Risk Management - Assignment

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RISK MANAGEMENT ASSIGNMENT
By (Student’s Name)
Professor’s Name
College
Course
Date

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Part 1
Q1. Reflecting on Statement
Risk management is defined as the systematic process of identifying, evaluating, and
addressing potential and actual risk. Risk management according to the article is way more than
just health care, it goes beyond clinical care. Risk management entails reducing the possibilities
of error. Risk management in health care involves reducing costs on matters that may cause
injury, disability and stress. Risk management is done. However, the risk management also
enhance quality health care delivery. Risk management entails a process that detects,
communicates and reports any detected deficiency in a system that would otherwise led to
damage and a costly mistake. It basically entails running the day to day programs that is free of
mistakes to achieve quality healthcare.
For instance before an operation, the anesthetist has to assess the patient by asking questions
about their health. They need information such as their allergies, their health history and any
recurring conditions. This is a form of risk management because the anesthetist aims at ensuring
that once the patient is a sleep during the operation then all risks are eliminated for a successful
surgery.
The definition of risk stands out to be the probability or threat of liability or loss maybe
caused by vulnerabilities and solved. Risks can occur in when human interact with machines, the
complex technology that might be involved in the hospital, negligence among others. For
instance before surgery the scrub nurse is supposed to sterilise all the equipment that will be used
for surgery. They need to make sure that all this equipment are 100 percent sterile to use on the
patient and will not cause any risks to the patient. However, the predominant underlying causes

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of medical errors are as follows; communication problems, inadequate policies and procedures,
technical failures and staffing patterns and work flow.
Risk management being involved in reducing risks and errors that is just one aspect of
provision of quality clinical care. Clinical care is just more than just risk management, however
together with other aspects and branch of hospital health care provision maximizes the quality of
health care (Bagheriyan, Setareh, Nezhadnik and Niknam 2011).
After having an understanding of risk management, it is also crucial to have an in depth
understanding of clinical care, but not just clinical care but quality of health care. Clinical care is
much more than just the professional aspect but it is intertwined among many other level of
performance. Patients too are involved as far as quality care is concerned. The patients’ freedom
of choice and access to quality health care provision is also part and parcel of quality care. This
therefore brings us to the question what exactly is meant by the term quality clinical care
(Chourey 2015).
Clinical care has its standardized measure of operation as per the terminology it is related to
the discrete elements of nursing practice. Therefore, this practice has to be done if fulfilment and
to provide maximum care. Clinical care basically covers the essence of patient care, data
elements, care needs that sums up to resources, the workload that sums up to productivity, costs
of care and lastly the outcomes which sums up to quality. The nurses are the main persons
involved in clinical care. They need to give clinical care during their stay in the hospital and also
after their stay in the hospital. If the care was to end only at the time the patient was in hospital
then it would really not be care given. The clinical care as used by nurses in health care giving
facilities involve a sit step series processes

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Assessment
Diagnosis
Outcome identification
Planning
Implementation
Evaluation
However, the stablished fact is that risk management does not in any way mean clinical acre,
but it is just a broader aspect of clinical care that has to be implemented in many stages of health
care. Without a risk management process then the clinical care given would be put at jeopardy as
illustrated by Maxwell (1984).
Q2. Assessing Quality
When the need to assess quality comes in handy, Donabedians classification of health
care is seen. He divides health care into its structure, process and outcomes. However, Maxwell
classification is quality improvement based on the methodical assessment of the implemented
programme. Maxwell bases his findings on these aspects of dimension of quality (Pandey and
Sharma 2017).
Effectiveness, efficiency, Appropriateness, acceptability, Access, and Equity. Therefore,
this process of evaluation can be applicable in the provision of health care to outpatients’ clinics.
Outpatients’ clinics offers services to patients and they leave. Maxwell Classification assess
outpatient clinics, on the clinical examinations and investigations, clinical interventions such as

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drug prescription and outpatient appointment (Kubheka 2015). Outpatient clinics may seem easy
to manage, however there are some aspects that need to be looked into.
Assessing quality in outpatients clinics
Structure process outcome
Effectiveness Access to medical
resources such drugs
The patient’s daily
admittance
The records of those
treated
The amount paid
during treatment
The daily successful
treatment
Acceptability Provision of the
medical drugs and
supplies
Patient help in case of
severe cases
The patient ability to
pay for the services
The prescription
dosage
Follow up for the
prescription of the
drug
The advice you get
when done or when
under medication
Equity If treated, records to
show according to
attendance lists
Evidence based on
the service provided
such as receipts
Relevance Appropriate
treatment according
Difference and
monitoring of
treatment done to

