Risk Management in Royal Adelaide Hospital

This document provides an overview of the risk management process and strategies in Royal Adelaide Hospital. It discusses the organization's processes, procedures, and requirements for risk management, as well as the scope of the risk management process. The document also explores the internal and external stakeholders, the purpose and vision of the organization, and the availability of resources. Additionally, it delves into the risks associated with electricity, machinery and equipment, clinical errors, radiations, and biological errors. The document is a valuable resource for understanding risk management in a healthcare setting.

Assessment
1

Table of Contents
INTRODUCTION ..........................................................................................................................3
Assessment 1....................................................................................................................................3
TASK 1 ...........................................................................................................................................3
The organisation processes, procedures and requirements for risk management.......................3
The scope of risk management process.......................................................................................4
The internal and external stakeholders .......................................................................................4
The purpose and vision of the organisation ...............................................................................5
The external environment and organisational structure .............................................................5
The availability of resources.......................................................................................................5
TASK 2............................................................................................................................................6
TASK 3..........................................................................................................................................10
Task 4 – Select and implement treatments ...................................................................................12
Assessment 2..................................................................................................................................15
Question 1 – What are the AS/NZS ISO 31000:2009 Risk Management - Principles and
Guidelines? How are you able to access this document? .........................................................15
Question 2 – What legislation, codes of practice and/or national standards within the health
industry does risk management relate to? ................................................................................16
Question 3 – Review organisation’s Risk Management strategy and policies and procedures 16
Question 4 - Research about safety and quality issues within the healthcare industry.............17
Question 5 – Risks associated with handover...........................................................................18
Question 6 – Risk associated with care provided to clients from different cultures.................18
Question 7 – Organisational risk analysis.................................................................................19
CONCLUSION..............................................................................................................................19
REFERENCES..............................................................................................................................20
2

INTRODUCTION
The risk management is the process of identifying the factors that are affecting the
internal and external environment of the organisation. It is analysing, assessing, controlling the
risks and factors that will affect the business of the organisation. They are affected by the
financial management, legal factors, strategies and the nature of the business (Shahtaheri and
et.al., 2017). Every business and organisations are facing risks that are making them affecting
the process band they will affect the direct cost of the company. The risk management allows the
organisations top analyse the performance and make the strategies to reduce it and increase the
performance of the employees. The risk management plan will help the organisation and it will
make them successful when they will find the methods of reducing the risks. The organisation
chosen for the report is Royal Adelaide Hospital and it is the largest hospital of Australia owned
and operated by the state government. It was founded in 1840 and is in the public health care.
The report includes Risk management plan of Royal Adelaide Hospital, the analysis of the risk
an the external factors affecting the organisation, the options for reducing the risks, legal factors
in the risk management, quality of the products of healthcare industry, assessment of risks.
Assessment 1
TASK 1
The organisation processes, procedures and requirements for risk management
Royal Adelaide Hospital is making the strategies for the health and safety of the
employees of the organisation and customers coming to the organisation. The health and safety
of the organisation and the resources are according the safety of the people in the organisation.
The risk of the people in the hospital should be reduced and they should be given an environment
that is safe from all the business processes.
Risk Management
Royal Adelaide Hospital is analysing the day to day risk in the process of the
organisation. They are making strategies, planning and coordinating the decisions of the
business. They are committed to analysing the processes of the business and reducing the risks,
analysing, and coordinating the factors that are helping the organisation increasing the
performance of the employees. The are analysing the risk according to the industry and they are
3

