Recognizing Risks and Improving Patient Safety- Mildred Story - Case Study Example

Risk Management Name: Course: Institution: Date: Risk Management Introduction The safety of patients and employees has become a matter of interest for healthcare professionals and governments on a global scale. This explains why in the past decade, numerous research initiatives have been conducted with the objective of assessing the severity, prevalence, and causes of different types of adverse effects including the effectiveness of approaches and efforts that enhance safety while reducing adverse events and risks (Queensland Health 2007). Risk management in any health care facility requires the management to develop strategies that are coordinated and relate to wide variety of organizational aspects that are associated risks and safety (Scally and Donaldson 2008). These aspects include resource allocation, co-ordination, and standardization in healthcare institutions, effective human resources management, information technology, communication, and inter-institutional improvement initiatives (Gautam 2006). The main objective of this research paper is to conduct a risk management activity on the services and associated processes as presented in the video case study, “Recognizing Risks and Improving Patient safety- Mildred Story” The importance of evidence-based healthcare quality, safety, and governance frameworks Among healthcare professionals, the provision of effective, safe, and high quality treatment defines the extent to which patients get the best outcome from hospital care (Penny 2001). Evidence-based practice provides health care professionals with guidelines that incorporated into the routine healthcare service management processes to allow for systematic monitoring (Robinson 2008). Through this approach, it becomes possible for healthcare professional to develop techniques and ways that can be used in the delivery of quality and safe care (Vanu 2004). It is possible to add value to evidence based practice through a systematic and strategic approached that are properly resourced and supported (Spark and Rowe 2004). This allows for allocation of responsibilities according to the qualifications, skills, and capabilities of healthcare professionals. In addition, evidence-based practice also provides healthcare professionals with guidelines that provides quality assurance to the patients and is associated with service delivery priorities (Swage 2000). Effective evidence-based practice in healthcare organizations is dependent on the ability of the leaders to ensure that the guidelines and polices provided are implemented with regard to the delivery of high quality and safe medical care (Maynard 2009). This is a way that the leadership established evidence-based policies and processes aimed at improving the efficiency of a healthcare facility (Stanton 2006). The leadership can draw its undressing and knowledge of the healthcare institution in the devilment and implementation of evidence-based polices. This is often applicable when conducted in relation to the health, social and political care context (Wright et al 2001). The incorporation of these elements as part of the healthcare system facilitates the development of an all-inclusive process targeting the delivery of quality and safe medical care (Maley 2006). The essence of evidence-based practice in the delivery of quality and safe medical care is in its ability to develop measures aimed at improving the nature of services provided by healthcare professionals (Rogers, et al 2004). This is because, evidence based practice facilitates the development of structured programs for systematic monitoring and improvement of the quality of medical care provided across all services within a medical facility (Busfield 2004). This includes system that monitor facility’s effectiveness, mechanisms of assessing and implementing relevant healthcare guidelines , systems for the dissemination of relevant information, and systems that support the existing information structures. Evidence-based risk management best practice Integrated risk managements approach is an evidence-based risk management practice, which asserts that addressing risks is the responsbility of every stakeholder. Safe and high quality healthcare requires that the entire system work effectively, not just that parts that have direct responsbility to the healthcare professional (Malcom 2001). This is an indication that the processes and systems of a comprehensive risk management process need to be developed throughout the system with the objective of addressing all the risks within a health care facility. Through the integrated risk management methodology health and safety processes and other risk management practices work together (Carr 2010). The effectiveness of this approach to risk management is in the ability of a healthcare facility that the framework has the ability to identify all the risks arising in relation to the needs of the patients, staff, and the organization (McSherry and Pearce 2011). This often requires the addition of legislations and policies as stipulated by the Ministry of Health, which ensure that the integrated framework is supported using structures that provide a platform for the identification and the management of possible risks (Gilbert et al 2011). The legislations allow a healthcare organization to operate within the requirements of the law. Addressing risks within the requirement of the law not only guarantees safe and high quality medical care, it ensures that the healthcare practitioners are qualified to provide the intended services (Woloshynowych et al 2005). Risk management objectives Engage in the development of structures that ensure continuous improvement of patient safety while minimizing or preventing the occurrence of events, errors, and system breakdowns which might harm the patients, employees of visitors though proactive patient safety and risk management activities. Minimizing adverse effects of events, system breakdowns, and errors when they occur within a medical facility Minimizing loses to a healthcare facility through proactive identification, analysis and prevention and control of potential medical and operational risks. Enhancing the protection of human and intangible resources through the development of procedures and structures aimed at safeguarding the reputation and dignity of the patients and the healthcare facility. Facilitating compliance with legal, regulatory, and accrediting agency requirements to ensure that the risk management strategies and structures developed by a healthcare organizational are in accordance with the requirements of the law Risk identification