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to diagnosis made
The financial record
of services offered
and relevant costs
patient
The health status
after treatment.
Efficiency Enough Available
medical personnel to
attend to the patients
Admission and
discharge
arrangements
Costs for the cases
treated and the
facilities in case the
services offered are
being offered at a fee
Access How many patients
can be attended to a
time
Are facilities enough
to accommodate the
out patient
What happens in a
event there are no
health clinical
officers to attend to
the patient
What alternative
means are put in
place to ensure that it
does not happen
Q3. Interactions:
Risk management involves evaluation assessment and creating a communication and
feedback of how to implement the risk management programs to evaluate the quality of services

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(Jones 2015). The health care giver in any case is supposed to critically evaluate a situation for
example when a patient is brought in what they are ailing from. The health care giver is then
supposed to communicate with the patient to learn more about the ailment and the views of the
patient in question. This helps in determining what medical care will be given that will be best
suited for the patient. This is done after looking at all the risks involved and picking an option
that has the least risks involved or those that cannot be avoided.
Health care risk and quality has evolved and tends to work hand in hand. There exists a
relationship between the risk management and quality management. Risk management programs
are aimed at a better service for the patients, hospital and the staff without error. It these two
merge we will look in to a greater quality improvement in clinical care. It can also apply to the
surrounding environment that the practice stakeholders are under, the safety and the
comfortability (Haghi, Gh and Aataran 2005). Risk management can be evaluated in the
approaches as ensured within the quality dimensions. Donabedians classification is based upon
these three classifications, and we will look at the quality dimensions in relations to the three
classification.
 PROCESS; this entails the procedures, events and the relevant action within a practice
that drives its activity; assessment, examinations as well as investigations
 STRUCTURE; this entails the resources that combine to deliver care
 OUTCOME; this entails the change in health care .it can mean improvement in the relief
symptoms and the general feel of a patient’s health as compared to the initial state they
were in,
Effectiveness; in relation to structure, risk management can be involved in ensuring
highly trained professional who are competent enough to operate in such medical practices. In

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relation to process, a more efficient and thorough program should be put into place to ensure that
the productivity is at maximum and that the tools, say the data analysis and data management
system is efficiently stored and errors avoided. That way patients and staff records will only be
accessed by the relevant and authorised personnel with a particular health care facility. Outcome
in relation to effectiveness is an indication of the various successful approaches the practice
gives. The outcome in this scenario could be the effectiveness of the tools and the successful
medical operation.
Efficiency; this involves the efficient use of the available resources to the maximum. This
also focuses on the avoidance of extravagance in the staffing, ensuring that there is no equipment
that is being over utilised or underutilised. The processes and the costs of the whole operations
are to be considered efficiently to avoid errors that might in turn lead to the practice being put at
burdens and eventually closure. The main aim of efficiency is to ensure that the health care
facility is correctly and accurately using its facilities for the betterment of health of the patients.
Appropriateness/Relevance; the underlying factor to this is having in mind exactly how
the process applies relevantly to a patient, what appropriate resources are to be used and in to
what expenditure level is acceptable.
Acceptability; this refers to what policies or measures that are acceptable to the hospital
facility and perhaps the visits from relatives or what privacy and confidentiality factors are put in
place. As for the outcome the risk management is to look at the errors that might occur if such
policies may seem to pose a threat or create a vulnerability to the system in place.
Access; this is a matter of urgency as access to proper and quality medical health care is key to
patients. The same also applies to the hospital staff. In an event the facilities are full, what then

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happens to the surplus? Is there an alternative plan that is implemented to ensure quality
healthcare? All these can be answered by the risk management program in place to evaluate the
whole system (Bagheriyan, Setareh, Nezhadnik and Niknam 2011).
Equity; this applies to same or an equilibrium or a state of balance within the
organization either resources, service providers or access to the medical care there should not be
a balance system. If so, the risk management program has to rectify this and look on to how the
equal distribution should be implemented to offer quality health care services without
discrimination at any cost (Haghi, Gh and Aataran 2005).
Part II
1: Questions
Are these cases belonging to the same surgeon of the hospital?
Are cases happening from the same operating room?
Are we sure that the procedures and protocol for cleaning the surgical tools being followed
strictly?
Is anybody on the team consistent in the cases that are being reported?
2. Inputs
The Chief of General Surgery and the Head of pathology could have suggested the
following;
No physicians that are constant with respect to these injections.
There is no common operating room or staff involved with these cases.