making the strategies to reduce it so that the process of the business is faster (Suter, 2016.). They
are focussing to giving good quality services to the employees and customers and making the
strategies to increase the efficiency of the performance (Mohajeri and Fallah, 2016 ). The
employees should be skilled to coordinate the performance of the organisation and make the
strategies to analyse the factors that can affect the business of the organisation.
The risk management process used by Royal Adelaide Hospital is the clinical risk and it
includes planning, managing, coordinating, reporting, analysing, etc. the risk of the organisation.
The agreement between the quality team, risk analysis team, directors and the employees to
reduce the risk and they monitor the performance of the organisation. Clinical risk management
is the process of identifying the day to day risk of the organisation. The risk should be analysed
in all the levels of the organisation and should make the process faster that will help them in
increasing performance of the organisation.
The scope of risk management process
The risk management process of the organisation is helping them to make the strategies
for reducing risk, allotment, complexity of resources, health care services to customers to the
people of Australia. They should have the state responsive of the business of Royal Adelaide
Hospital. The organisation is making the strategies for giving safe and healthy environment go
the people affected by the organisation. There are healthcare services of the organisation which
requires planning an monitoring of the performance of the organisation.
The internal and external stakeholders
The internal and external stakeholders of the organisation are affected by the strategies of
the organisation. They should be helped by the businesses because they have the role in the
decision on the organisation and the success of the organisation will be based on the analysis of
the stakeholders and they will help the organisation increasing performance (Kumar, Jindal and
Velaga, 2018).
Internal stakeholders
Employees
Top level employees
External stakeholders
Ministries
Media
4

Agencies
Political parties
The purpose and vision of the organisation
Royal Adelaide Hospital has the purpose of changing the lives of the people by giving
them quality health services. They will raise the fund from the government and gives the better
lifestyle to customer. The vision of the organisation is to give the most important clinical service
to the people of Australia and they are increasing the services to improve the performance. They
are giving services to customers and are focusing on privacy, controlling and performance of the
organisation.
The external environment and organisational structure
The PESTEL analysis of the organisation help them to analyse the factors that bare
important and affects the strategies. The political conditions of Australia is helping Royal
Adelaide Hospital and the economy is funding them to give services to customers. The legal
factors are helping them to make strategies and they are having a organisational structure with
transparency at all levels of the organisation.
The availability of resources
Royal Adelaide Hospital have skilled employees and they are performing to increase the
business of the organisation. They are helping the organisation to manage the resources and
having long term relationship with customer. The customers are giving them business and they
are improving the performance to give them quality services.
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TASK 2
Risk
identification
Impact or
consequence from
risks identified
Likelihood rating Rating assigned
to the
consequences
Priority rating
assigned to each
of the risk for
treatment
Electricity risks –
This risk can be
explained as those
hazards which
can arise on some
fault in electric
system (Carvalho
and Rabechini
Junior, 2015). As
this is a risk
management
process of a
hospital,
therefore, there
are various
possible
electricity issues
that are possible.
To illustrate, live
electric wires left
open, it can shock
shocks, burns or
death from
electrocution.
There are various
possible impacts
that electric
shocks can have
on healthcare
firm. The most
significant impact
that occurs relates
to stuck balance
of lives between
success and
failure those who
comes in contact
with some electric
hazards.
Low High High
6

Machinery and
Equipment – This
risk is associated
by several
machineries that
are moving and
situated in a
hospital and
health care place.
There are several
possible losses
that can occur in
chosen health
care. To illustrate,
there are various
testing tools for
patients that
assists in
diagnosis of
patients. If repairs
and maintenance
of these
equipments are
not done at
scheduled time,
than it will be
hazardous for
patients.
There are various
possible effects
that these hazards
can cause for
given health care
company
(Giannakis, and
Papadopoulos,
2016). Identify
items of
equipment which
must be tested or
examined at
predetermined
intervals and
make
arrangements for
these services e.g.
patient hoists and
slings - thorough
examination at
least once in
every 6 month
period by a
competent
person; passenger
lifts- thorough
examination at
least once in
every 6 month
period by a
Low High High
7

competent
person); work
vehicles to be
maintained as per
manufacturer’s
instructions
(Glendon, Clarke
and McKenna,
2016).
Clinical Errors -
These risks are
associated with
misdiagnosis and
delayed
diagnosis. If there
are some wrong
diagnosis, than it
may lead to
severe
consequences
which can even
lead to shut down
of hospital.
Possible
consequences are
very bad, such as,
bad health
hazards like
death, some life
impacting effects,
etc. if some
infection is there,
than it may lead
to some impact
that will effect the
patient for life
time.
Low High High
Radiations -
There are several
machineries and
equipments in a
hospital setup and
it may lead to
release of some
Radiations can
impact not only
patients in
hospitals but also
other attendees
with them and
medical staff too.
Low High High
8

