Risk Management Strategy of John Radcliffe Hospital - Case Study Example

Name: Course: Topic: Risk Assessment Institution Date: Table of Contents Table of Contents 2 RISK ASSESSMENT: JOHN RADCLIFFE HOSPITAL 3 Introduction 3 Tick list 6 PESTLE analysis of John Radcliffe hospital 7 SWOT analysis 8 Risk ranking (FN diagram) 10 FMEA, PHA or HazOp 11 Preliminary Hazards Analysis (PHA) 12 Hazard and Operability Analysis (HazOp) 13 Fault tree analysis (FTA) 13 Reliability block diagram (RBD) 16 Event tree 16 Cost Benefit Analysis 17 Utility function 18 Business continuity planning (BCP) 19 Pros and cons for the risk assessment methods 21 Allocation of fixed budget on risks assessed 21 Conclusion 21 Bibliography 22 RISK ASSESSMENT: JOHN RADCLIFFE HOSPITAL Introduction Risk management is a process of identifying, analyzing and either accepting or mitigating uncertainty when making fundamental organizational or investment decisions. In consideration of an organizations goals and objectives, management of risk involves a critical analysis of the apparent potential for loss and development and implementation of suitable actions or in-action. The purpose of this study is to explore the strategy employed by John Radcliffe hospital at Oxford in management of risk (Ostrom &Wilhelmsen, 2012). The strategic objective of John Radcliffe hospital is to be the hospital of choice. To this end, the hospital seeks to demonstrate outstanding outcomes in provision of medical care to its patients, while ensuring optimum safety and security for the patients. Of critical significance to accomplishment of its objectives, the hospital focuses not only on the welfare and care for people who use their services; it also invests heavily in assessment and monitoring of the suitability of its premises in regard to its suitability and safety for patients and employees. To this end, the hospital guarantees provision of safe premises and suitable equipment that enhances general safety of the hospital (Pas, 2011). John Radcliffe Hospital Organizations record incidents that result in injuries of people in a work environment. Safety in the workplace remains a fundamental obligation of any organization, and this demands a rigorous and continuous assessment of probable threats to safety in the work place. According to Ben-Asher (2008), the process of risk assessment requires a comprehensive evaluation and analysis of risk issues, while ensuring efficiency in implementation of strategic initiatives to ensure safety of the work place. The process of risk assessment and management cannot be considered as a onetime event, but a continuous process that involves assessment, documentation and continuous review of safety challenges. This approach is well exemplified in John Radcliffe’s risk management strategy where it is incorporated in the overall corporate strategy as a fundamental component in accomplishment of the hospitals goals and objectives. The process of risk assessment employs a variety of tools that can be used in determination of areas of potential risk, the challenges posed by imminent risks, and possible safety measures that can be implemented to minimize the impact of the risks (O’Brien, 2002). Management of risk as exemplified in John Radcliffe hospitals strategy requires employment of proven tools to come up with significant and accurate information and data that can be used to access risk issues and provide a comprehensive solution framework that can be efficiently affected. The tools that are discussed below enable an organization to identify factors that present safety challenges to an organization, and this analysis will discuss these tools with specific reference to the case of John Radcliffe hospital (Brink, 2004). The table below shows a number of incidences that were reported in John Radcliffe hospital between 2007 and 2010. The incidences are graded by use of matrix of consequence the perceived incidences and the likelihood of the incidences taking place. Risk Grade 2007/08 % 2008/09 % 2009/10 % High 2 0.1 0 0 0 0 Moderate 589 39.2 543 39.3 553 42 Low 103 6.9 89 6.5 88 7 Very Low 809 53.8 749 54.2 671 51 Total 1503 100 1381 100 1312 100 Illustration of risk matrix Tick list A tick list simply refers to a checklist used in provision of information that is essential in analysis of a situation, and in this case, a risk management assessment with reference to John Radcliffe hospital. The checklist provides a reflection of the goals and achievements of the organizations risk management strategy. The checklist provides a list of potential risks to the organization that are to be analyzed in regard to their impact on the organizations safety and the strategy The significance of the checklist is essentially to provide analyses of potential risk and the strategy employed to minimize risk, and the progress in achievement of these goals (Assmuth, Hilden & Benighaus, 2009). In the analysis of John Radcliffe hospital strategy on risk management, several key areas that are of significance to the hospitals health and safety can be summarized into several categories; Reporting and management structures Performance against target Consultation with staff and third parties Safety Action Group’s progress to Date Falls Reduction Dermatitis reduction Improved awareness Essentially, the checklist not only provides a list of issues or components that the organization considers critical to enhanced safety within its premises, it provides a confirmation of the progress the organization has made to ensure compliance of the organization to stipulated regulations by bodies mandated to enact policies on safety (Ostrom &Wilhelmsen, 2012). PESTLE analysis of John Radcliffe hospital This is an analysis that highlights the impact of legislation on the activities an organization undertakes to put in places