório observacional prospectivo longitudinal com abordagem quantitativa. A pesquisa foi desenvolvida na Unidade de Hemoterapia, Hematologia e Oncologia (UHHO) nos setores: Serviço de Transplante de Medula Óssea (STMO), Quimioterapia de Alto Risco (QTAR) e seus ambulatórios, Unidade de Terapia Intensiva (UTI) cardíaca, clínica médica e pediátrica, num hospital de ensino da região do sul do país. A amostra foi não-probabilística, por conveniência constituída de dois grupos, (Grupo 1) pacientes que utilizaram a primeira geração do PICC e (Grupo 2) pacientes que utilizaram a terceira geração do dispositivo. Os dados foram coletados no período de janeiro de 2015 a agosto de 2016 através de instrumento elaborado para este estudo, contendo 22 variáveis sócio-demográficas e 35 variáveis clínicas. 40 PICCs primeira geração foram inseridos em 36 pacientes por técnicas “às cegas”, totalizando 830 dias de cateter, média de 20,71 dias, tendo alcance mínimo de dois e máximo de 141 dias. Quanto à terceira geração do cateter, dez PICCs foram inseridos em dez pacientes por Técnica de Seldinger Modificada (TSM) guiados pelo Ultrassom (US), totalizando 397 dias de cateter, média de 39,7 dias com alcance mínimo de dez e máximo de 86 dias. Realizou-se análise descritiva por meio da distribuição de frequência absoluta, média e desvio padrão. Posteriormente, todas as variáveis foram analisadas pelo ‘Software R’, identificou-se 11 componentes principais que fortemente se relacionaram e constituíram a base do Modelo de Equações Estruturais (MEE). Estas variáveis expressam-se de maneira relevante para o desenvolvimento de investigações futuras. Em suma, o PICC pode ser utilizado com sucesso na maioria dos pacientes internados na oncohematologia e em outros setores no ambiente hospitalar, assim como em crianças. Pode ser inserido por enfermeiros, desonerando o ambiente cirúrgico, processo anestésico e o médico especialista, conferindo-lhes autonomia. / The Peripherally Inserted Central Catheter (PICC) consists of an intravenous device, installed through a peripheral vein, wich advanced to the vena cava acquiring central catheter characteristics. In this sense, the present study had as general objective: to identify the feasibility conditions for the definition of standards and protocols that allow the use of PICC in adult and pediatric patients. And as specific objectives: to analyze the performance of the first and third generation of PICC in oncohematology patients comparing with the international literature; to detect sensitive points in the context of the use of the PICC for the protocol proposal; propose an instrument for the collection and relevant investigation of data and variables; and to propose protocol of use of PICC for pediatric and adult patients. This is a descriptive prospective longitudinal observational exploratory study with a quantitative approach. The research was developed in the Hematology, Oncology and Hematology Unit (UHHO) in the following sectors: Bone Marrow Transplantation Service (STMO), High Risk Chemotherapy (QTAR) and its outpatient clinics, Intensive Care Unit (ICU), cardiac, medical clinic and pediatric in a teaching hospital in the southern region of the country. The sample was non-probabilistic, for convenience consisted of two groups, (Group 1) patients who used the first generation of PICC and (Group 2) patients who used the third generation of the device. Data were collected from January 2015 to August 2016 through an instrument developed for this study, containing 22 socio-demographic variables and 35 clinical variables. 40 firstgeneration PICCs were inserted in 36 patients by "blind" techniques, totaling 830 days of catheter, average of 20.71 days, with a minimum range of two and a maximum of 141 days. Regarding the third generation of the catheter, ten PICCs were inserted in ten patients by Ultrasound-guided Modified Seldinger Technique (TSM), totaling 397 days of catheter, mean of 39.7 days with a minimum range of ten and a maximum of 86 Days. A descriptive analysis was performed by means of the absolute frequency distribution, mean and standard deviation. Afterwards, all variables were analyzed by 'Software R', we identified 11 main components that were strongly related and formed the basis of the Structural Equations Model (MEE). These variables express themselves in a relevant way for the development of future investigations. In summary, PICC can be used successfully in most patients admitted to oncohematology and other sectors in the hospital setting, as well as in children. It can be inserted by nurses, discharging the surgical environment, anesthetic process and the specialist doctor, granting them autonomy.

