1.

INTRODUCTION:

1.1 What is a RISK?

Risk is the probability that a hazard will turn into a disaster. Vulnerability and hazards are not dangerous,
if taken separately.

But if they come together, they become a risk or, in other words, the probability that a disaster will
happen.

It is measured in terms of likelihood and consequence.”

The effective management of risk enables you to

maximize opportunities and achieve your outputs.

1.2 The Risk Management Process

• Establish Goals.
• Identify Risks.
• Analyze Risks.
• Evaluate Risks.
 • Treat Risks, and
• Always Communicate, Consult, Monitor and Control.

1.3 The steps involved in managing risk:

A. Establish Goals:

As outlined in the Risk Management process, the risk assessment is undertaken within the
context of your goals. The identification / validation of your goals are therefore a critical
first step in the risk management process. The organizational context provides an
understanding of the organization, its capability and goals, objectives and strategies.
According to the Standard, organizational context is important because:

a) Risk management occurs within the context of endeavoring to achieve the goals and objectives,
b) Failure to achieve the objectives is one set of risks that need to be managed, and
c) The goals and strategies assist to define whether a risk is acceptable or unacceptable.
d) The risk management context defines that part of the organization (goals, objectives, or project) to
which the risk management process is to be applied.

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B. Identify Risks

Identify the risks most likely to impact on your outputs, together with their sources and
impacts. It is important to be rigorous in the identification of sources and impacts as
the risk treatment strategies will be directed to sources (preventive) and impacts
(reactive).

C. Analyse risks

Identify the controls (currently in place) that deal with the identified risks and assess
their effectiveness. Based on this assessment, analyze the risks in terms of likelihood
and consequence.

D. Evaluate risks

This stage of the risk assessment process determines whether the risks are acceptable or
unacceptable. A risk that is determined as acceptable should be monitored and
periodically reviewed to ensure it remains acceptable.

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E. Determine the treatments for the risks
Treatment strategies will be directed towards:

I. Avoiding the risk by discontinuing the activity that generates it.

II. Reducing the likelihood of the occurrence,
III. Reducing the consequences of the occurrence,
IV. Transferring the risk, and
V. Retaining the risk.
F. Monitor and report on the effectiveness of risk treatments

The relevant manager is required to monitor the effectiveness of risk treatments and
has the responsibility to identify new risks as they arise and treat them accordingly. The
person who has the responsibility for a risk treatment is expected to provide feedback
on the progress of the ‘project / initiative’ as detailed in the ‘monitoring’ field of the
treatment.

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2. INTRODUCTION TO THE PROJECT

The project is an existing 5 storied private hospital in Mumbai. It is a hospital with about 300 beds.
Project Cost – 15 crores.

2.1 WHAT IS HOSPITAL RISK MANAGEMENT?

A framework for a systematic identification, assessment, treatment and monitoring of risks. Its purpose is
to prevent or minimize the possibility of the recurrence of risks and their associated consequences.

Consists of clinical & hospital administration activities to identify, evaluate, & reduce the risks for
patients, doctors, hospital employee, & visitors.

2.2 Hospital Risk Management Objectives:

• To identify the major sources of risks to hospital, staff & visitors.

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• Develop regular statistical & qualitative risk management reports.

• Establish mechanisms to maintain & develop structures & processes for a cohesive approach to the
management of clinical & non clinical risk.

• Conduct operational reviews of departments to identify deficiencies & potential areas for
improvement.

• To minimize the financial loss to the institution should an injury or an accident occur.

• Managing the Risk so it can give a high quality of service and safe environment for its patients and
visitors.

• The ultimate output of Risk Management is an improvement in quality of service & patient safety,
with the spirit of not “zero defect” but more towards “no accident”.

• Initiation of actions that reduce these risks.

• Reporting the findings & action taken to improve processes & systems.

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3. RISK IDENTIFICATION

3.1 TYPES OF RISKS:

1) MEDICAL RISKS.

2) NON- MEDICAL RISKS.

3.1.1 MEDICAL RISKS :

a) Professional Errors

i) Improper use of anesthesia.

ii) Improper administration of drugs.
iii) Incorrect treatment of diagnosed illness.
iv) Failure to order proper tests.
v) Improper use of medical device.

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 b) Occurrence of an Epidemic.

3.1.2 NON-MEDICAL RISKS:

a) Organizational Risks:
i) Shortage of Resources.
ii) Loosing critical staff at critical point.
iii) Strikes.
iv) Medical Records.
b) Fire Risks.
c) Security:
i) Occurrence of thefts.
ii) Hostage Type Situation.
d) Financial Risks:
i) Smooth & steady flow of fund including cash.
ii) Inadequate Insurance Cover.
e) Explosive Substances.
f) Waste Management.
g) Electricity.
h) Maintenance & Repair.
j) Planning:

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 i) Parking.
ii) Entrance & Exits.
iii) Staircase, Corridors & Lobbies.
iv) Kitchen.
v) Furniture.
k) Other Risks:
i) Legal Risks.Natural Risks like adverse climatic conditions, Earthquakes.
ii) Ambulance carrying a patient involved in a road accident.
iii) Risk on Image & Reputation.

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