safety measures. Legislation has enforced measures that have compelled John Radcliffe hospital to be proactive in implementing health and safety strategies that protect it from adverse actions that may result from non-compliance to required safety standards (Vose, 2008). In consideration of the legal implications of risk matters, John Radcliffe hospital is committed to reducing exposure to battles related to safety and health legislation that may result in claims for damage to clients and employees. SWOT analysis SWOT analysis as a tool of research analysis and assessment that puts into consideration the strengths and weaknesses of an organizations abilities and resources. The strength of an organization involves factors such as a strong financial base, the quality or diversity of its product and service portfolio, ad its geographical location. These factors directly influence the capacity and ability of a company to develop and implement strategic risk management measures. A significant strength of John Radcliffe hospital is its commitment and massive investment in staff training on health and safety measures. The number of the hospitals employees that attended safety and health awareness and Risk related course has increased by 8% over the last one year. Reports on non-clinical incidents have reduced by 5%, with a similar decline in staff accidents, falls, trips and slips. However , in an edit done to establish the level of compliance to policy and legislation on health and safety, the hospitals management unsatisfactory adherence to these issues, and this was largely attributed to ineffectiveness in identification and assessment of risk, and limited development of measures aimed at risk reduction. The inspection team also recognized the inefficiency of the current incident reporting system that is paper based, as it takes longer to be entered and analyzed on software. Challenges have also been noted in extraction of accurate and effectual data and information. It has been recommended that a web-based data management system be developed to increase the speed at which incidents are reported. The hospitals management however acknowledges the hospital in subsequent years may have to deal with limited financial resource and an organizational transform. Nonetheless, the position of the hospitals in regard to its goals and objectives is that the safety and wellbeing of patients, employees and visitors will remain of utmost priority and significance, with enhanced safety measures o reduce injuries, damage claims and legislative enforcement exploits from external association (Safie, 2000). Lack of sufficient financial resources coupled by a lack of innovativeness in the measures put in place to ensure a safer work environment could adversely undermine a n organizations health and safety strategy Below is qualitative representation of an organizations SWOT status. Risk ranking (FN diagram) In an F-N diagram, F represents the estimated frequency of occurrence of a given variable, where as N represents an estimation of the number of variables that are affected. Risks are assessed in consideration of the frequency they occur, and the perceived magnitude of effect resulting from t him occurrence. The pattern of a perceived risk is depicted in the slope of F-N curve. The measures employed by John Radcliffe hospital in reducing accidents a and work related ill health incidents earned the hospitals team on the health and the safety the silver achievement award from the Royal Society for the Prevention of Accidents. Some of the measures included a successful conversion of three sites to safer devices and to non latex sterilization, and the introduction of sterilized gloves for examination. Indeed 59% of inspections on safety and ended up being converted to scheme projects aimed at improving work environment, and 72% of the projects are complete. This is a demonstration of compliance to regulation 15 that focuses on premise suitability and safety. Risk Ranking Table By employing a quantitative risk analysis, a historical representation of events can be achieved and be employed in judging the severity of the risk. Below is an illustration of results presented in an F-N Diagram Illustrative FN Criteria In plotting graph, frequency is plotted against number of fatalities. FMEA, PHA or HazOp FMEA as an assessment tool involves analysis of failure modes end effects. Effective risk management requires that probability of failure be detected early enough, and this is the essence of the FMEA tool in risk assessment. This tool enables risk analysts to depict the severity of apparent risk and recommend appropriate action. The tool borrows on manufacturing and engineering models and can be effectively applied by organizations in not only preventing and reducing risk, but significantly reducing the resources incurred in management of risk. Preliminary Hazards Analysis (PHA) The risk assessment and management process involves identification, anises and implementation of measures to prevent or reduce the consequence of the risk. The process Of PHA employs a systematic identification of potential risks and hazards, provides an assessment of the risks and recommends measures that can be employed to mitigate the potential threats to safety. In John Radcliffe’s annual report of 20009-10, Non-Clinical Risk Management activities have been outlined and analyzed. This is to ensure risk, safety and health issues are continually reviewed, and improvement in inter processes, premises and equipment enhance the safety and wellbeing of patients, staff and visitors. Improvement in safety measures has been on a steady rise, and safety awareness has been enhanced though training and safety meetings. An illustration of the PHA worksheet System: Operating mode: Analyst date: Ref: Hazard Accidental event (what, where, when) Probable causes Contingencies Or preventive actions Probability Severity Comments Hazard and Operability Analysis (HazOp) The threat of risk and hazardous activity to operations of an organization can be well analyzed by employing HAZOP procedures that enable an organization to identify hazards that are likely to cripple its operational ability. At the John Radcliffe hospital has a committee on health and safety that meets on quarterly basis, and reports the board on care quality. The nursing and clinical directors the committees, that has the mandate to oversee issues related to healthy and safety. Health and safety is an integral part of corporate risk management utility, under the supervision of the associate director on risk, safety and quality. Fault tree analysis (FTA) FTA is a deductive process where probability of failure at the lower levels in organization can easily affect the efficiency and effectiveness of top levels of organizations. The tree in essence seeks to provide a qualitative and quantitative analysis of apparent failures. The challenge of this assessment tool is the enormous resources and time consuming procedures that are involved. The John Radcliffe hospital risk management team organizes training for new starters on reporting of incidents, and this takes place at Jon Radcliffe on weekly basis. The main objective of this induction process is provide knowledge on information that is required in completion of IRI incident reporting forms, the procedure of escalating reports for investigation, and to create awareness of the policy on incident reporting. Between 2009 and 2010, 726 staff attended the training, which is essentially 70% of new starters. A significant discrepancy witnessed in 2009/10 is that 50 managers and supervisor that had registered to attend had registered to attend annual health and safety training, failed to do so, and this was attributed to confusion on whether it was mandatory to attend training the training. Illustration of the steps of FTA Common cause analysis (CCA) Deductive assessment procedures are in this case used to assess dependence between variables that were previously considered to be independent. Four dependency levels are identified; functional dependencies, human interface dependencies, equipment dependencies and physical interaction dependencies. The committee on health and safety at Jon Radcliffe hospital meets on regular basis to set objectives that aimed at ensuring continues improvement in risk management. These objectives are set in consideration and consultation with staff safety representatives. The committee lays immense embassy on enhancing co-coordinating the hospital and its partners in Private Finance Initiative. The committee receives several reports every six months, such as the Risk Policies and procedures, learning/development, radiation protection, operational security management, fire safety and occupational health. The team has developed important links with other institutions such as Oxford University, Carillion Health and G4S to enhance c-operation and co-ordination on issues of health and safety. Below is a representation of CCA processes The only requisite for data transfer from a given source to the other is that the two sets of the regions should have the same number of elements. The particular linearization defines where the elements will be placed. Reliability block diagram (RBD) An evaluation of risk can be done in the context of reliability in determination of its probability and consequences on operations. Reliability and availability testing procedures are done on complex systems. Block diagrams provide an indication of linkages between subsystems. Probability of failure in system interaction in support of a systems operations are emphasized Event tree This is a risk assessment tool that focuses on the binary logic between events. The focus is on an events occurrence and a components failure or non-failure. This assessment tool is suitable where the consequences of risk are due to failure or an undesirable event. The ultimate objective of this assessment is to ensure minimal losses incase of undesirable event related to safety. Despite being able to be employed in general risk assessment, event tree are more applicable in situations that have multiple measures of prevention Cost Benefit Analysis Cost and benefit analysis is essentially applicable to risk that involves operational events. It provides the organization a tool for comparison and determination of the right and cost effective options in resolving challenges. Risk assessment in this regard is done in consideration of the financial implications of employing certain options ii undertaking given tasks. Of significance to this consideration of options is the benefit an organization is likely to get in undertaking a particular task (Campbell & Brown, 2003). Severe risk bears significant consequences on an organization especially in consideration of the apparent risks and benefits (Assmuth, Hilden, & Benighaus, 2009). The safety measures employed by the John Radcliffe hospital are in absolute reflection of financial and resource considerations. According to Brink (2004), the hospital recognizes that enhancement of safety is critical to achievement of its objectives and subsequent improvement in quality ratings. A reduction in undesirable incidents is observed to increase cost effectiveness in health care services. Improvement in safety measures is thus viewed to be a critical element in delivery of financial stability in the long term (Cowan, 2005). Lerche, Glaesser, Walter (2006), notes that with due consultation with floor covering manufacturers and suppliers, the hospital has been able to acquire relevant technical information and data that is employed in procurement of flooring. Incorporation