waves or
radiations which
can be harmful
for patients in
hospital.
Furthermore,
these radiations
are hard to
control.
Therefore,
hospital should
take care of these
errors (Ivanov,
2018).
To illustrate,
exposure to
ionizing radiation
can result in
tissue reactions or
stochastic effects.
One of the most
significant
examples of
carcinogenesis.
Biological Errors
– These errors
relates with some
wrong
medications that
are delivered to
patients and it is
being considered
as ill treatment.
One more
biological error is
related with some
micro-organisms
that may occur in
hospital place and
it will result in
infecting patients
Possible impacts
that can occur due
to biological
errors are
hepatitis,
legionnaires,
disease, Q fever,
HIV/AIDS or
allergies. These
infections can
have life
impacting effects
on a patient and it
will result in
making the
situation
Low High High
9

as they are
already weak.
worsened.
TASK 3
I
D
Date
raised Risk description
Likeli
hood
Impac
t Severity Owner
Mitigating
action
Contingent
action
Progress on
actions
Statu
s
[12/10/2
020]
This is a risk that is
associated with
electric shocks and
hazards in setup of
hospitals.
Furthermore, is
some live wire is
left open, if low
quality of
equipments are
used in electric
system of hospital,
than it may result
in serious
consequences, like,
short circuit,
shocks, burns, etc.
This
risk is
having
an
unlikel
y
possibi
lity to
occur,
which
means,
it is
possibl
e, but
have
rare
chance
s , over
5 to 10
years.
Impact
of
these
hazard
s have
major
effects
and
they
are
threate
ning or
can
affect
one
with
serious
impact
s.
Impacts are
having very
high severity
impacts on
one facing
these hazards
and also the
hospital will
face these
consequences.
Electroni
c
engineer
heading
technical
departm
ent.
These types of
risk and their
impacts can be
reduced by
adopting the
technique of
scheduled
maintenance
and making the
inputs in
electric system
of high quality.
Hospital can
also give
insurance of
employees who
are in direct
contact with
electric
equipments.
There should
be proper
system that can
be attempt to be
applied on
saving the one
confronting
with the issue.
Actions are
implemented
and they are
being
executed by
the electric
department.
open
ed
Machinery and
equipments risks
are related with
those machineries
which are
continuously
moving or any fault
in them can result
in serious hazards
like injuring some
staff member or
even patient.
Intensi
ty of
these
hazard
s are
likely
and
they
occur
once in
time
period
Impact
s range
from
moder
ate to
major.
It is
depend
ing
over
the
inciden
Impacts are
also moderate
scaled and
they can be
rectified and
hospital can
also take
precautionary
measures.
Mechani
cal
departm
ent
handling
machine
s and
equipme
nts are
responsi
ble for
these
Mitigation
strategy can
relate time to
time repairs and
maintenance.
Furthermore,
hospital can
also foresee
which
machinery is
now have
expired life and
A proper
system having
all actions that
are necessary to
mitigate risk
can be
implemented in
the hospital
setup.
This setup is
in process in
the hospital
and will be
executed in
coming
future
period.
In
proce
ss.
10

of 5
years.
t. hazards. they should be
disposed off.
Clinical errors are
related with the
main business line
of the hospital and
that is medical
treatment. If these
errors occurs, it
may lead to failure
of complete image
and operations of
the hospital.
It is
very
rare to
occur.
Once
in life
time.
The
impact
id
having
the
intensit
y of
major
range.
It can
have
life
threate
ning
impact
on the
patient.
Impacts are
scaled at low
scale and they
are sometime
non
rectifiable.
Medical
departm
ent
having
experien
ced
doctors
on the
board
can
supervis
e these
risks.
These risk can
only be
mitigated
through
diagnosing
carefully all
tests and check
ups.
A proper team
should be set
up those can
handle risky
cases having
high chances of
mistakes and
they should be
properly trained
to handle such
cases.
Executed Open
ed.
Risk associated
with radiations are
having the chances
of emitting such
waves that are
harmful for
patients and staff
members too.
Very
rare
chance
s, once
in life
time.
Very
severe
impact
s on
several
people.
It is
scaled
as
catastr
ophic.
Very intense
impacts.
Radiolog
ists
departm
ent can
supervis
e this
process
of risk
manage
ment.
Can be reduces
through timely
maintenance
and tracking of
their
performance.
Reimbursement
s of losses can
be done to
impacted
people.
Executed Open
ed.
Biological errors
are related with
spread of some
infections in the
place and if it
happens it can
result to severe
infections to
several people.
Likely
to
occur.
Catastr
ophic
impact
s.
Intense. Cleaning
departm
ent can
take care
of
hygiene
and also
medical
departm
ent will
take care
of this
Cleaning of all
places that have
regular
touching of
number of
persons.
Proper medical
facilities can be
provided to
reciprocate the
infection.
Executed Open
ed.
11

