Risk Management: From 3 Different Sources
A predictive technique for identifying potential untoward occurrences. It has been in use in certain industries (such as nuclear power generation) for many years and was introduced to the NHS in 1991 when self-governing trusts were ?rst set up. The reasons were, ?rstly, that Crown immunity had been removed from the health service in 1988, so that ceased to be immune from prosecution for non-compliance with health and safety legislation; secondly, because trusts were responsible for their own liabilities and any consequential costs. Risk management starts with three simple questions:
what can go wrong?
how likely is it to happen?
how bad would it be if it happened?
The combined answers allow an estimate to be made of the risk. Given the scope for clinical mishaps in the NHS – let alone sta? and corporate risks – the need for a credible, operational risk strategy is substantial.
The function of identifying and assessing problems that could occur and bring about losses legally, clinically or financially.
a framework are applied to clinical and nonclinical aspects of health care to increase patient safety by identifying potential hazards, assessing the degree of risk, and reducing the risk or determining an acceptable balance between risk and benefit. Risk management should include systems for learning from untoward, significant, or critical incidents and near misses. It is a feature of *clinical governance.
An aspect of personal behaviour or lifestyle, an environmental exposure, or an inborn or inherited characteristic, which, on the basis of scientific evidence, is known to be associated with health-related condition(s) considered important to prevent.... risk factor
See RISK REGISTER.... at-risk register
The probability that an event will occur.... risk
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences.... risk assessment
The process of analysing and comparing, on a single scale, the expected positive (benefits) and negative (risks, costs) results of an action, or lack of an action.... risk-benefit analysis
The probability of an event in a population as contrasted with relative risk. See “relative risk”.... absolute risk
A measure of treatment effect that compares the probability (or mean) of a type of outcome in the control group with that of a treatment group.... absolute risk reduction
A risk that has minimal detrimental effects or for which the benefits outweigh the potential hazards.... acceptable risk
In a total population, the proportion of disease incidence, or risk of the disease, that can be attributed to exposure to a specific risk factor; the difference between the risk in the total population and the risk in the unexposed group.... attributable risk
See “case management”.... care management
A continuous process of planning, arranging and coordinating multiple health care services across time, place and discipline for persons with high-risk conditions or complex needs in order to ensure appropriate care and optimum quality, as well as to contain costs.... case management
Initially driven by anxiety about the possibility of medical negligence cases, clinical risk management has evolved into the study of IATROGENIC DISEASE. The ?rst priority of risk managers is to ensure that all therapies in medicine are as safe as possible. Allied to this is a recognition that errors may occur even when error-prevention strategies are in place. Lastly, any accidents that occur are analysed, allowing a broader understanding of their cause. Risk management is generally centred on single adverse events. The threat of litigation is taken as an opportunity to expose unsafe conditions of practice and to put pressure on those with the authority to implement change. These might include senior clinicians, hospital management, the purchasing authorities, and even the Secretary of State for Health. Attention is focused on organisational factors rather than on the individuals involved in a speci?c case.... clinical risk management
The practice of promoting and maintaining continence and the assessment, evaluation and action taken to support this.... continence management
The process of identifying and delivering, within selected populations (e.g. people with asthma or diabetes), the most efficient, effective combination of resources, interventions or pharmaceuticals for the treatment or prevention of a disease. Disease management could include team-based care, where medical practitioners and/or other health professionals participate in the delivery and management of care. It also includes the appropriate use of pharmaceuticals.... disease management
The process of gathering, analysing and comparing an individual’s prognostic health characteristics with a standard age group, thereby predicting the likelihood that a person may develop a health problem.... health risk appraisal
A chemical, psychological, physiological, social, environmental or genetic factor or conditions that predisposes an individual to the development of a disease or injury.... health risk factor