of a criteria matrix emphasizes on vinyl floor covering that enhances slip resistance thereby reducing risk from slips and falls. In conjunction with the National Flooring Stakeholder Working Group, the Safety Risk manger is at present developing a working program meant to improve electronic information that will enhance standardization in selecting, installing and utilization of flooring aimed at minimizing falls, slips and trips. In consideration of the decision making process for a given risk assessment project, the qualitative and quantitative aspects of the analysis can be represented as shown below: Utility function The utility theory in its application to risk assessment focuses on quantifiable presentations that involve the consequences of a given risk or hazardous activity. Presentation of a quantitative analysis is achieved through employment of the utility loss function which is essentially derived from probable events that indicate possibility of getting the worst of possible outcomes. It is possible then to predict the worst possible outcome from the figures derived. Risk in this case is categorized in consideration of anticipated possible losses the utility theory as depicted in the functions demonstrates preferred options and the apparent reasons for preferences (Ben-Asher, 2008). In the hospitals strategy on Health and safety management, several areas of potential high risk have been recognized and categorized for inclusion in a 3-year plan to minimize to injury staff, patients, contractors, visitors and property. The strategy aims preventing or reducing falls, trips and falls. It seeks to increase awareness in risk prevention, safety management, and information management. The strategy aims at preventing, reducing and effectively managing occupational dermatitis. It also seeks to prevent and reduce injuries related to needle sticks. Of priority is also a reduction in muscular-skeletal ailments, as well as prevention of illnesses that are related to stress (European Agency for Safety and Health at Work, 2013). Business continuity planning (BCP) Business continuity planning as an organizations internal procedure involves assessment of potential threats that exist within a business and the external environment (Ostrom &Wilhelmsen, 2012) Business continuity planning provides an analysis of the current and fixed assists within a business that are essential in provision of prevention and mitigation measures for an organization. Griffin (2000), argues that business continuity planning is done in consideration of the ability of the business to sustain competitive edge against probable competitors and the level of the systems reliability. BCP e enables organization guidelines for continuity in operations in the event of unfavorable circumstances such as increase in crime. To this end the John Radcliffe hospital lays emphasis on increased awareness of health and safety matters that affect the hospitably both internally and externally. The strategic objective of the awareness initiative for enhanced business continuity was to enhance the level of awareness on procedures and policies, and issues related to health and safety. ‘At a Glance’ posters were introduced to disseminate information submitted by SAG groups. A survey was conducted by use of the intranet and which focused on communication of policies related to safety issues. The outcomes of this survey were to be incorporated in the overall strategy on awareness. Below is a representation of the process of business continuity. Pros and cons for the risk assessment methods Information provided from SWOT analysis for example is critical in developing strategic plans for a given organization. It optimizes organizations responsiveness to emerging opportunities and dealing with the challenges and threats posed by the external environment (Cowan, 2005). Allocation of fixed budget on risks assessed Budgeting for risks refers to deliberate evaluation of potential risk and allocation of sufficient resources to enhance prevention or reduction of risk while optimizing the organizations return to investment. This is in consideration of other options for investment and drawing a line between n what is considered of critical significance to the achievement of the organizations goals and objectives (Pas, 2011). Conclusion Risk assessment is of critical significance to an organizations achievement of not only of its risk management objectives, but the overall success of an organizations corporate strategy. Risk management strategy should be considered and incorporated in the business strategy of any given business entity or organization. This however must be in a comprehensive consideration of the resources available to the organization to sustain profitability or meet its strategic objectives. Apart from enhancing a safer work environment and enhancing the decision making process, risk management provides opportunity for the company to realize emerging opportunities while protecting itself from apparent internal and external threats. Bibliography Ostrom, L. &Wilhelmsen, C. 2012, Risk Assessment: Tools, Techniques, and Their Applications, 2012, New Jersey, John Wiley & Sons. European Agency for Safety and Health at Work, 2013, Risk Assessment, available at: . [Accessed on March 18, 2013]. Pas, 2011, Fire Risk Assessment_ Guidance and a recommended methodology, Brink, C. 2004, Measuring Political Risk: Risks To Foreign Investment, England, Ashgate Publishing, Ltd. Cowan, N. 2005, Risk Analysis and Evaluation, 2nd Edition, UK, Global Professional Publishing. Assmuth, T., Hilden, M. &Benighaus, C. 2009, integrated risk assessment and risk governance as socio-political phenomena: A synthetic view of the challenges, Science of the Total Environment. 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