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Risk management in Healthcare

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Risk Management has been a valuable and essential subject in projects and financial businesses but it is new to health care management. This presentation will help you understanding basics of Risk Managment.

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Risk management in Healthcare

  1. 2. Risk Management
  2. 3. What is Risk? Definition of Risk There are many definitions of risk that vary by specific application and situational context. Risk is described both qualitatively and quantitatively.
  3. 4. What is Risk? Definition of Risk “ risk is considered as an indicator of threat , or depends on threats, vulnerability , impact and uncertainty .”
  4. 5. What is Risk? Definition of Risk “ Qualitatively , risk is proportional to both the expected losses which may be caused by an event and to the probability of this event. Greater loss and greater event likelihood result in a greater overall risk .”
  5. 6. What is Risk? Definition of Risk “ Financial risk is often defined as the unexpected variability or volatility of returns and thus includes both potential worse-than-expected as well as better-than-expected returns.”
  6. 7. What is Risk? Definition of Risk “ In statistics , risk is often mapped to the probability of some event which is seen as undesirable .”
  7. 8. What is Risk? <ul><li>Definition of Risk </li></ul><ul><li>“ In information security , a risk is defined as a function of three variables: </li></ul><ul><ul><li>the probability that there is a threat </li></ul></ul><ul><ul><li>the probability that there are any vulnerabilities </li></ul></ul><ul><ul><li>the potential impact.” </li></ul></ul>
  9. 10. Types of Risks? <ul><li>Facility and Safety Risk </li></ul><ul><li>Operational Risk </li></ul><ul><li>Occupational Health risk </li></ul><ul><li>Financial Risk </li></ul><ul><li>Communication Risk </li></ul><ul><li>Security Risk </li></ul><ul><li>And Many Others!!! </li></ul>
  10. 11. Examples of Risks <ul><li>Nosocomial Infections </li></ul><ul><li>Communications Failure </li></ul><ul><li>High Occupancy </li></ul><ul><li>Wrong Identification of Patient </li></ul><ul><li>Chemical/Radiation Exposure </li></ul>
  11. 12. Risk Management Risk management is a structured approach to managing uncertainty related to a threat, through a sequence of human activities including: risk assessment , strategies development to manage it, and mitigation of risk using managerial resources. The strategies include transferring the risk to another party, avoiding the risk , reducing the negative effect of the risk, and accepting some or all of the consequences of a particular risk.
  12. 13. Risk Management <ul><li>STEPS in RISK MANAGEMENT </li></ul><ul><li>Establish a context </li></ul><ul><li>R isk identification </li></ul><ul><li>R isk Assessment (Analysis) </li></ul><ul><li>R isk Treatment / Control </li></ul><ul><ul><li>Avoidance ( aka elimination) </li></ul></ul><ul><ul><li>Reduction (aka mitigation) </li></ul></ul><ul><ul><li>Retention (aka acceptance) </li></ul></ul><ul><ul><li>Transfer (aka buying insurance) </li></ul></ul>
  13. 14. Risk Management Is Risk Management Applicable to Healthcare? Answer is Yes Examples?
  14. 15. Risk Management Operation Room Risk Management Anesthesia 1 Patient Monitoring in the OR: Vigilance, Monitoring, and the Standard of Care 2 Anesthesia Malpractice: An Overview 3 Pre-Use Checklist for Anesthesia Units (Machines and Accessories) 4 Selecting and Using Physiologic Monitors 5 Selecting and Using Multiple Medical Gas Monitors 6 CO2 Monitors 7 Pulse Oximetry 7.1 Pulse Oximetry—More Than Meets the Eye 8 Automated Record Keeping in Anesthesia 9 NIOSH Alert: Controlling Exposures to Nitrous Oxide during Anesthetic Administration 10 Medical Gas and Vacuum Systems
  15. 16. Risk Management Operation Room Risk Management Anesthesia 12 Waste Anesthetic Gas 13 Technology Overview: Anesthesia Units 14 Awareness during Anesthesia Critical Care/PACU 1 Recovery Room Care 2 Do-Not-Resuscitate Orders 3 Termination of Life-Sustaining Treatment 4 Blood Transfusions 4.1 Refusal of Blood Transfusions on Religious Grounds Education/Credentialing 1 The Credentialing Process 2 Proctoring 3 First Assistants in Surgery
  16. 17. Risk Management Operation Room Risk Management 4 OR Nursing Preceptor Programs 5 Physician Credentialing in Gastroenterology 6 Clinical Competence in the Use of Flexible Simoidoscopy for Screening Purposes 7 Clinical Competence in Colonoscopy 8 Clinical Competence in Diagnostic Esophagogastroduodenoscopy 9Clinical Competence in Diagnostic Endoscopic Retrograde Cholangiopancreatography 10 Clinical Competence in Hemodynamic Monitoring 11 Clinical Competence in Adult Echocardiography 12 Clinical Competence in Percutaneous Transluminal Coronary Angioplasty 13 Medical Staff Credentialing
