University Report: Clinical Risk Management and Patient Safety

This report, focusing on clinical risk management (CRM) and patient safety, details the importance of CRM in healthcare, highlighting the potential risks across various departments and patient groups. It outlines CRM principles, including identifying, evaluating, and mitigating risks, emphasizing the need for communication and collaboration among healthcare staff. The report further explores organizational and performance-based CRM strategies, such as incident reporting, sentinel event reporting, and staff training. It concludes that the timely implementation of comprehensive CRM strategies is crucial for reducing clinical errors, improving patient satisfaction, and delivering safe, effective, and high-quality healthcare interventions. The report uses examples and references to support the discussed principles and strategies, emphasizing the collaborative efforts required from all healthcare staff to achieve positive patient health outcomes. The report is a submission for a NURS 4001 course, which required a group presentation and a supporting document detailing clinical risk management and patient safety.

Running head: CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION OF EACH
SECTION
Name of the Student:
Name of the University:
Author note:

1CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
Introduction
Clinical Risk Management (CRM) is the process of identifying potentially harmful or
risky healthcare factors which can threaten patient health for the purpose of improving safety and
quality of services and resources provided by a healthcare organization (World Health
Organization, 2020). The following paper will briefly expound upon the importance of CRM in
patient safety, its underlying principles and strategies with which organizations and practitioners
can implement the same.
Discussion
Importance in Patient Safety
Healthcare organizations are required to address numerous complex and emergency
patient situations in a short period of time, which increases the risk of errors and make it
imperative to practice CRM, especially considering life and death situations in patients (Smith,
2017; Fonarow, 2019). Prevalence of preventable errors also contributes to loss of patient trust
and financial losses both for the family as well as the organization (Trevino et al., 2018).
Mitigation of patient harms and risks by practicing CRM helps in reduced incidences of errors
and practices, reduced harmful patient outcomes and increased ability to deliver safe, quality and
effective patient care (Walker et al., 2018).
Risks in Healthcare
Risks across healthcare professionals
 Absence of providing the correct diagnosis.
 Absence of correctly interpreting or reviewing results of patient assessments (Flannigan,
2018).

2CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
Risks across healthcare outpatient as well as inpatient departments
 Errors in correct medication administration.
 Healthcare associated infections due to lack of adequate disinfection practices.
 Lack of correct or timely handover communication practitioners, families, patients and
staff (Pankiewicz-Dulacz et al., 2018).
Risks across elderly care, community care or residential healthcare facilities
 Inability to reduce falls and pressure ulcer incidences across patients.
 Inadequate fluid or food intake resulting in dehydration, malnutrition and choking (Tariq
et al., 2018).
CRM Principles
According to the Government of Western Australia (2019), CRM involves:
 Identification of potential errors which may occur in healthcare,
 Evaluating the factors influencing the occurrence of these errors,
 Taking insights from previous experiences of negative health outcomes and adverse
health events,
 Administering necessary action for preventing repetition of such outcomes, and,
 Ensuring the prevalence of a system which are free from risks or where such risks are
reduced.
With this respect, the principles of CRM are:
1. Step 1: Establishing the context or scenario where risks can occur.
2. Step 2: Identifying potential risks relevant to the context.
3. Step 3: Analyzing the severity and likelihood of risks.

3CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
4. Step 4: Evaluating the factors underlying occurrence of the risks.
5. Step 5: Treating or delivering interventions to mitigate the risks.
6. Healthcare staff of the organization must communicate and collaborate with each during
each of the above CRM steps and principles. The healthcare management must also
engage in repeating the above CRM process in regular intervals (Government of Western
Australia, 2019).
Organizational CRM Strategies
 Incident Reporting: Documenting accidents for identifying contributors of accidents.
 Sentinel Event Reporting: Documenting unexpected patient death or psychological
trauma of a patient for identifying contributors of ‘catastrophic events’.
 Complaint/Conflict Management Protocols: Documentation of patient complaints for
identifying patient expectations.
 Coronial Investigations: Investigating patient deaths by coroners, for identifying
preventable errors or malpractices.
 Accreditation: Conducting certified quality control audits such as the National Safety
and Quality Health Service (NSQHS) Standards.
 Credentialing: Systematically delegating based on staff competency such as the
Decision Making Framework by the Nursing and Midwifery Board of Australia
(Zadfallah, Bastan and Ahmadvand, 2017; World Health Organization, 2020;
Government of Western Australia, 2019).
Performance-based CRM Strategies
 Engagement in staff and practitioner training frameworks to increase awareness on
healthcare organizational CRM principles and policies.

4CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
 Engagement in regular patient documentation and inter-departmental handover
communication.
 Engagement in adequate conflict and complaint management and incident reporting
strategies (de Vries et al., 2016).
Conclusion
Timely implementation of comprehensive CRM strategies can reduce malpractices and
clinical errors and improve patient satisfaction and deliverance of safe, effective and high quality
healthcare interventions. To conclude, every department and staff of a healthcare organization
must collaboratively work towards practice CRM strategies for achieving positive patient health
outcomes.

5CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
References
de Vries, M. G., Brazil, I. A., Tonkin, M., & Bulten, B. H. (2016). Ward climate within a high
secure forensic psychiatric hospital: Perceptions of patients and nursing staff and the role
of patient characteristics. Archives of psychiatric nursing, 30(3), 342-349.
Flannigan, A. C. (2018). Governance in practice: Corporate and clinical governance update for
health and aged care providers. Governance Directions, 70(5), 235.
Fonarow, G. C. (2019). Clinical risk prediction tools in patients hospitalized with heart
failure. Reviews in cardiovascular medicine, 13(1), 14-23.
Government of Western Australia. (2019). Clinical Risk Management Guidelines. Retrieved 15
April 2020, from https://ww2.health.wa.gov.au/Articles/A_E/Clinical-risk-management.
Pankiewicz-Dulacz, M., Stenager, E., Chen, M., & Stenager, E. (2018). Incidence Rates and Risk
of Hospital Registered Infections among Schizophrenia Patients before and after Onset of
Illness: A Population-Based Nationwide Register Study. Journal of clinical
medicine, 7(12), 485.
Smith, R. (2017). Clinical risk management in obstetric practice. Obstetrics, Gynaecology &
Reproductive Medicine, 27(9), 277-284.
Tariq, A., Georgiou, A., Raban, M., Baysari, M. T., & Westbrook, J. (2016). Underlying risk
factors for prescribing errors in long-term aged care: a qualitative study. BMJ Qual
Saf, 25(9), 704-715.

6CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: DESCRIPTION
Trevino, P., Green, A., Middaugh, D., Heo, S., Beverly, C., & Deshpande, J. (2018). Nursing
perception of risk in common nursing practice situations. Journal of Healthcare Risk
Management, 37(3), 19-28.
Walker, L. E., Nestler, D. M., Laack, T. A., Clements, C. M., Erwin, P. J., Scanlan-Hanson, L.,
& Bellolio, M. F. (2018). Clinical care review systems in healthcare: a systematic
review. International journal of emergency medicine, 11(1), 6.
World Health Organization. (2020). Understanding and managing clinical risk. Retrieved 15
April 2020, from
https://www.who.int/patientsafety/education/curriculum/who_mc_topic-6.pdf.
Zadfallah, E.L.A.H.E.H., Bastan, M.A.H.D.I. and Ahmadvand, A., 2017. A qualitative system
dynamics approach to clinical risk management. In The 13th International Conference on
Industrial Engineering (IIEC 2017) (Vol. 2117).