Risk Management

Lecture 3
Dr: Naglaa Sayed Esa
naglaa24sayed@gmail.com
01002281221
Risk and Quality of Care
 Intended Learning Outcomes

By the end of this lecture, each participant will be able to:

1. Define quality from risk management aspect.

2. Enumerate steps of risk management process.

3. Discuss Failure Mode and Effect Analysis (FMEA)

 Quality
• Quality is the optimal achievement of the
therapeutic benefit, avoidance of risk and
minimization of harm.(Joint commission definition of
quality)
 Risk management in Health Care

• Risk management is coordinated activities to direct and

control an organization with regard to risk (ISO31000 -
2018).

• Risk is defined as the chance of loss (JCI)

Risk management can be defined as:
Identifying circumstances that put patients or a hospital at
risk for adverse outcomes and putting into operation
methods that avoid, prevent, and to mitigate (reduce or
eliminate) the risks
 Risk Management Process

1. Identification of risks.

2. Analysis of risk.

3. Risk control / treatment.

4. Continuous monitoring.

5. Creating risk management culture

 1- Identification of risks
- By continual collection of information ( it is not one time static
analysis) .

- Risk manager must have steady stream of information (claims ,

Occurrence Variation Reports "OVR" ,staff credentialing, facility
management, etc.)

- Analysis of past near misses or accidents or incidents .

- Or by virtual imagination
 2- Analysis of risk
Impact of risk
Impact of harm
Categorization of risk
By FMEA
RPN (Risk Priority Number ) = Severity X Occurrence
*Detection .
SEVERITY = 1,5,10
OCCURRENCE =1,5,10
DETECTION = 10,5,1
 Failure Mode and Effects Analysis
(FMEA)
Definition:

• Is a designed tool for assessing risk associated with different

ways (modes) in which a part or system can fail.

• Is a methodology aimed at allowing organizations to anticipate

failure during the design stage by identifying all of the possible
failures in a design or manufacturing process
 FMEA
- Developed in the 1950s

- FMEA was one of the earliest structured reliability improvement method.

- FMEA is an analysis done by a cross – sectional team.

- FMEA is a tool to anticipate potential problems before they occur

(proactive and preventive), identify potential risk and priories issues, so
you can work to eliminate the most serious concern before people
impacted.
 5 steps of FMEA
1. Define scope and topic of FMEA.

2. Assemble multidisciplinary cross – functional team of experts.

3. Create a detailed flow chart of the process.

4. Hazard analysis:

- Identify potential failure at each step.

- Visualize the risk by creating Risk Priority Matrix

- Classify all failure modes into Risk Priority Number (RPN)

Likelihood of Risk = Probability X Frequency

5. Actions and measures: to prevent high risk issues, monitoring

and creating follow up plan.

Success is not just following but also

creating effective protocol.
 Risk Matrix
Visual and Communicating Tool

 ALARP = As Low As Reasonably Practicable

 Risk Matrix
Visual and Communicating Tool
FMEA
 3- Risk Control /Treatment
1. Risk Acceptance
2. Exposure avoidance

3. Loss prevention

4. Loss reduction

5. Exposure segregation

6. Contractual transfer

7. Risk financing
 4- Standardization of The Process
- Create Policies and Procedures

- Work Instructions

- Training

- And Continuous Monitoring

 5- Creating Risk Management Culture
• Non - punitive culture.

• Free to report risks.

• “we immediately speak up when we think we

see an unsafe practice developing.”
“we immediately speak up when

we think we see an unsafe

practice developing.”
 Remember

Risk Management Process Could be:

Proactive ( avoiding and preventing the RISK)

Reactive (minimizing the loss or damage from RISK)