The HSWI: Health and Safety Workplace Index. A new method for managing the residual risk in hospitals

Introduction
This study's purpose is to develop a useful tool for assessing and managing the residual risk in hospitals. The method is structured according to the principles based on the occupational H&S. The model's peculiarities are: the smartness of implementation, the possibility of reproduction and the opportunity to easily control through the time the identified residual risk factors.

Methods
The theoretical approach starts from an overall vision of an integrated management system designed to quantify and measure the antecedents, not only for the inner negative factors, but also to consider the positive factors of the concerned organization.
In order to do that, an accurate analysis is carried out of the incidents & accidents or near misses causes (related to: corporate organization, personal factors, machinery or equipment, etc.) and the positive or anticausal factors that are also involved. While the causal variables (lack in procedures, insufficient training, etc) are responsible for the generation errors, the anticausal ones (efficient internal communication, good ergonomics, etc) increase the corporate system of H&S while working.

Results
The selected factors will be submitted to a ternary statistical analysis, bearing in mind that the remaining residual risk cannot be eliminated, with the purpose of obtaining two different values (for the causal and anticausal factors). Using these values a torus will be created, in which the two types of variables will be put together. The created relation between the factors will define the current hospital HWSI.

Discussion
By applying this method, the HSWI could be estimated for hospitals and the results shown as a simple toroidal graph representation, as a donut. Over time the fluctuation system can identify easily which factors were properly managed and those that still need to be worked on in order to optimize the result, by deepening each variable as to avoid or minimize the possible adverse events.