Hazard Identification, Risk

Assessment and Risk Control

(HIRARC) at Hospital
 Dr. YULIANI SETYANINGSIH,SKM,M.Kes
Work Experience

• Ketua Prodi S2 Magister Promosi Kesehatan FKM UNDIP

(2017-2022)
• Kepala Bagian Keselamatan dan Kesehatan Kerja FKM UNDIP
(2008-2012)
• Sekretaris Bagian Keselamatan dan Kesehatan Kerja FKM
UNDIP (2004-2008)
• Pengurus AIPTKMI Regional Tengah I
• Pengurus PAKKI Jawa Tengah
• Pengurus IAKMI Jawa Tengah
• Pengurus Komnas UKAKMI

Riwayat Pendidikan Haki Buku

 Buku Ajar Higiene Lingkungan Industri (2019)

S1 Kesehatan Masyarakat UNDIP (1994)  Buku Pos Upaya Keselamatan Kerja (2019)
S2 Ilmu Kesehatan Kerja UGM (2002)  Buku ajar Dasar-Dasar Keselamatan dan Kesehatan
S3 Ilmu Kedokteran dan Kesehatan UGM Kerja (2020)

(2016)  Buku Panduan Bekerja Aman Pada Pekerja Pelapis

 Definition

•Hazard means a source or a situation with a

potential for harm in terms of human injury or ill
health, damage to property,
•Hazad suatu situasi atau sumber ynag berpotensi
untuk terjadinya cidera kepada manusia, sakit
kesehatan, kerusakan harta
 Definition

•Danger: Relative exposure to hazard

•Bahaya: dedahan kepada hazad
•Risk means a combination of the likelihood of an
occurrence of a hazardous event with specified
period
•Risiko adalah kombinasi diantara kemungkinan
(peluang) untuk terjadinya hazad pada masa tertentu
 Definition

•Risk assessment means the process of evaluating

the risks to safety and health arising from hazards at
work.
•Hazard control means the process of implementing
measures to reduce the risk associated with a hazard
 What is Risk?
How to predict the risk?
Purpose of HIRARC
a) Legal requirement
b) to identify all the factors that may cause harm to
employees and others (the hazards);
c) to consider what the chances are of that harm actually
be falling anyone in the circumstances of a particular
case and the possible severity that could come from it
(the risks); and
d) to enable employers to plan, introduce and monitor
preventive measures to ensure that the risks are
adequately controlled at all times.
When to Carry out Risk Assessment?
• Before operation
• During
• operation After
operation
When to Review Risk Assessment?
1. Internal Operation
 Before modification, changes or introduction of new
- material, machinery or processes, working
procedures
2. External – legal requirement
Basic Component of Risk Management
1. Hazard Identification
2. Risk assessment
3. Risk Control
4. Review
HIRARC Process
 Hazard
Identification
 Sources of Hazard

1. M a n  Unsafe act
2. Machinery  Installation, layout
3. Materials  Substances such as
chemicals, radioactive and gases
4. m e t h o d  The way people carry out
their work
5. M e d i a  Work place condition i.e.
ari quality, ventilation, lighting, noise,
vibration
 Classification of Hazard
Classification Example
Physical Mechanical ( Sharp point, edges, overload)
Electrical (Electrical cord insulation damaged,
wire cover)
Biological Blood borne, viruses, bacteria and Fungus
Chemical Exposed to carcinogens chemicals
Ergonomic Awkward design of workstation
Psychological Stress, sexual harassment and violent
 Assessment- Identifying Hazard
• Information Gathering (Area Map, site
plans)
• Review of Documents and publication
• Inspection and observation
• Measurement of the atmosphere, monitor
environment
• Health or medical surveillance
• Previous hazard analysis
 Hazard Analysis
• Job safety analysis
• HAZOP (Hazard Operational)
• Fault tree
 Hazard Analysis (Job safety )
• Identify job to be done
• List things that can go wrong
 Hazop
• To identify and evaluate safety hazards in
the process plants
• New design or process
• “What if” questionnaire method
 Risk Rate
Risk rate = Severity x likelihood
= hazard x exposure
Likelihood = is an event likely to occur within the
specific period or in specified circumstances
@ How much quantities of chemicals enter the
body
 Severity of Hazard

Severity is the outcome of event

 Harm to health
 Damage to property
 Damage to environment
 Combination of the above
Risk Rate
Risk Rate
HiRARC FORM

Legal
requirement
Spot The Hazard
Spot The Hazard
Hirarc At Hospital
Hirarc At Hospital
(Radiant RISK)
Hirarc At Hospital
Medical waste
 Hospital Risk Management

Backgrounder

What is “RISK”?

What is Hospital Risk Management (HRM)?

 What is “RISK”?

Risk is a probability or threat of a

damage, injury, liability, loss, or other negative
occurrence that is caused by
external or internal vulnerabilities, and
that may be neutralized through
preemptive action.

http://www.businessdictionary.com/definition/risk.htm
l
 What is Hospital Risk Management (HRM)?

Hospital risk management (HRM) is

a system or program that
manages the “risks” of a
hospital.

•Department Risk Management

•Disaster Risk Management
•Patient Treatment Risk Management (Benefit-Risk; Medical
Malpractice Risk Management)
•Others
 What are the general goals of HRM?

• Prevent and mitigate all potential risks

• Be prepared in terms of response and recovery
in case the risks become real
• Control resulting damage, injury, liability,
loss, or other negative occurrence to a
minimum level
 What are the general goals of HRM?

• Avoid loss of and disability in

 People (patients, visitors, staff) in the hospital
 Resources of hospital
 Business of hospital (business discontinuity)
• Avoid complaints related to risk occurrence and
consequences!
 What are the preventive goals of HRM?

• Promote safety for ALL patients, visitors, and staff in the

hospital
• Provide effective assistance and management during
emergencies (disasters)
• Prevent controllable deaths and disabilities
• Prevent and control losses (business, finances,
properties, and infrastructure).
 What are the ultimate goals of HRM?

SUSTAINABILITY OF THE HOSPITAL

AS LONG AS POSSIBLE
(target: 100 years)
 What are the ultimate goals of HRM?

SUSTAINABILITY OF THE HOSPITAL

AS LONG AS POSSIBLE
(target: 100 years)

Sustainable structure-wise
Sustainable financial-
wise Sustainable service-
wise
 Sustainable structure-wise goal of HRM?

Sustainable structure-wise

Will NOT collapse

NOT be burned
NOT be flooded
NOT be destroyed by
whatever hazards
and will continue to operate its business as long as
possible (target: 100 years).
 Sustainable financial-wise goal of HRM?

Sustainable financial-wise

Will NOT go bankrupt

Will have positive income
and will continue to operate its business as long as
possible (target: 100 years).
 Sustainable service-wise goal of HRM?

Sustainable service-wise

Will continue
to provide adequate and quality services
expected of a hospital for as long as possible, both
during crisis and non-crisis situations
 Quality parameters of an excellent HRM?

• Systematically and comprehensively formulated

(with document)
• With full support and commitment of top
management and ALL staff
• ALL staff of the hospitals trained and educated
on program
 Quality parameters of an excellent HRM?

• With testing or exercises done regularly and at

planned intervals and as needed
• Being reviewed regularly at planned intervals
and as needed
• Has been tried and tested and has achieved its
formulated goals and objectives and specified
targets
 Basic processes in Hospital Risk Management?

• Risk identification and assessment

• Formulation of strategies and action plans to

prevent, mitigate risks and to respond and
recover from the consequences of unavoidable
risk occurrence