Hoi thao 28 08 quan ly su co rui ro trong y te mr karim (EN)

10 steps to Future Risk Management Program Two questions healthcare leaders ask before committing to action: 1.. Currently, the Risk Management program in the hospital is fragmented an

Doctors of

Vietnam-Germany Hospital

operated the wrong leg!

The operation took place in

the evening of July 19,

instead of surgical treatment

for paralysis in the left leg of

the male patient, the doctor in

the Department of Orthopedic

3 of Vietnam-Germany

Hospital operated the right

left

Strategic Conversation

• Moved from the Age of Knowledge to the Age of Intelligence

• The 21st century started as a century of uncertainty

• Hospital Risk Management: Why flags matter

The impossible made possible

Nelson Mandela was the first black President of South Africa During apartheid, he was imprisoned for 27 years From prison, many believe he lead the ANC and drove the successful movement to stop apartheid He was released from prison in 1990 and was President by 1994

Do you think that transition occurred

Clem Sunter Success Stories

Strategic Conversation

Strategy, the aim of the healthcare business, should not change that often, while

tactics to stay on course will vary according to how the game evolves

1 Strategy is direction Tactics are how to get there

2 Strategy formulated without first consulting the context will probably end up

being bad strategy

3 Strategy is as much about ruling in potential paths that fit our scope as ruling out others that don't

4 Good strategy can be turned into bad strategy by a future change in the

context Scenarios are a way of exploring alternative futures, which might necessitate a change in strategy

5 Bad tactics can destroy good strategy, but no tactic can rescue bad strategy

6 Good strategy has a greater chance of being converted into good results if

tactics are accompanied by a set of measurable outcomes to which people can aspire

7 Above all, strategy is about understanding what we do and don't control, and what is certain and uncertain about the future - and knowing when to change direction to avert unintended, and possibly tragic, consequences

10 steps to Future Risk Management Program

Two questions healthcare leaders

ask before committing to action:

1 what do we and do we not

control?

2 What is certain and uncertain

about the future?

Many healthcare leaders have

constructed an ingenious matrix

around these questions, which

assists to identify the rules of the

game; assess the key uncertainties;

paint scenarios; evaluate realistic

options; and thereby make effective

decisions Essentially the matrix will

give us the edge:

1

1 Hospital Risk No 1: Medication Errors: A 2006 report from the

Institute of Medicine estimated that every year, there are 450,000 injuries resulting from medication errors in hospitals, and perhaps many more that are unreported

2 Hospital Risk No 2: MRSA and Other Hospital-Acquired

Infections: According to the CDC, there are 1.7 million

health-care-associated infections every year; 22% are infections of surgical

wounds Even more 32% are urinary tract infections

3 Hospital Risk No 3: Pneumonia

4 Hospital Risk No 4: Deep Vein Thrombosis (DVT)

5 Hospital Risk No 5: Bleeding After Surgery

6 Hospital Risk No 6: Anesthesia Complications

7 Speaking Up Lowers Hospital Risks

1

Questions to ask:

1

Major Risk Types:

1 Facility and safety risk

1 Failure Mood Effective Analysis (FMEA): Proactively perform

risk assessments by scoring ‘Risk Priority Numbers (RPN)’ The Risk Priority Number is a mathematical product of the numerical Severity, Probability, and Detection ratings: RPN = (Severity) x (Probability) x (Detection)

1

RPN: Severity Score

1

RPN: Probability Score

1

RPN: Detection Score

S E V

Potential Causes

P R O

Current Controls

D E T

R P N

Actions Recomme nded

Resp Actions

Taken

R S E V

R P R O

R D E T

R R P N

or internal requirements

Should have actions only on high RPN's

Who is respon sible for the recom mende

d action?

What actions have been taken and date completed?

1 Currently, the Risk Management program in the hospital is fragmented

and not organized

2 MOH 83 KPIs to monitor QA program in the hospital But it is limited to

certain standards without proper explanation

3 Huge scope for establishing Risk Management program with holistic

approach and establish a separate department to overview the Risk of the hospital

2

2

1 Where is there Scope to extend the field into new risk management

program, or extend within QA activities?

2 Should you change your strategy totally, because the current ground

has become unattractive to staff?

3

3

1 identify and develop the organizational

structure to promote Risk management

program within hospital

2 Who are the Players (internally or

externally) who can significantly affect the

outcome of the Risk Management Game

we have chosen?

3 Who are the ones for us, who want to win;

who are those against us, who want to

2 Normative Rules (those that cover

ethics, corporate governance, the

environment, health, safety and

corporate social investment), and

our organization the edge to win the

Game) and influence whole hospital!

5

1 What are the major uncertainties surrounding your risk management

program that keep you up at night?

2 Which are internal (usually controllable)?

3 Which are external (sometimes uncontrollable)?

5

1 Will they, in your opinion, affect

the outcome of the Game?

2 Can you or your organization

influence these uncertainties or will you just have to deal with them?

3 Follow the American Society for

Healthcare Risk Management, ASHRM

6

• What are the two principle variables affecting your risk

management program from which you can construct a Best-Case Scenario, a Worst-Case Scenario and two Intermediate Case Scenarios?

An example might look like this, depending on the State of the program and State of the Acceptance:

1. Strong Program/High Acceptance (Best)

2. Strong Program/Low Acceptance (Intermediate);

7

• What are your internal Strengths and

Weaknesses?

• Consider this question in terms of

your: Customers, Products &

Services, Human Resources, Support Services, Administrative Management System and Financial Management System)

SWOT – The “As Is” to the “Should Be” –

1 How do determine strengths and weakness inside our organization?

2 How do see opportunities and threat from outside our organization?

3 How do create Action Plan and monitor progress?

7

Patient

Services

Human Resources Management

Support Services System

•Knowledge of Service/ Product

•Philosophy, Nature, & Scope

•Wage & Salary

•Training & Development

•Supply Chain Management

•Policies, Procedures, & Protocols

•Regulations

8

1 What are your Strategic and Tactical Options to take the

negative scenarios out of play? What are those that will help you to thrive in the good scenarios?

2 How do you get closer to the Rules to Win?

3 Does your organization have the Resources – Time, Material,

People and Money (TMPM) – to execute the delineated Options?

4 Are your Options exclusive (either/or) or inclusive (this and

that)?

9

1 What preferred Options can be exercised right now?

2 What Decisions do these Options dictate?

3 For each Decision, what action steps are required?

incidence and complaints

for prevent recurrence?

for compliance

10

1 What is your personal criterion by which you will judge

whether your risk management program has won or lost the Game in five years?

2 How will the organization track incremental performance

against the Desired Result?

3 What will you measure day-to-day, week-to-week and

month-to-month to ensure you are on track?

Current Condition Future Condition

The Tactical Response

Gap Analysis

Action Plan Execution

10

Gantt Chart (Year-wise)

Action to be done 2016 2017 2018 2019 2020

Risk Department Organogram

Recruitment of Staff

Department budget

Policy on incident, complaint and grievance reporting

Activate RM Committee

Start risk collection data

Annual risk management action plan

Fire safety plan

Infection control safety plan

Biomedical and equipment safety plan

International patient Safety Goals implementation plan

Patient and visitor safety plan

Anaesthesia and surgery safety plan

Medication management and safety plan

Facility Safety Plan

1 Context

2 Scope

3 Players

4 Rules of the Game

5 Key Uncertainti

Strong Weak

Strong Strong

Weak Weak

Weak Strong

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