  17. 18. Risk Management Operation Room Risk Management Employment 1 Hiring and Firing 2 Residents 3 Floating Nurses 4 Back Injuries among Hospital Personnel 5 Employee Radiation Exposure 6 Sexual Harassment 7 Physician Substance Abuse 8 Reproductive Hazards 9 Employing Temporary and Agency Staff 10 Fatigue in Healthcare Workers 11Disruptive Practitioner Behavior
  18. 19. Risk Management Operation Room Risk Management Lasers 1 Surgical Lasers: A Technical Overview 2 Laser Use and Safety 3 Preventing and Fighting Laser-Related Airway Fires 4 Laser Smoke Evacuators 5 Gas Embolism during Intrauterine Laser Surgery Medical Records 1 Medical Abbreviations 2 Perioperative Documentation 3 Unauthorized Changes of Medical Records 4 Guidelines for Obstetrical Documentation 5 Retaining Electronic Monitoring Records 6 Safeguarding Electronic Medical Records
  19. 20. Risk Management Operation Room Risk Management Environmental Management 1 Environmental Acronyms and Abbreviations 2 Medical Waste 3 Waste Minimization 4 Personnel Exposure to Ethylene Oxide 5 Personnel Exposure to Formaldehyde 6 Noise in the OR Equipment 1 Critical Alarms 2 Defi brillator Failures 3 Antishock Trousers 4 High-Risk Equipment Problems 5 Product Briefi ng: Operating Tables 6 Cell Phones and Walkie-Talkies 7 Surgical Smoke Evacuation Systems
  20. 21. Risk Management Operation Room Risk Management Infection Control 1 Aseptic Technique in the Operating Room 2 Preventing Nosocomial Infections 3 Sharps Disposal Units 4 AIDS Liability 5 Hand Hygiene Safety 1 Surgical Fires 2 Surgical Fire Safety Training Program 3 Disaster Planning 4 Physical Restraints 5 Ergonomics 6 Public Address System Emergency Codes 8 Violence in Healthcare Facilities
  21. 22. Risk Management Operation Room Risk Management Surgery 1 Counts 2 Locating “Lost” Neurosurgical Sponges 3 Patient Positioning 4 Intraoperative Autologous Blood Transfusion 6 Surgical Drapes 7 Hypothermia Blankets 8 Electrosurgery 9 Burns during Cataract Surgery 10 Implants and Explants 11 Laparoscopic Electrosurgery Risks 12 Wrong-Site, Wrong-Procedure, and Wrong-Person Surgery 13 Bariatric Surgery
  22. 23. Risk Management Operation Room Risk Management Technology Management 1 Managing Equipment Service 2 Borrowing and Lending Equipment: Strategies for Reducing Liability 3 Alternate Parts and Supplies 4 Mismatched Parts and Accessories 5 Reusing Disposable Products Device Alerts Medical Device Tracking
  23. 24. Risk Management Is Risk Management Only About Safety? Is Risk Management Only Responsibility of Top Management? Answer : NO Answer : NO
  24. 25. Risk Management WHEN IT COMES TO RISK MANAGEMENT, ARE YOU: A Fatalist - willing to react to events without any prior thinking A Fanatic - believing that there are no risks to manage A Pessimist - never willing to take any risks because of a strong fear of failure A Pragmatist - understanding that there is a balance between risk and reward and to identify and manage risks
  25. 26. Risk Management Application of Risk Management Tools and Strategies in Hospital <ul><li>Meetings / Committee Reports </li></ul><ul><li>OVRs </li></ul><ul><li>HAZARD Surveillance </li></ul><ul><li>Hazard Vulnerability Analysis </li></ul><ul><li>Risk Analysis Form </li></ul>
  26. 27. Risk Assessment Risk Rating = Number x Severity x Likelihood Score Action to be taken Less than 10 Risk is acceptable provided cost or effort to control the risk further is very low. 11 – 20 Risk is low. Action is required to reduce the risk, although low priority. Time, effort and cost should be proportional to the risk. 21 –50 Risk is medium . Action required urgently to control. Interim measures may be necessary in the short term.
  27. 28. Risk Assessment Risk Rating = Number x Severity x Likelihood Score Action to be taken 51 –100 Risk is high . Action required urgently control risks. Interim measures required in the short term. Significant effort, time etc. may have to be used to control risk. 100 + Risk totally unacceptable , immediate action required before work activity can continue.
  28. 29. Risk Matrix High Likelihood Control Share Mitigate & Control Accept High Risk Medium Risk Medium Risk Low Risk Low High S e V E R I T Y
  29. 30. Patient Service Risk Assessment High Likelihood <ul><li>Equipment obsolescence </li></ul><ul><li>Repeat calls for same problem </li></ul><ul><li>Loss of phones </li></ul><ul><li>Loss of computers </li></ul><ul><li>Patient has a long wait </li></ul><ul><li>Patient can’t get through </li></ul><ul><li>Patient can’t get answers </li></ul><ul><li>Fraud </li></ul><ul><li>Lost transactions </li></ul><ul><li>Employee morale </li></ul>High Risk Medium Risk Medium Risk Low Risk Low High S e V E R I T Y
  30. 31. Impact vs. Probability Risk Assessment
  31. 32. Risk Assessment Job / Facility Risk Analysis Form
  32. 33. Risk Assessment Job / Facility Risk Analysis Form
  33. 34. Risk Assessment Job / Facility Risk Analysis Form
  34. 35. Thanks
  35. 36. Risk Management By: Nadeem Baig HSE OFFICER ZAYED MILITARY HOSPITAL ABU DHABI – U.A.E. If you have any queries, please contact Email: [email_address] LinkedIn: http://ae.linkedin.com/pub/nadeem-baig/14/68a/515