The Expectation Triad

The Third Triad Leg:

Risk Assessment

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Why Perform Risk Assessments?

Not enough time!

Not enough staff!

Not enough money!

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Risk Assessment Format

Risk =

Probability X Impact

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Risk Assessment Format

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Global Risk Assessment Form

Department/ Area:_____________________________ Date: _____________ Completed by: _____________________

Risk Element Description Occurrence Probability(1-5)

Occurrence Impact(1-5)

Total Impact Score(Probability X Impact)

Notes: To use this form, list all of the possible risk elements associated with the department or area that may impactpatient or staff safety or result in damage to buildings or equipment. Using all available data sources, including experienceand previous history, insert numerical values for the probability and impact for each element. Calculate the total impactscore for each element, prioritize in descending numerical order and select a “cut-off” limit. For all scores above the “cut-off”, perform the six step risk assessment process.

Performing a Global Risk Assessment

Step 1: Identify a “Global” Area to Assess

Step 2: Select a Team of Stakeholders

Step 3: Brainstorm and List the Risk Elements

Step 4: Assign Probability and Impact to the Risk Elements

Step 5: Prioritize the Risk Elements

Step 6: Perform the Specific Risk Assessments

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Global Safety Risk Assessment

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Global Risk Assessment for Safety Management

Risk Element Description Occurrence Probability (1-5) Occurrence Impact (1-5) Total Impact Score(Probability X Impact)

Employee injuries 5 2 10Ergonomic issues 4 2 8Unauthorized staff appliances 4 2 8Unauthorized smoking 5 1 5Egress corridor clutter 4 1 4Unlocked clean supply roomsin inpatient areas

4 1 4

Improper storage 3 1 3General housekeeping 3 1 3Unlocked supply rooms inoutpatient clinics

2 1 2

Improperly stored cylinders 1 1 1

Note 1: This form is used to determine the possible impact to safety that may occur in the hospital resulting from a variety ofdifferent risk elements. Each of the risk elements is prioritized based on the total impact score, starting with the highest scoreobtained. Specific assessments are then performed for each risk element (starting with the highest impact score) to determineactions that may be taken or processes that may be altered to reduce the overall risk to the hospital.

Note 2: The scoring is defined as follows:

Probability Score Description Impact Score Description

1 Very unlikely to ever occur 1 No injury is likely to occur 2 Unlikely to occur in one year 2 Minor injury is likely to occur 3 May occur in one year 3 Moderate injury is likely to occur 4 Likely to occur in one year 4 Serious injury is likely to occur 5 Almost certain to occur within one year 5 Death is likely to occur

Global Security Risk Assessment

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Global Risk Assessment for Security Management

Risk Element Description Occurrence Probability (1-5) Occurrence Impact (1-5) Total Impact Score(Probability X Impact)

Infant abduction 1 3 3Pediatric abduction 1 3 3Assaultive behavior - ED 5 3 15Assaultive behavior – mentalhealth unit

5 3 15

Theft – gift shop 4 1 4Theft – pharmacy 2 2 4Theft of hospital property 5 2 10Theft from patients 5 2 10Auto accidents on hospitalproperty

4 3 12

Trespassing 4 1 4Auto vehicle break-in 4 2 8Weapons brought ontohospital property

4 1 4

Utility systems intentionallyturned off or damaged

2 4 8

Terrorist activity near or onhospital property

1 5 5

Toxic gas introduced intohospital air intakes

2 4 8

Note 1: This form is used to determine the possible impact to security that may occur in the hospital resulting from a variety ofdifferent risk elements. Each of the risk elements is prioritized based on the total impact score, starting with the highest scoreobtained. Specific assessments are then performed for each risk element (starting with the highest impact score) to determineactions that may be taken or processes that may be altered to reduce the overall risk to the hospital.

1

Performing a Specific Risk Assessment

Step 1: Identify Issues and Select a Team

Step 2: Analyze Factors

Step 3: Make a Decision

Step 4: Document the Evaluation and Decision

Step 5: Make the Necessary Changes

Step 6: Monitor and Reassess

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Specific Risk Assessment Examples

Lock clean supply room doors?

Infant/ pediatric abduction

Environment for mental health

Defibrillator testing

Refrigerator temperature tests

Equipment test tags

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Performing a FMEA*

Step 1: Select a Critical Process

Step 2: Identify Failure Modes and Effects

Step 3: Perform an “RCA” for Critical Effects

Step 4: Redesign the Process

Step 5: Test and Implement the New Process

Step 6: Measure Effectiveness

Step 7: Implement a Strategy

* Failure Mode Effects Analysis

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Performing a Root Cause Analysis

Step 1: Assign a Team

Step 2: Create a Work Plan

Step 3: Define the Issues

Step 4: Evaluate Contributing Factors

Step 5: Search for Common Causes

Step 6: Redesign Processes

Step 7: Measure and Assess

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