Healthcare:Organizational Risk Management Interview
RiskManagement in Healthcare
What kind of risks are likely to happen at any given time?
How much are they likely to happen?
What is the severity of the outcome should the risks happen?
How can the likelihood of the risks happening be mitigated on the forefront?
To what degree can the mitigation take place?
Are there actions that can be taken before hand to reduce the impact of the happenings? What are the actions and to what degree?
What is the exposure potential?
What kind of risks cannot be proactively avoided?
What is the hospital’s level/ degree of preparation to handle the risks that are practically considered non-avoidable?
What is the kind of training offered to staff to aid in the mitigation of risks, if any?
How are patients and visitors sensitized or made aware on the mitigation of risks? What is their involvement in matters of risk awareness?
In what ways does the hospital ensure that policies and guidelines set for risk mitigation have been implemented and followed?
Are all members of staff, clinical and non-clinical, aware of their duties and responsibilities in the management of risk?
How does the hospital measure the ability to handle the management or risk?
Justlike all other complex systems found in diverse institutions, thecomplexity of healthcare systems could generate adverse outcome whencontrol measures are relaxed. In this regard an adverse outcome isdefined as an involuntary injury or complication that results infurther hospital stay, disability or even death. The risky nature isbrought about by a factor that it is not related to the underlyingdisease/ condition of the patient. In the delivery of medical care,patients are at risk of suffering a disease, infection or injury as aconsequence of treatment (Baker et.al. 2004). Putting this intoconsideration, the probability of suffering adverse effects orcausing errors cannot be totally eliminated in medical careorganizations. However, control measures can be put in place by arisk management team to foresee, prevent and deal with these risks asthey occur. The team plans, identifies, analyses, responds, monitorsand controls these measures. The primary aim is increasing theprobability and impact of positive events, while decreasing theprobability and impact of adverse effects. Risk management shouldcover all risks to healthcare, whether clinical or non-clinical innature (Cagliano, Grimaldi & Rafele, 2011).
CarlsonMedical Clinic’s Risk Management Program
CarlsonMedical Clinic is a medium sized healthcare facility offering bothoutpatient and inpatient services. The hospital has a bed capacity ofninety two, and on average receives between 200-300 patients daily inits outpatient section. The hospital’s Risk Management Strategyprovides the structure for risk management within the institution. Itis aimed at ensuring patient, staff and public safety whiledelivering quality patient centered services which attain exceptionalresults. A review is carried out annually, with the necessary updatesand amendments also taking place annually.
Theprogram clearly identifies the specific duties of each member ofstaff, plainly stating that they are all accountable for individualactions. The duties and responsibilities of all persons are outlinedand there are no grey areas as to what should and should not be done.The program has gone ahead to state the key principles of riskmanagement as patients and visitors, staff, finances, the business,compliance with duties and the reputation of the institution. Sourcesof risks, their identification and process of evaluation have beenarticulately elaborated thus leaving no doubts(Kingstonhospital.nhs.uk).
Shortcomingof the Risk Management Program
Asstated earlier, the duties and responsibilities of all partiesincluding patients and visitors have been spelled out in the program.However, there are concerns on whether this information is availableto the patients, visitors and hospital workers. Without information,it is difficult, impossible even, to take measures to mitigate,identify or report risk related cases.
Thehospital’s risk management program was formulated by the initialrisk managers of the institution. Updates and amendments are doneannually so as to meet the present state of affairs. The RiskManagement Committees, Audit Committees, Compliance and RiskCommittees and the Trust Board are charged with overlooking thiscrucial annual exercise. However, the question arises as to whetherthese documents are lying in desks, or whether they are availed tostakeholders (Kingstonhospital.nhs.uk).
Duringthe interviewing process, some of the staff (though not the maininterviewee) were not aware of the existence of the risk managementprogram. Some of these members of staff, particularly thenon-professional workers, have not been officially informed of theirresponsibilities in risk management. Most act on human instinct whenfaced with issues of risk. For instance, a newly employed cleaner whocomes across an agitated patient may momentarily get stranded as tothe action they should take since on employment, guidelines on how toreact to such situations were not communicated. However, afterspending time working amongst patients and professional caregivers,they get hands on training through observation. It is thereforeimportant to not only formulate the risks but also to ensure that theinformation is made available to all partisans.
ActionSteps Required to Implement the Suggestion
Thefirst encounter that the hospital has with its staff is during therecruitment process in the search for potential employees. At thiscrucial point, the issue of risk management should be introducedwhile also testing the candidate’s knowledge on risk. Once thesuccessful staff have been picked and absorbed into the institution,the orientation process should lay significant emphasis on riskmanagement. Introduction of the topic should be done at this time,with the staff being provided with details on their duties andresponsibilities in risk management. Thereafter, the hospital shouldundertake continuous trainings and assessments for all members ofstaff to ensure that everyone is at par with the requirements of thedocument. This could be reinforced by holding departmentalinteractive/ consultative meetings between staff and departmentalheads to chart the way forward, while also providing ideas andpossible solutions to challenges encountered along the way. Inaddition to the above, the management should hold regular drills totest the readiness of staff and probably patients (Sage,2003).
Visitorsand patients may not be at the institutions for long durations. Thismakes it a little difficult to incorporate them into the program.However, displaying visible informative posters and charts atstrategic points communicates necessary information at a glance.These strategic points include notice boards, lobby, waiting areas,the triage, wards, public eating areas and bathroom areas. Placing ofinformative brochures and fliers in dispensers along corridors,lobbies, waiting areas and other areas with human traffic could alsopass information to visitors and patients. It would also beinfluential to air short periodic video recordings on the televisionsets strategically placed for entertainment of patients and visitors(Sage,2003).
Toensure that the above actions become implemented, they should beincorporated into the existing Risk Management Program by the currentmanagement.
CaglianoA.C. Grimaldi S. Rafele C. (2011). A systemic methodology for riskmanagement in healthcare sector. SafetyScience.49(5): 695-708
RiskManagement Strategy 2014/2016. Retrieved on 29thJuly 2016 fromhttps://www.kingstonhospital.nhs.uk/media/66699/enc-l-risk-management-strategy-version-12-final-ld-ready.pdf
Sage,W. (2003). Medical liability and patient safety. Health Affairs,
Baker,G.R. et.al. (2004). The Canadian Adverse Events Study: The Incidenceof Adverse Events among Hospital Patients in Canada. CanadianMedical Association. 170(11) 1678 – 1686