Root Cause Analysis to Identify the Invisible Barriers in Clinical Practice: a Systematic Literature Review

The COVID-19 pandemic has strongly impacted clinical risk management in public and private healthcare organizations globally.In this situation, the main factors causing adverse events in the health system have emerged. Digital healthcare innovations are of increasing importance for scholars and professionals in the field. To this end, the aims of this study are: to identify the causes that lead to adverse events in healthcare, and to investigate whether the use of Root Cause Analysis by healthcare managers is a useful tool for identifying invisible barriers in clinical management.In order to deepen knowledge in the field, a systematic literature review was carried out encouraging management of healthcare organizations towards the adoption of digital innovations in healthcare.The results have been grouped in 4 clusters: medical error, patient safety, risk assessment, and e-health. The clusters analysis has highlighted that the organizational gaps, also known as invisible barriers, are within operational units or within simple care paths. Several streams are offered for future research as well as suggestions for effective management of healthcare organizations that benefit from digital health innovations.