Em 2013, foi implantado no Brasil o Programa Nacional de Segurança do Paciente (PNSP), que através da Resolução RDC No 36, prevê que as instituições de saúde brasileiras devem apresentar um Plano de Segurança do Paciente (PSP) para as situações que possam proporcionar a ocorrência de eventos adversos (EAs), ou seja, lesão ou dano não intencional causado ao paciente pela intervenção assistencial e não pela doença base. O PSP é um documento com embasamento científico que aponta as situações de risco e descreve estratégias e ações definidas pelo serviço de saúde para a gestão do risco com objetivo de prevenção e redução dos EA em todas as fases da assistência. O implante de eletrodos para estimulação encefálica profunda (EEP) é um procedimento realizado rotineiramente no Hospital Marcelino Champagnat (HMC), localizado na cidade de Curitiba – PR, para melhorar a sintomatologia e a qualidade de vida de pacientes portadores de determinados distúrbios neurológicos crônicos. A confiabilidade e a precisão do posicionamento dos eletrodos cerebrais após a implantação de sistemas de EEP é de suma importância para a eficácia do método, sendo a Imagem por Ressonância Magnética (IRM) pós-operatória, atualmente, o padrão ouro para documentação do correto posicionamento dos eletrodos. Entretanto, a interação do sistema de EEP com o campo de radiofrequência do equipamento de IRM pode constituir uma fonte de EAs, uma vez que possibilita a indução de correntes elétricas com potencial de causar lesões térmicas ao paciente em locais de alta resistência. As recomendações de segurança dos fabricantes para a maioria dos sistemas de EEP implantados são bastante restritivas e resultam em longos tempos de exame ou em imagens de baixa qualidade, fatores que dificultam a prática em muitos centros. Estudos in vitro revelam que o aquecimento excessivo ocorre sob determinadas configurações, enquanto outras não oferecem risco fisiológico ao paciente. Estudos clínicos com base em vasta experiência sustentam a evidência de que é possível realizar exames pós-operatórios de forma satisfatória e sem a ocorrência de EAs utilizando parâmetros menos restritivos que aqueles determinados pelos fabricantes, desde que alguns padrões de segurança sejam cuidadosamente seguidos. Dessa forma, o presente trabalho propõe a elaboração de um PSP para a situação específica de pacientes com sistemas de EEP submetidos à exames de IRM no HMC, com base nas recomendações de segurança do fabricante e na revisão sistemática da literatura. De acordo com a base de dados consultada, um total de 26 artigos científicos foram considerados relevantes e permitiram identificar as possíveis fontes de risco de forma a evitá-las, colaborando com a conclusão satisfatória do PSP. Além de suprir a demanda local, o presente trabalho visou também promover a cultura de segurança do paciente e despertar a atenção para a necessidade de interposição de barreiras às diversas oportunidades de EAs que os setores de radiologia podem oferecer. A metodologia aqui proposta pode servir, ainda, de base para que outros centros de diagnóstico por imagem componham seus próprios PSPs. / In 2013, the National Program Patient Safety (PNSP) was implemented in Brazil through Resolution RDC 36, providing that the Brazilian health institutions must have a Patient Safety Plan (PSP) for situations that may lead to adverse events (AEs), which are unintentional injury or damage caused to the patient by the health care intervention and not by the primary disease. The PSP is a document with scientific basis that points to hazardous situations and describes strategies and actions defined by the health service for risk management in order to prevent and reduce AEs in all phases of patient care. Implantation of Deep Brain Stimulation (DBS) devices is considered a routine procedure at the Hospital Marcelino Champagnat (HMC), located in Curitiba – PR, and it consists in a practice widely used to improve symptoms and quality of life of patients with certain chronic neurological disorders.The reliability and accuracy of the final brain positioning of the leads, after the DBS implantation are of paramount importance to assure efficacy. Currently, post-operative Magnetic Resonance Imaging (MRI) is the gold standard for the documentation of the correct lead positioning. However, the interaction between the DBS system and the MRI radiofrequency field could represent an important source of adverse events (EAs) since it allows electric currents induction with potential to cause local thermal injuries on high resistance sites. The safety recommendations from the DBS system manufacturers for most of the already deployed systems are quite restrictive resulting in long examination times or low quality images, which compromises the practice in many centers. Thus, the present work proposes the development of a PSP based on the manufacturer's safety recommendations and a systematic review of the literature to the specific situation of patients with DBS systems undergoing MRI scans at the HMC. We found a total of 26 papers, that were considered relevant and allowed us to identify the potential sources of risk in order to avoid them, collaborating to the successful elaboration of the PSP. Besides supplying local demand, this work also aims to promote patient safety and draw attention to the need of interposing barriers in order to avoid significant AEs situations that a radiology department may be presented with. Moreover, the methodology proposed here can serve as a basis for other imaging centers to compose their own PSPs.