This is considered as the first step in the process of proactive risk management. The identification process provides the management with indicators, opportunities, and information that allows a healthcare facility to develop informed risk management strategies before they develop and affect operations within the organization (Titterton 2005). Through effective risk identification techniques it becomes possible for a health care facility to identify the risks or hazards that exists of those that are probable, their attributes, remoteness in terms of time, and the possible outcomes (Wilson & Tingle 2009). The risk identification process is the therefore essential in providing an organization with baseline information with regard to different factors that threaten the safety of the patients and the ability of the healthcare professionals to deliver quality medical care to the patients (Girling 2013). Understanding the possible outcome of risks facilitates the development of effective risk management strategies (Faulkner 2012). In the video case study, “Recognizing Risks and Improving Patient safety- Mildred Story” the following risks were identified; Overload in the emergency room (ER) increases the risk of delay in treatment because of failure to acquire timely physical assessment Wet floor in the medical facility increases the risk of falling resulting to patient injury. Failure by the medical practitioners to review the patient medical chart increases the risk of not knowing the injured side. This results in marking the wrong side of the body for surgery Failure to have adequate pre-operation preparation increases the risk that a patient will take longer time while preparing for surgery hence delay in the operation Insufficient knowledge about the cause of allergy increases the risk of prescribing drugs whose pharmaceutical ingredients might be containing allergens. This increases the risk of allergic reaction in patients upon consumption of the said drugs. Risk estimation This entails a process of expressing a perceived risk in terms of duration, its intensity, magnitude and the potential consequences through a quantifiable approach (Kellison and Richard 2011). Furthermore, risk estimation can also entail the description of the probability that the exposure of an organism to a specific dose of substance will lead to the development of an adverse effect (Kellison and Richard 2011). Risk estimation facilitates the establishment of a scale that indicates the perceived likelihood that a risk will occur (O’Rourke 2003). In the context of the video case study, failure by the hospital employees to ensure dry floors increases the risk that a patient will fall and suffer an injury. This is an indication that it is the responsbility of the healthcare providers to ensure that sufficient measures are introduced to reduce the possibility of risks occurring (Runciman et al 2007). Risk estimation also facilitates the process of determining the consequences of a risk. These include the possible adverse effect that may occur when patient are exposed to a specific risk (Doyle and Dolan 2007). For example, according to the video case study failure by the medical practitioner to determine the allergies of a patient and the pharmaceuticals with allergens as ingredients may result in prescription of the wrong drug to the patient. This increases the risk of adverse allergic reactions by the patient. Depending on the dosage provided by the medical practitioner it is possible for the patient to suffer from the allergic reaction in varied ways and there will be need for urgent medication to minimize the consequence of death. Risk estimation approximates the impacts of the consequences on the healthcare facility with regard to the provsionof safe and quality medical care.in the video case study, it is notable that the hospital does not have effective risk management structures considering that the medical practitioner operate with high level ignorance on the safety of the patient (Runciman et al 2007). This affects the reputation of the hospital with regard to effective and high quality health care services. Risk estimation also facilitates the development of overall accuracy of risk projections as a way of minimizing the possibility of misunderstanding (Khatta 2008). Accurate risks projections are important in facilitating the development of evidence-based medical care strategies (Davidson 2009). This is because through such strategies, it becomes possible for medical facilities to operate on informed structures that are aware of the probable and prevailing risks (Doyle and Dolan 2007). Risk evaluation Risk evaluation is a risk assessment process, which involves the development of an understanding of the risks identified (Kavaler and Spiegel 2003). This is an indication that process of evaluating risks involves an assessment of the potential and actual impact and an assessment of the likelihood of a risk occurring (Hickey and Christine 2012). The process of risk evaluating requires taking into account the existing control measures. This will facilitate the process of putting a value on a risk and its implications as a way of monitoring the extent to which the state of the risk has been altered (Emslie and Charles 2008). Risk evaluation also provides a platform of confidently assessing the threats posed by a risk with regard to the delivery of quality healthcare services and the possible risk mitigation strategies (Duncan 2014). Through the risk evaluation process, it becomes possible for the leadership in a healthcare organization to make decision based on the outcome of a risk analysis process (Frenkel 2005). The evaluation process will identify the risks that require immediate treatment and distinguish them from those that do not require such treatments (Duncan 2014). In addition, through risk evaluation, it becomes possible for the management in a healthcare organization to prioritize on the best strategies of risk mitigation (Ball et al 2005). Therefore, the risk evaluation process is an aid to decision making with regard to the prioritization of risk management approaches (Brandeau et al 2004). This may involve the decision to accept he risk, address the risk through risk avoidance strategies or develop control mechanisms of the risk (Handlechner 2008). It is the responsbility of the management in a healthcare of organization to ensure that the methodology used in making decisions regarding the acceptance or treatment of risks is consistent with defined internal and external risk management contexts while considering the goals and objectives of the healthcare organization (Cappelli and Connie 2008). Furthermore, through effective