The administrative machinery for planning, delivering and monitoring health care provided by health professionals and their supporting sta?. This may range from running a small primary-care centre to organising a large hospital or being responsible for meeting the health needs of a region or a nation. Whether the overall structure for proving care is state-funded, insurance-based, private-practice or a mixture of these, health-service management is essential in an era of rapidly evolving and expensive scienti?c medicine. Health-service managers are administrators with special training and skills in managing health care; sometimes they are doctors, nurses or other health professionals, but many have been trained in management in commercial, civil service or industrial environments.... health-service management
Decision processes oriented towards the creation or acquisition of information and knowledge, the design of information storage and flow, and the allocation and utilization of information in organizational work processes. See also “health information system”.... information management
The sum of the measures taken to plan, organize, operate and evaluate all the many interrelated elements of a system. Such measures are required to translate policies into strategies and strategies into plans of action for determining the action required to define and operate health programmes and ensure that the health system infrastructure is built up to deliver them efficiently and effectively.... management
A system of databases designed to process and exchange information to support decision-making as well as implementation, monitoring and evaluation of programmes, activities and projects. See also “health information system”.... management information system
Activities that support a person in keeping control over bank accounts, finances, etc.... money management
More than one risk factor for the development of a disease or other outcome is present and their combined presence results in an increased risk. The increased risk may be due to the additive effects of the risks associated with the separate risk factors, or to synergism.... multiple risk / causation
A set of strategies to address an individual’s pain management requirements and supportive of the individual’s pain control.... pain management programme
A system of management which involves the integration of planning, resourcing and evaluation processes to achieve stated outcomes.... programme management
The ratio of the risk of disease or death among the exposed to the risk among the unexposed; this usage is synonymous with risk ratio.... relative risk
The process of trying to attain the most rational use of manpower, knowledge, facilities and funds to achieve the intended purposes with the greatest effect with the least outlay.... resource management
An approach consisting of identifying and devoting more care to individuals or groups who, for biological, environmental or socioeconomic reasons, are at special risk of having their health impaired, contracting a specific disease, or having inadequate attention paid to their health problems.... risk approach
The practice of bringing several risks together for insurance purposes in order to balance the consequences of the realization of each individual risk.... risk pooling
Risk rating means that high-risk individuals will pay more than the average premium price.... risk rating
The practice of singling out or disaggregating a particular risk from a pool of insured risks.... risk selection
The distribution of financial risk among parties furnishing a service. For example, if a hospital and a group of medical practitioners form a corporation to provide health care at a fixed price, a risk-sharing arrangement would entail both the hospital and the group being held liable if expenses were to exceed revenues.... risk sharing
The capacity of individuals, communities or national authorities to take the initiative in assuming responsibility for their own health development and adopting adequate measures to maintain health that are understood by them and acceptable to them, knowing their own strengths and resources and how to use them and knowing when, and for what purpose, to turn to others for support and cooperation.... self-reliance / self-sufficiency / self-management
TQM is synonymous with continuous quality improvement (CQI). It is an integrative management concept of continuously improving the quality of delivered goods and services through the participation of all level and functions of the organization to meet the needs and expectations of the customer.... total quality management (tqm)
a *behaviour therapy designed to allow patients who suffer from anxiety disorders to reduce their symptoms by learning how to achieve states of relaxation and deal with excessive *rumination about anxiety-provoking thoughts.... anxiety management
an assessment tool that predicts a ten-year risk of developing cardiovascular disease based on gender, age, total and HDL cholesterol, blood pressure, and smoking, thereby enabling preventative treatment. It does not incorporate the presence of diabetes or familial history of cardiovascular disease into the scoring.... framingham risk score
(RMI) a scoring system that combines ultrasound findings, menopausal status and age, and serum CA125 levels to give an estimate of the risk of malignancy in a woman with a mass in the Fallopian tubes or ovaries. If the total RMI score is <200 the risk of malignancy is considered to be low. If the total RMI score is >200 the chances of malignancy are raised and management should be planned with a gynaecological oncologist.... risk of malignancy index
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