process.
12

Task 4 – Select and implement treatments
Risk management plan refers to a written document that includes different types of risks
along with effective options for overcoming that type of risk in systematic manner. Risk
management plan of the current risks will be shown as below:
Business
name
Royal Adelaide Hospital Complete
d by
Business
location
United Kingdom Date
complete
d
Work area Schedule
d review
date
Identify the
hazard
Assess the risk Control the risk
What is
the
hazard?
What
might go
wrong?
Who
might be
harmed
and how?
What are you already
doing to control the risk?
Priorit
y or
risk
level
(low,
med,
high)
*
What else do
you need to do
to control the
risk?
Acti
on
by
who
m?
A
c
t
i
o
n
b
y
w
h
e
n
?
Date
completed
Electricity
risk
This is a
main risk
For controlling this risk,
Inspect wiring of
Low In order to
control this
Hosp
ital
15 days
13

that
impact on
healthcare
profession
al while
using
equipment
s for
treatment.
equipment before each
use was already used.
risk, I Know
the location
and how to
operate shut-
off switches.
mana
gers
Machiner
y And
Equipmen
t
This is
another
risk that
impact on
both
healthcare
profession
al and
service
user.
For mitigating this risk, I
already check the
Machinery And
Equipment on regular
basis.
High I order to
overcome this
risk, I follow
the Provision
and Use of
Work
Equipment
Regulations
(PUWER)
2002
Busi
ness
mana
ger
10 days
Clinical
Errors
(chemical
s)
This
impact on
service
user in
negative
manner.
For reducing this risk, I
already keep heath care
team informed.
Moder
ate
I order to
reduce such
type of risk, I
take changes
in heath care.
Healt
hcare
profe
ssion
al
20 days
Radiations This risk
impact on
patients in
negative
manner.
I already Lead strips
during fluoroscopy
procedures for
overcoming the
radiations risk.
High For reducing
or mitigating
radiations risk,
I remote
procedures
that can be do
Heat
h and
socia
l care
work
ers
30 days
14

from a
radiation-free
room.
Biological
Hazards
This is a
biggest
risk that
have
impact on
both
healthcare
providers
and
service
user.
For overcoming the
current risk, washing of
hands on regular basis
was done.
Moder
ate
In order to
overcome this
risk, I suggest
the patients to
change the
clothes on
daily basis.
Doct
ors
1 months
Action plan:
Actions require for overcoming the risk Description
Strategies For overcoming the all risks, there is
requirement for using safe equipments and
machines.
Resources Time, cost, accurate equipments etc. resources
will be needed for overcoming the any type of
risks.
Person who will be responsible for action Professional healthcare workers are require for
overcoming all risks.
Time-frame for the strategy to be implemented 3 months and 15 days will be needed for
overcoming any type of risks in systematic
manner.
Monitoring the risk Proper utilisation of sources are effective in
15

