Risk Management in Health Care

Lead Researcher and Programme Director: Dr. Janet Anderson

Aims

The aim of this study is to identify and describe how operational risk is managed in an acute hospital trust and in a mental health trust. The objectives are to identify:

• The roles and responsibilities of healthcare staff with risk management responsibilities
• Perceptions of the aims and effectiveness of risk management in healthcare
• Organisational risk management processes and functions and their interactions.

A diagrammatic model of the risk management processes in the Trusts and their interrelationships will be produced. These will be reviewed and validated with experts within each Trust.

Why is this important?

Risk management in safety critical work domains involves many different organisational functions and reporting processes. Although risk management practices in other industries such as the nuclear power industry have been extensively documented and reviewed, this is not the case in health care. The current focus on and interest in patient safety in healthcare is relatively recent, engendered by the Institute of Medicine report in 2000. Many researchers have encouraged healthcare organisations to adopt the risk management strategies of other industries such as aviation and nuclear power. This has resulted in the introduction of incident reporting systems and other safety practices such as checklists, the use of simulation for training and the development of non technical skills for healthcare practitioners. However, relatively little is known about the organisational processes through which risks to patients are monitored, reviewed and acted upon, and how those processes interact.

Participants

Our research is carried out in conjunction with a Research Advisory Group composed of key risk management staff at both King's College Hospital NHS Foundation Trust and South London and Maudsley NHS Foundation Trust. We will use the following research methods to collect data:

• Document analysis. Key Trust documents will be analysed to identify the organisational structures, processes and responsibilities for managing risk. These will include strategy documents, policy and procedure documents, reports and meeting agendas and minutes.
• Interviews. Semi structured interviews will be conducted with staff who have some risk management responsibilities. The interview schedule will include questions about how risks are identified, analysed and controlled. Specific questions about aspects of risk management including incident reporting and the investigation of serious incidents will also be included.
• Review questionnaire. The outcome of the document analysis and the interviews will be a diagrammatic model of the risk management processes employed in the hospital. This will be reviewed by a small number of risk management staff for accuracy and comprehensiveness. Staff will be given a short questionnaire which will ask them to rate the accuracy of the model, the comprehensiveness of the model, whether it should be amended and if so in what way.

Outputs

• Map of the risk management processes
• Report will be produced and disseminated within the Trust.
• Academic papers in peer reviewed journals
• Design of an intervention to improve the effectiveness of risk management in healthcare