Understanding Clinical Risk Management and Patient Safety (NURS 4001)

This presentation provides a comprehensive overview of clinical risk management and its crucial role in patient safety within healthcare settings. It begins by defining clinical risk management as the process of identifying, controlling, and preventing factors that could harm patients, thereby improving the quality and effectiveness of healthcare services. The presentation emphasizes the importance of CRM due to the complex and high-pressure nature of healthcare environments and the potential for preventable errors, adverse patient outcomes, and financial losses. Various types of risks in healthcare are discussed, including those related to diagnosis, medication administration, and care across different settings like outpatient, inpatient, elderly care, and community care. The core principles of risk management are outlined, including establishing context, identifying risks, analyzing severity and likelihood, evaluating underlying factors, and implementing interventions. Organizational and staff-based risk management strategies such as incident reporting, sentinel event reporting, complaint management, coronial investigations, accreditation, and credentialing are detailed. The presentation concludes by highlighting the multifaceted benefits of CRM, including the reduction of errors, improved patient outcomes, and enhanced organizational performance, stressing that engagement in CRM is a shared responsibility of both staff and management.

Running head: CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: TRANSCRIPT
CLINICAL RISK MANAGEMENT AND PATIENT SAFETY: TRANSCRIPT
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1CLINICAL RISK MANAGEMENT AND PATIENT SAFETY
Slide 2: Introduction: What is Clinical Risk Management?
Clinical risk management (CRM) is the process by which situations, factors or
circumstances within the healthcare organization, which have the potential to harm or threaten
the lifestyle of patients are identified, controlled, eliminated or prevented, for the purpose of
improving the overall safety, quality and effectiveness of services and resources delivered by a
healthcare organization (World Health Organization, 2020). It is the process of reducing and
limiting the potential healthcare risks and harms to patients, via (Government of Western
Australia, 2019).
 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.
Slide 3: Why is it important for Patient Safety?
Healthcare organizations and healthcare professionals are frequently required to
encounter a large number of patients with complex, critical conditions requiring complex
healthcare interventions on a daily basis and are often subject to high-pressure, emergency
situations every day (Smith, 2017). The challenge is to deliver interventions of the highest
quality and safety within the least possible time. Such challenging work environments coupled
with the uncertainties of patient healthcare outcomes increase the likelihood of situations and

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practices which can be potentially harmful to patient’s health (Fonarow, 2019). While every
organization implements some form of risk management strategies, their execution is more
crucial in healthcare due to the nature of work environments as well as possibility of life or death
in a patient. Additionally, prevalence of preventable errors can inflict fatal patient health
outcomes, loss of patient satisfaction and trust, low patient influx and resultant financial losses in
healthcare organizations (Trevino et al., 2018). Further, CRM strategies help healthcare
organizations to avoid incurring large financial expenditures both for the management as well as
for the patients. Thus, correction of harmful incidences and risks via CRM strategies in
healthcare is closely associated with reduced likelihood of errors, reduced likelihood of adverse
patient healthcare outcomes and thus, improved deliverance of healthcare interventions which
are safe, clinical effective and patient-centered (Walker et al., 2018).
Slide 4-5: Types of 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).
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).

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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).
Slide 6-7: Principles of Risk Management in Healthcare
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.
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).
Slide 8-9: Organizational based Risk Management Strategies
 Incident Reporting: It is the process of timely documentation of accidents using
specified recording protocols for evaluation by quality control departments.
 Sentinel Event Reporting: It is the process of reporting and documentation of
unexpected incidences like death or psychological trauma of a patient for prevention of
future ‘never’ or ‘catastrophic events’.

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 Complaint/Conflict Management Protocols: It is the process of timely management as
well as documentation of complaints registered by patients which can be used to identify
patient expectations and causes of errors.
 Coronial Investigations: The process of investigating the causes of a patient’s death by
coroners, for identification of the role of any preventable errors or malpractices.
 Accreditation: The process of conducting quality control audits in an organization based
on certified standards such as the National Safety and Quality Health Service (NSQHS)
Standards or Work Health and Safety committee.
 Credentialing: The process of practicing delegation based on a healthcare professional’s
competency and capability to deliver healthcare interventions 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).
Slide 10: Staff or Performance based Risk Management Strategies
 Each staff and practitioner must be educated, trained and made aware of the CRM
principles and policies followed by the healthcare organization.
 Each staff and practitioner must engage in regular documentation and recording practices
at every clinical step.
 Each staff and practitioner must be educated, trained and made aware of adequate conflict
and complaint management and incident reporting strategies.
 Each staff and practitioner must engage in inter-department communication at every step
of the CRM process (de Vries et al., 2016).

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Slide 11: Conclusion
Implementation of correct, timely and comprehensive CRM strategies demonstrate
multifaceted benefits since it encourages the avoidance of preventable errors and malpractices
and deliverance of safe, quality and effective interventions, which in turn instill beneficial patient
as well as organizational benefits. To conclude, engagement in CRM strategies is the joint
responsibility of staff and overall healthcare management of an organization.

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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.

7CLINICAL RISK MANAGEMENT AND PATIENT SAFETY
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).