monitoring the risks effectively and
systematically.
16

Assessment 2
Question 1 – What are the AS/NZS ISO 31000:2009 Risk Management - Principles and
Guidelines? How are you able to access this document?
ISO 31000:2009 gives generic guidelines and principles on risk management. ISO
31000:2009 can be followed by any private, public or community enterprise, group, individuals
or associations. It is intended that ISO 31000:2009 be utilised to harmonize the process of risk
management in resent and future standards. It can be used throughout the life of an enterprise,
and to a broad range of activities such as strategies and decisions, process, operations, products,
services, projects, functions and assets. This can be followed to any type of risk, whatever having
negative or positive consequence (Muthuveeran and et. al, 2019).
Although ISO 31000:2009 gives generic guidelines that is not intended to boost
uniformity of risk management crosswise organisations. The design as well as development of
risk management frameworks and plans will require to take into account the variable
requirements of a particular company, its specific objectives, structure, operations, context,
processes, functions, assets, projects, products, services and specific practices employed.
In context of Royal Adelaide Hospital, there is requirement of managing any type of risk
that impacted on productivity and performance of business. It is intended that ISO 31000:2009
be used to harmonize risk management processes within existing as well as future standards. It
gives a common approach in aid of standards dealing with particular risks and/or sectors, and
does not regenerate those standards.
For access this document, there is acquirement for following all principles and standers of
AS/NZS ISO 31000:2009 Risk Management in systematic and ethical manner. There are
different types of risks that faced by heath care such as electricity risk, machinery and
equipment, clinical errors (chemicals), radiations and biological hazards. For overcoming this
risks, it is necessary for Royal Adelaide Hospital to utilised AS/NZS ISO 31000:2009 (Sujana,
2018).
17

Question 2 – What legislation, codes of practice and/or national standards within the health
industry does risk management relate to?
There are different types of legislations that are essential and useful for heath and social
care in management of any type of risks and also enhancing of their business performance and
productivity. These legislations are:
Health and Safety at Work etc. Act 1974 – Sets out how employees, self-employed and
employers must work within a safe manner, providing all members on the work premises legal
responsibilities and duties. This act will help Royal Adelaide Hospital in overcoming of any type
of risks that are related with the health (Stubbs, 2020).
Control of Substances Hazardous to Health Regulations (COSHH) 2002 – This act
designed to defend people as of hazardous substances - that is, any type of substance that can
harm or ill health of the people (Sunley and et. al., 2018).
The Provision and Use of Work Equipment Regulations (PUWER) 2002 – This is
another act that will help Royal Adelaide Hospital in overcoming the risk of equipments. This act
set out how any kind of equipment is to be applied in safe and secure manner. Work equipment
requires to be checked as well as maintained on regular basis and staff members trained in its
safe use. Therefore, this is an effective and useful legislation of overcoming the risk associated
with the equipments (Andrews and et. al., 2020).
Question 3 – Review organisation’s Risk Management strategy and policies and procedures
Policies in line with ISO: All the practices in risk management plan and strategies that
are in-line with posing health hazards to patients and operations of Hospital are included in it.
Objectives: Risk management register is prepared accordingly. It gives ready points that
are needed to be considered which makes it easy for hospital to identify risks in its processes.
Other policies: Hospital has a developed and extensive risk management plan in place
which aligns itself according to ISO standards but includes other processes as well that are not in
it.
Governance structure: Hospital comes under the Central Adelaide Local Health
Network (CALHN) and all its strategies comes from it. Network has a well defined risk
management structure that is patient and welfare centric.
Risk management responsibilities: Responsibilities include developing practises,
outlining them and placing deadline for their implementation. Management board of the Hospital
18

is responsible for placing risk management practises and it is the duty of every staff member to
adopt and practise those practises.
Risk management process: Hospital performs all round-pervasive risk management
process i.e. it stays vigilant to all the risks that arises in the process, registers it in their risk
register and then develops mitigation strategy to implement it (Barakat-Johnson and et.al., 2018).
Risk register: Hospital ensures to have an updated risk register and only when the risks
are assured that it will not be repeated are removed from register, otherwise they continue to be
there.
Effectiveness: So far, hospital has been able to manage all its risks effectively and its risk
management plans have by far proved efficient. Hospital is ever ready to face risk that comes its
way.
Part of process: I have not been part of the risk management process of the organisation
and the required information has been conveyed to me and rest I found out by research. It was
not an easy to process but it was worthwhile all the efforts.
Question 4 - Research about safety and quality issues within the healthcare industry
Issues: Most common safety and quality issues within healthcare industry are hand
hygiene, nurse-patient ratios, drugs and medical supply shortage, ineffective quality reporting,
resurgent diseases, over-exhausted staff, etc. (Engaging consumers in safety and quality at Royal
Adelaide hospital, 2020).
Impact: These above mentioned issues are not only critical to patient care but also has
significant impact over staff providing care to patients. Both of these impact processes of care to
an important level. Exhausted staff will not be able to take proper care of in-patient and if
emergency cases arrive which is quite normal in hospitals, it becomes all the more difficult to
handle.
Changes: Hospital must have adequate patient-nurse ratio and also, emergency support
measures from other hospitals must be at stand-by in case of emergency (Final Report).
Reflection: It has helped me in identifying that hospital can ever become super-busy in
case of any emergency condition or any epidemic. Therefore, it is very important to have a
proper relaxation period for staff so that they can provide quality services to patients.
Recommendation: Royal Adelaide Hospital shall have in place a system that is
designated only to arrange other systems. For example, it should keep a check on nurse-patient
19