risk evaluation mechanisms it becomes possible for a healthcare organization to develop risk management priorities by establishing qualitative and quantitative associations between the probable benefits and the associated risk (Brandeau et al 2004). The main concern of risk evaluation is therefore to conduct an assessment of the probability and the impact of individual risks while considering and relationships or other factors outside the immediate scope of the risk (Cappelli and Connie 2008). The probability approach in risk evaluation entails the assessment of the likelihood of a specific outcome actually happening. This is with regard to the frequency with which the outcome may occur (Cappelli and Connie 2008). Impact in risk evaluation is perceived as the evaluated effect of a specific outcome actually occurring. The process of impact evaluation is often conducted with regard to time, quality, benefits and resources (Brandeau et al 2004). Risk control planning Risk control planning is a process that facilitates the strategies that will be used in the regulation and control of all the risks within an organization. Through risk control planning, it becomes possible for an organization to meet its legal obligations of identifying the possible hazards, assessing and controlling the risk (Brown and Carroll 2006). When perceived in relation to the video, provision of safe and high quality health care services will require the management to develop a risk control plan as part of its obligation. The first step in the preparation of the risk control plan is the establishment of effective communication and consultation (Youngberg 2011). This is based on the realization that effective delivery of services requires the creation of a safe working environment where staff members communicate to one another about potential problems in their workplaces and collaborate in finding solutions (Roberts 2002). Through consultation the management and the employees will share information on health and safety, provide an opportunity for employees to share their views and consider these vies was essential in risk management (Roberts 2002). The second step in the development of a risk control plan is the allocation of responsibilities through the deliberations of the management. This process requires administrative support, expert advice, employee training and an approval for the purchase of new equipment and substances where it is considered necessary (Runciman 2006) The third step is making decisions on working arrangements. Effective realization of this process may require the formation of teams to prepare different parts of the risk control plan (Runciman 2006). These teams will be dedicated to the determination of the kinds of risks involved, the type and number of incidents and injuries reported in different areas, the number of people involved, the level of risk associated with the hazards and feedback on the effectiveness of existing control measures (Runciman 2006). The fourth stage is the identification of the hazards. In a hospital setting, they can arise from poor workplace design, employee negligence and ignorance. This process allows for early detection of the possible hazards to facilitate the process of developing mitigation strategies (Runciman 2006). The next step is assessment of risks, which entails the process of finding out the extent of harm that each hazard can cause and the consequences of the risk. This helps in making decisions on the best approaches of controlling each hazard and reporting on the hazards that need immediate attention (Runciman et al 2002). The sixth step is control of risks, which entails the implementation of appropriate risk control measures. From a legal perspective organizations are required to eliminate risks or reduce their threat by reasonable polices (Lewis et al 2002). The seventh step is reviewing progress and maintaining the risk control plan. This is based on the realization that it is the responsbility of the management to ensure a regular review and update of the control plan. This is often aimed at ensuring that work is done within a reasonable timeframe. In addition, continuous assessment of the risks will ensure that they are addressed according to the plan before they enter the organization (Lugon and Secker-Walker 2009). Risk acceptance Risk acceptance occurs in situations where the leadership of an organization determines that the existing control measures and the available resources are sufficient in addressing the identified risks (Aven and Jan 2007). By accepting the risk, the management acknowledges that the organization does not have the ability to eliminate the risk while at the same time asserting that it has engaged the available resources in addressing the most critical aspects of the risks (Flynn and Bellaby 2007). In a healthcare organizational context, a risk assessment document contains the list of risks and the justification by the management for failure to address non-critical risks. This information includes the techniques used by the management in gaining confidences with regard to its responsbility of minimizing the potential negative outcomes from the non-critical risk (Herzig 2010). The decision by an organization to embrace risk acceptance as a risk response strategy is based on the understanding that the severity of the risk is lower than its level of risk tolerance (Aven and Jan 2007). Accepting the risk does not means that the organization will not respond when the risk occurs; it means that the organization will only respond if it occurs (Kavaler and Spiegel 2003). There are two types of acceptable risks. These are passive and active acceptable risk. An acceptable risk is active when an organization identifies a risk as being acceptable but develops a risk mitigation plan for when it occurs (Flynn and Bellaby 2007). An acceptable risk is passive when an organization does not prepare any plan for the risk occurrence because they are consider too small to be concerned about (Herzig 2010). Conclusion Risk management in any health care facility requires the management to develop strategies that are coordinated and relate to wide variety of organizational aspects that are associated risks and safety. Among healthcare professionals, the provision of effective, safe, and high quality treatment defines the extent to which patients get the best outcome from hospital care. The effectiveness of integrated risk management is in the ability of a healthcare facility that the framework has the ability to identify all the risks arising in relation to the needs of the patients, staff, and the organization. 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