Effective Risk Management in

Healthcare Practice Dr.Abdul Qawi Almohamadi

TQM-Manager USTH

Healthcare

System made up of thousands of inter-linked processes……………..

things can go wrong

What is risk?

Clinical Risk Non Clinical

Risk Financial Risk Organizational

Risk Significant Risk

Definition of risk management

Risk is generally defined as the potential harm that may arise from some present process or from some future event.

In everyday usage, "risk" is often used synonymously with "probability", but in healthcare risk assessments, stricter parameters must apply due to the nature of the risks to life and health involved.

Definition of risk management

Risk Management is the process of measuring, or assessing risks and then developing strategies to manage the risk.

Definition of risk management

Planned and systematic processes to reduce and/or eliminate the probability of losses occurring in a specific setting:

risk identification and analysis

loss control claims management and risk

financing

Definition of risk management-summary

1- To identify the hazards rising from work

activities that employees and other people are exposed to.

  To decide on the likelihood of harm or

damage occurring to people, equipment or property from those hazard.

  To determine what action needs to be

taken to control adequately the risks identified.

 

Why risk management 1/3?

Risk Management employs a number of systems to identify and provide notification of incidents or events that have occurred involving patients, visitors, staff, equipment, facilities or grounds which are likely to give rise to potential liability, affect the quality of patient care or affect safety in the hospital.

Why risk management 2/3?

The early identification of such occurrences allows to immediately investigate the circumstances of the incident, and if necessary, institute corrective action to prevent similar occurrences in the future.

Why risk management 3/3?

To have clearly defined roles and responsibilities for the management of risk.

To improve patient safety through the adoption of a coordinated and multidisciplinary approach to the management of risk.

To encourage open and honest reporting of incidents through the use of a single incident reporting system.

To establish clear and effective communication that enables information sharing.

To foster an open culture that allows organization wide learning.

To ensure that risks are identified, assessed and prioritized for action

Categories of Risk Patient care-related

risks Medical staff-related

risks Employee-related risks Property-related risks Organizational risks Financial risks Other risks

Patient Care-related Risks

Risk associated with clinical practice – direct patient care and incident reduction.

Indirect patients care – security, personal, infection control, management of buildings and the environment.

Patient Care-related Risks Direct association with patient care Consequences of inappropriate or

incorrectly performed medical treatments Confidentiality and appropriate release of

information Protection from abuse, neglect and assault Was patient informed of risks? Nondiscriminatory treatment

Exercise Patient flow in the hospital

Admission Office

Emergency Room

Outside Clinics

Discharge

Transfer to another facility

Admission

Admission

Special care units

General floors

Endoscopy

OR

Cath. Lab.

Radiology

Patients Flow

Medical Staff-related Risks

Was patient properly managed?

Do we have adequately trained staff?

Medical Staff-related Risks

Occupational safety and health, - working practice, legislative requirements, training and education.

Exercise Medication management cycle

Medication Management Process

Physician write the medication order

Medication prepared by pharmacy

Registered Nurse prepare medication

Porter send the order to the pharmacy

Porter send the medication to the nursing unit

1. illegibility2. Use of

abbreviations3. Incomplete orders

Registered Nurse transcribe the

medication order

1. Wrong transcription

Delay

Delay

Registered Nurse administer medication

to the patient

1. Patient identification

2. Wrong medication3. Wrong time4. Wrong dose 5. Wrong route

Miss labelMiss label

Delay

Miss label

Employee-related Risks

Maintaining a safe environment - Employee Health Policyreducing risk of occupational

illness and injuryproviding for the treatment and

compensation of workers for work-related illnesses or injuries

Employee-related Risks Provide a healthy atmosphere for

workers Promote increase work production

by improving the health of the worker

Promote safety against health hazards encountered in the work environment

Promote full functional capacity of the worker

Property-related Risks Protect assets from losses due to

fires, floods, etc. Paper and/or electronic records -

patient, business and financial - protected from damage or destruction

Bonding and insurance to protect facility from losses

Organizational risks

Organizational risks – claims management, communication and information technology development.

Quality in Healthcare

Begins with ensuring patient safety

Key reasonsPatients are more at risk

than non-patientsMedical interventions are,

by their nature, high-risk procedures - small error margins

Medicine remains an inexact, hands-on endeavour

Errors are inevitable

………….but most are preventable

Risk Management is Everyone’s

Responsibility!

The steps in risk management

Carrying out a risk assessment comprises of the following 5 steps:

STEP 1: Look for the hazards. STEP 2: Decide who might be harmed. STEP 3: Evaluate the risks and decide

whether the existing precautions are adequate or whether more should be done

STEP 4: Record your findings. STEP 5: Review your assessment and

revise it if necessary. 

HOW TO IDENTIFY RISK ?

Risk Identification & Analysis

Risk RankingSignificant RisksUnacceptable RisksAcceptable Risks

Risk Analysis

Once identified, risks will be analyzed using the risk grading matrix – risk

ConclusionIntegrated and coordinated

approachAccountability by leadershipEnvironment

encourage recognition & acknowledge risk

actions to reduce riskfocus on process and systemsorganizational learning

ALWAYS REMEMBER Risk Management is not about

pointing blame but about promoting a culture that fosters learning and improvement as a result of errors.

Everyone has a right under the law to an environment that is as risk free as possible.