Intended learning outcomes of risk management

Prepared by:
Mashael Aljuraied
Abdullah Alsharary
To define risk management
To describe risk hierarchy.
To describe the documented plan for integration of risk management and quality improvement.
To identify the goal of risk management in health care.
To identify Risk management process.
To identify the role and context relevant to the organization.
To determine dimensions of risk in health care.
To determine risk management resources.
To identify processes and strategies that assist with risk identification and management.
To determine elements of risk management.
To analyze requirements of the risk management policy.
To define risk register
To determine standards components that should be included in the risk register.
To differentiate sentinel event, adverse event, and root cause.
To determine an incident monitoring.
To define Failure Mode Effect Analysis (FMEA).
Risk management
Risk management, a formalized way dealing with hazards, is the logical process of weighing
the potential costs of risk against the possible benefits of allowing those risk to stand
uncontrolled. In order to better understand risk management, the terms hazard and risk need to
be understood.
Risk hierarchy
Development Risk
Management of Development
Internal Process
External Influences
Management of Development
 Prime Mission Product
Supporting Products
The integrated risk management and quality improvement framework should be
documented in a plan that is provided to all staff members, this plan should:
 Outline the specific roles of the two systems
 Explain how the two system work together
 Address problem identification, process monitoring and
 analysis
 Explain implementation of changed processes
 Address evaluation of improvements.
The goals of risk management in health care are to:
1. Minimize the risk of death, injury and/ or disease for consumers / patients, employees and
others as a result of services provided.
2. Minimize the likelihood of possible events that have negative consequences for
consumers/patients, staff and the organization
3. Enhance consumer/patient outcomes
4. Manage resources effectively
5. Support legislative compliance and to ensure organizational viability and development.
Risk management process
 Communication and Consultation
 Monitoring and Review
 Establishing the Context
 Risk Assessment
 Risk Identification
 Risk Evaluation
 Risk Treatment
The Role and context relevant to the organization should be documented with
consideration given to:
 The mission and values of the organization
 Its community
 The organizational services
  Its location, for example rural facilities may have different risk issues from the
metropolitan facilities
 The funding model, such as public, private, for profit or not-for-profit
 Jurisdictional requirements
 Clinical and non clinical services provided
 Service delivery models
 The governance structure for the organization
 Relevant stakeholders.
Dimensions of risk in health care
1. Corporate Risk
a. Financial
 Resource allocation
 Budget and resource management
 Risk management process
 Treasurers instruction
 Fiduciary failures

b. Political
 State/territory and commonwealth relations
 Organizational culture
 State/territory and commonwealth legislations and regulations
 Community and political and media expectations.
2. Clinical Risk
a. Operational
 Clinical service and procedure
 Clinical and management failures
 Equipment and infrastructure
 Rules, policies and standards
 Working management
 Training and education
b. Legal
 Complaints
 Duty of care
 Legal and regulatory responsibilities
 Medico legal responsibilities
 Statutory responsibilities
 Workplace health and safety law
Requirements of the risk management policy should identify:
 WHO: is required to report, communicate, action
 WHAT: is required to be reported by staff, managers, executives, governance committees
 WHEN: risk are to be reported and when information is to be disseminated to the
clinicians, staff, executive governance committees/ governing body
 WHERE: information is stored, communicated
 HOW: tools and processes are to be used- e.g. risk assessment, risk registers and when a
risk may be removed from the current risk register.
Risk management resources
Resources may include financial resources, human resources, and physical resources such
as building design and equipment.
Examples of processes and strategies that assist with risk identification and management
include but not limited to the following:
1. Clinical examples
 Collection and effective use of clinical indicators
 Morbidity and mortality reviews
 Clinical audits
 Adverse outcomes screening an d clinical incident reporting
 Health records audits
 Consumer/ patient risk assessment
2. Non-clinical examples
 Collection and effective use of indicators relevant to the
organization
 Budget variance monitoring
 Lost time injury reports
 Workforce planning
 Education and mandatory training programs fro staff
 Staff performance review and development
Elements of risk management
 Plan (what, when how).
 Assess (identify and analyse).
 Handle (mitigate the risk.
 Monitor and report (know what happening).
Risk Register
Are a tool that can be used to assist prioritization of risk and appropriate allocation of
resources. They are dynamic documents that should support decision making and
communication in key committees/forums.
Some of the most widely used standards components that should be included in the risk
register:
 Dates
 Description of the risk
 Risk type or area
 Likelihood of occurrence
 Counter measures
 Responsibility/owner

Sentinel Event, Adverse Event, Root Cause:

 Sentinel Event: an unexpected occurrence of the issues involving death or serious
physical or psychological injury, or the risk there of serious injury specifically includes
loss of limb or functions.
 Adverse Event: an incident in which an intended harm resulted to a person receiving
health care.
 Root Cause: finding related to a process or system that has the potential for redesign to
reduce risk.
An incident monitoring includes:
 confidentially of reported data
 Involvement of all staff
 Just culture
  Education of all staff
 Investigation of all incidents b relevant staff and managers
 Trending of incidents an learning from the information
 Benchmarking information and systems with other organizations
 Linkage with the organizations risk management system
 Evaluation of the system
Failure Mode Effect Analysis (FMEA)
is a systematic, proactive method for evaluating a process to identify where and how it might
fail, and to assess the impact of those failures in order to identify the parts of a process that are
most in need of change or improvement.