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No common organism is identified in these infections.
3. Clinical, financial and legal implication
The clinical implications include; systemic infections, other complications, no response to
first line of drugs, no treatment options, increased length of stay.
The financial and legal implications can be due to increased length of stay, this in turn will
lead to increment in cost of treatment, the rise in hospital bills increases, as well as the related
ethical issues related with the patients and diseases. This could even lead to the facility to be
sued (Wiryoatmojo and Surya 2013).
4. Plan
A monitoring plan to be implemented will have to focus on the specific job title and the roles
or functions to be operated and handled at what particular time and by who. This will facilitate
the smooth running. The work plan will ensure that;
a) To implement infection control measures in ward
(b) To keep check on emergence of new pathogens
(c) To sterilize wards, instruments and to implement hand wash practices among health care
workers.
(d) To routinely screen surgery patients for surgical site infection.
(e) To ensure no outsiders inside ward of surgery patients
Part III: Scenario Analysis

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REGISTRATION PAYER INTERFACE BILLING
TYPES OF RISKS
The risks that might be encountered include
Information and data manipulation
False money expenditure
Registration flaw
Harm caused.
As the administrator, information confidentiality is key. Therefore, the safety of the patients’
records need to be saved. In an event one gets access to them, it can cause private information
leaking resulting to blackmailing (Singh and Ghatala 2012). The patient records need to be saved
in manner that only those who have an obligation to access them can do so. Also at times
information between patients can be mixed up which may cause a patient to be treated for the
wrong diagnosis. It is important for the hospital to have an accurate filling system to avoid such
mishaps. Being special care facility, records might be tampered with for example altering the list
of surgery and some miss the opportunity.
Who would be potentially harmed?
The patients trust with the medical facility; the medical facility will be harmed as it will lose
credibility. The employees who might be involved in data manipulation. The patient will also be

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harmed because they will continue being sick or get another ailment due to the wrongful
diagnosis.
The risk level, precautions that are already in place
The check system of the information should be in place to regulate data manipulation
Only authorized personnel are to access the data
Additional precautions needed prior to implementation
Better access to billing system that shows and gives receipts after service delivery.
Registration form in an online system so as to show the number of admissions, discharge and
anomaly that might be encountered.
 This will be based on the employees’ level of performance and the levels will be rated in
percentage to be able to reach potential of the employees and ensure maximum work
productivity.
Evaluation Of Performance Percentage Ratings
Focusing on the departments from top to
bottom
Close monitoring on the services
Measuring the consistency between policy of
an organization and performance of
operations

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Task management
Employee engagement
Patient satisfaction
Smooth functioning of departments
 Collection of Data :
Employee feedback on the present processes
Patient feedback on services of employees
and organization facilities
Performance results
Daily reports
Compliants from patients
Regular monitoring on employee performance
Completing the rest of Plan :
 Plan
For changing processes
Setting up of operational standards and
systems
Identifying the blocks in the processes
Making policy to improve the overall
performance of an organization
 Testing of new practices/ideas
Observe the results
Evaluation of result- long term/short term

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benefit
Decide whether to include in policy or not
On the job training if necessary
Check :
Key issues in processes
Analysis of data
Data designing using charts for proper
decision making
Comparison of past results with test results
Additionally, If results are fine, new process
techniques are to be added to the policy
Framing new change policy
Communicate it to the staff members
If need make an arrangement of training for
staff

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References
Bagheriyan, H., Setareh, M., Nezhadnik, M. and Niknam, M., 2011. Ayubiyan a. Prevalence and
causes of medical errors in the cases referred to Isfahan Legal Medicine. Health Information
Management, 9(1), pp.101-9.
Chourey, R., 2015. Risk Management in Hospitals. Editorial Board, 44(2), p.9
Haghi, Z., Gh, Z. and Aataran, H., 2005. Factors affecting the surgical team trials in medical
malpractice lawsuits and claims handling system Mashhad University of Medical Quality.
Forensic Mwdicine, 11(3), pp.141-5.
Jones, V., 2015. Hospital and physician professional liability trends and industry topics. Journal
of Healthcare Risk Management, 35(1), pp.7-19.
Keikavoosi Arani, L. and Nasiripour, A., 2012. Overt Threats Affecting Medical Errors in Public
Hospitals in Tehran Province. Teb Va Tazkieh, 20, pp.65-76.
Kubheka, B., 2015. Risk management competencies for medical practitioners working in South
African hospitals (Doctoral dissertation, University of Pretoria).
Pandey, A. and Sharma, R., 2017. Risk Management For Health Care Operations And Protected
Healthcare Information. International Journal of Pharmacology and Biological Sciences, 11(1),
p.55.

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Singh, B. and Ghatala, M.H., 2012. Risk management in hospitals. International journal of
innovation, management and technology, 3(4), p.417.
Wiryoatmojo, A.S. and Surya, B.A., 2013. Risk Management Analysis of Third Construction
Stage in Diagnostic and Cardiac Center Building at Dr. Hasan Sadikin General Hospital.
Indonesian Journal of Business Administration, 2(11).
Zaboli, R., Karamali, M., Salaem, M. and Rafarti, H., 2011. Evaluation of risk management in
various parts of Tehran city hospitals. Journal of Military Medicine, 12(4), pp.197-202.
Zaboli, R., Karamali, M., Salaem, M. and Rafarti, H., 2011. Evaluation of risk management in
various parts of Tehran city hospitals. Journal of Military Medicine, 12(4), pp.197-202.