ratio and starts hiring process if it goes low or regularly orders medicine supplies so that neither
the ordering and storage cost increases nor the services disrupt because of unavailability of
drugs.
Steps: Above issues also prompt to develop a standard for quality reporting and hygiene
practises that are needed to be maintained by all the staff of the Hospital.
Question 5 – Risks associated with handover
Handover refers to transfer of patient. It is aimed by Royal Adelaide Hospital that they
provide or receive all the required information right from transfer of clinical documentation,
letter of referral to discharge documentations, so that a chain in continuity of patient care can be
maintained. Biggest risk associated with handover is poor or incomplete communication.
Handover are generally handled by trainees which are relatively inexperienced and provide
handover without written documentation. Also, when there is interdepartmental handover,
boundaries are unclear which have the capacity to lead to high risk situations (Nicholas and
et.al., 2020).
It is very important for hospital to lay down a standard protocol related to handover be it
inter-hospital or inter-departmental. Trainees need to be given proper training as well as must be
overseen by an experiences staff before giving final discharge. All the information related to
treatment that the patient is receiving shall be duly noted down so that they can be informed
when giving handover. It will help reduce risk for both patient as well as the new doctor and
medical staff which is supposed to be providing healthcare services.
Question 6 – Risk associated with care provided to clients from different cultures
South Australia has an interesting mix of various aboriginal communities as well as
modern contemporary white Australian community. Both have different aspirations and
expectations from healthcare services. Aboriginals are more comfortable with their local
practices as well as around their own people owing to centuries of discriminations they have
been facing while white Australians have been in touch with and has access to healthcare from
all over the world. Therefore, they expect advanced technologies in healthcare. Creating a
balance between two ideally opposite expectations, Royal Adelaide Hospital tries to walk a
tightrope (Sullivan and et.al., 2017).
To reduce and prevent those risks, Hospital management shall first of all hire staff and
doctors which are not only high in IQ but also has a considerably high level of EQ. They shall
20

then be provided training to be compassionate towards all patients from different culture and
neither discriminating against nor being bias against aboriginals. They shall also be allowed to
learn various practises and technologies present all over the world to improve their services.
They shall be allowed to experiment various practices that are not harmful to human health.
Question 7 – Organisational risk analysis
Political – Royal Adelaide Hospital is a public hospital and run with assistance from
government. So, changing government policies towards hospitals, change in employment and
healthcare regulations as well as tax rates on hospitals pose a risk for the organisation identity.
Economic – Factors like unemployment, interest rates, poverty, etc. directly and
indirectly affect performance of hospital (Loosemore and Cheung, 2015).
Social – Demographic factors like social awareness, hygiene issues as well as cultural
belief about healthcare practises and access in different ethnic groups present in society are able
to pose as a risk for the hospital management.
Legislative – Hospital is subjected to various laws and procedures, that keeps on
changing as per requirement. Frequent changes in compliances and legal procedures are able to
result in lawsuits and can harm goodwill of the hospital.
Technology – There are various new technologies and equipments that are advancing
healthcare practices. Not able to procure them or use them efficiently can pose as a risk to overall
performance of the hospital.
Policies - Hospital management is responsible for policy making. If it is not able to make
flexible policies and such policies that are able to adapt according to environment, they can pose
risk to organisational performance and operations.
CONCLUSION
From the above report it is concluded that the risk management is important for the
organisation because they are helping them in making strategies. The organisation include cost
and they are affected by the risk so they need to analyse it to help the organisation increasing the
performance. The process of risk management is helping the organisation in coordinating the
organisation and making strategies of the organisation.
21

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