University of science and technology hospital sana'a

1. Effective Risk Management
in Healthcare Practice
Dr.Abdul Qawi Almohamadi
TQM-Manager
USTH

2. Healthcare
 System made up of thousands of inter-
linked processes……………..
things can go wrong

3. What is risk?
 Clinical Risk
 Non Clinical Risk
 Financial Risk
 Organizational Risk
 Significant Risk

4. 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.

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

6. 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

7. 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.

8. 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.

9. 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.

10. 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

11. Categories of Risk
 Patient care-related risks
 Medical staff-related risks
 Employee-related risks
 Property-related risks
 Organizational risks
 Financial risks
 Other risks

12. 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.

13. 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

14. Exercise
Patient flow in the hospital

15. Admission Office
Emergency RoomOutside Clinics
DischargeTransfer to
another
facility
AdmissionAdmission
Special care
units
General
floors
Endoscopy
OR
Cath. Lab.
Radiology
Patients
Flow

16. Medical Staff-related Risks
 Was patient properly managed?
 Do we have adequately trained staff?

17. Medical Staff-related Risks
 Occupational safety and health, - working
practice, legislative requirements, training
and education.

18. Exercise
Medication management cycle

19. 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. illegibility
2. Use of
abbreviations
3. 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 medication
3. Wrong time
4. Wrong dose
5. Wrong route
Miss label
Miss label
Delay
Miss label

20. Employee-related Risks
 Maintaining a safe environment - Employee
Health Policy
reducing risk of occupational illness and
injury
providing for the treatment and
compensation of workers for work-related
illnesses or injuries

21. 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

22. 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

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

24. Quality in Healthcare
Begins with ensuring patient safety

25. Key reasons
 Patients are more at risk than non-
patients
 Medical interventions are, by their
nature, high-risk procedures - small
error margins
 Medicine remains an inexact, hands-
on endeavour

26. Errors are inevitable
………….but most are preventable

27. Risk Management is
Everyone’s Responsibility!

28. 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.

29. HOW TO IDENTIFY RISK ?

30. Risk Identification & Analysis
Risk Ranking
Significant Risks
Unacceptable Risks
Acceptable Risks

31. Risk Analysis
 Once identified, risks will be analyzed
using the risk grading matrix – risk

33. Conclusion
Integrated and coordinated approach
Accountability by leadership
Environment
encourage recognition & acknowledge risk
actions to reduce risk
focus on process and systems
organizational learning

34. 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.