HIROC Integrated Risk Management (IRM) Initiative Taxonomy of Healthcare Organizational Risks October 2014

Transcription

1 Apprach/Best Practices Fcus n risks t key rganizatinal bjectives Fcus n material/significant risks nly; risks requiring attentin f senir leadership and bard Aggregate risks wherever pssible A risk may fit in mre than ne categry; assign t ne/best fit categry if pssible Recgnize that risks are interrelated and that clear delineatin between risks is nt always pssible Use plain language A. Care Examples f subscriber strategic bjectives related t care include: Deliver High Quality Care; Renewed Cmmitment t Quality and Safety; Reduce Wait Times; Accessible and Available Services at the Right Time; Cmpassinate, Respectful and Safe Care; Innvative and Evidence Based Care; Reduce Length f Stay t Meet Targeted Benchmarks; Effective Pain Management; Effective Transitins f Care; Reduce Infectin 1. Adverse events (AE) (Shrt, standardized name f the risk t facilitate reprting and tracking f healthcare risks acrss the healthcare system) AE general (Suggested lnger name) A general categry fr all adverse events which sme rganizatins may wish t use instead f selecting specific types f adverse events (such as falls) 2. Abductin AE related t infant/child abductin 3. Access Access t care issues/lng wait times/pr patient flw 4. Acuity High patient acuity/cmplexity 5. Birth trauma AE birth trauma (includes unexpected birth utcme) 6. Care/cnsent cnflicts Cnflicts with patient/client/substitute decisin maker and/r family related t care e.g. declining treatment, end f life, cnsent and capacity, discharge 7. Cmmunicatin AE inadequate cmmunicatin/hand-ffs 8. Cmplaints management Pr management f patient cmplaints, extremely challenging cmplaint 9. Cntracted services mnitring Inadequate mnitring f cntracted services 10. Discharge/transitins AE inadequate discharge planning/transitins/crdinatin 11. Experience/relatins Pr patient/client/resident experience/satisfactin/invlvement/cmmunicatin 12. Falls AE falls 13. Funds management Mismanagement f patient/resident funds 14. Infectins AE healthcare acquired infectins Page 1 f 7

2 15. Length f stay Excessive/high/lng lengths f stay 16. Medicatin AE medicatins 17. Mnitring AE inadequate triage/assessment/mnitring 18. Multi-incidents AE related t multi-patient events e.g. infectin utbreaks, diagnstic errrs, etc. 19. Pain management Inadequate pain management 20. Pressure ulcers AE healthcare acquired pressure ulcers 21. Readmissins Excessive/high readmissin rates 22. Restraints AE mismanagement f restraints/entanglement/entrapment 23. Retained bjects AE retentin f freign bjects/bdies 24. Security/assault AE safety/security/assault/neglect By staff r ther patients/client/family/caregivers 25. Supply shrtages Critical drugs/supplies shrtages 26. Supprt services Inadequate supprt services e.g. supplies, laundry, fd 27. Wrng patient/site AE wrng patient/site/prcedure 28. Other B. HR Prvide a Safe and Engaging Wrk Envirnment f Staff and Physicians; Staff Reflect the Diverse Nature f Cmmunity; Accuntable, Recgnized, Respected, and Rewarded Staff; Prvide a Safer and Healthier Wrk Envirnment; Enhance Physician Leadership and Accuntability; Implement a Staff Wellness Prgram 1. Agency issues Pr perfrmance f sub-cntracted/agency rganizatins/prviders 2. Develpment Inadequate staff develpment/training 3. Engagement Pr staff relatins/cmmunicatin/engagement 4. Labur relatins Pr labur (unin) relatins/wrk disruptin 5. Physical injuries Wrkplace injuries physical (e.g. muscular skeletal, needlestick, falls) 6. Psychlgical injuries Wrkplace injuries psychlgical e.g. stress, wrklads 7. Retentin Failure t attract/retain tp talent (including cmpensatin issues) Page 2 f 7

3 8. Rights Human rights vilatins/discriminatin/harassment 9. Scpe f practice Healthcare prvider practicing utside scpe Regulated and nn-regulated 10. Shrtage Wrkfrce shrtages/aging wrkfrce/absenteeism 11. Vilence/disruptive Wrkplace vilence/disruptive behavir 12. Wrngful dismissal Wrngful dismissal claims 13. Other C. Financial Maintain Strng Financial Perfrmance; Make the Best Use f Resurces; Sustainability; Cst Effective and Efficient Operatins; Achieve Stable Surces f Funding/Adapt t Changing Funding Mdels 1. Cntracts Failed/inadequate cntracts (including cmmercial; service prviders) 2. Csts Increased csts (salaries, supplies, etc.)/inflatin 3. Fines/liabilities Unfunded fines/liabilities 4. Fraud Emplyee dishnesty/fraud 5. Inefficiencies Inefficient use f resurces 6. Investments Pr investment returns 7. Prcurement Mismanagement f prcurement prcesses 8. Reprting Financial accunting and reprting/asset management 9. Revenue/funding Financial instability/decreased perating revenue 10. Supply chain Supply chain failure 11. Other D. Leadership Strng Leadership and Gvernance; Lead and Participate in Effective Partnerships; Psitive Leadership That Fsters Organizatinal Values; Culture and System that Fcuses n Learning and Cllabrative Imprvement Where Patient Safety is the Primary Fcus fr all Staff; Implement an Organizatin-wide Apprach t Drive Perfrmance and Transfrmatin; Supprt Effective Reginal Distributin f Clinical Services 1. Alignment acute/nn-acute Lack f alignment/resurces/ambulatry/cmmunity care 2. Change management Change management/change readiness/change fatigue Page 3 f 7

4 3. Cnflict f interest Cnflict f interest Failure t act in best interests f rganizatin/public 4. Culture Weak culture/insufficient tne at the tp ethics, patient safety, quality culture, accuntability 5. Emergency respnse Inadequate emergency respnse/business cntinuity lss Pandemic, terrrism, natural events, technlgy 6. Gvernance Issues with gvernance ability/accuntability/infrmatin/cnflicts 7. Infrmatin gaps Inadequate infrmatin/knwledge e.g. decisins are based n pr data/lack f infrmatin 8. Mergers Failed mergers, integratins, strategic partnerships 9. New prgram/technlgy Inapprpriate intrductin f new prgram/technlgy/treatment High csts, inadequate cmpetency 10. Plitics Plitical uncertainties/plicy changes 11. Strategic prjects Failed/inadequate implementatin f strategic prject Can have mre than ne 12. Strategy alignment Lack f rganizatinal alignment/engagement arund visin, missin, values, strategy 13. Successin Inadequate successin planning (key leaders/staff) 14. Other E. External Relatins Listen t the Needs f Our Cmmunity; Cmprehensive Public Input; Inspire the Cmmunity t Supprt Patient Care and Research Prgrams 1. Cmmunity relatins Pr public/cmmunity relatins 2. Dnr relatins Pr dnr relatins 3. Gvernment relatins Pr gvernment relatins 4. Media relatins Pr media relatins 5. Partner relatins Pr cmmunity agency/partner relatins/stakehlder perceptins 6. Other F. IS/Technlgy Implement Clinical Infrmatin Systems/Electrnic Tls t Imprve Care and Effectiveness; Implement an Integrated and Cmprehensive Business System t Imprve Management f Spending; Cmplete the Develpment f the Electrnic Health Recrd and Data Warehuse Page 4 f 7

5 1. Systems access e.g. privacy/security breach, hacking, cybercrime 2. Systems failure Critical infrmatin systems failure e.g. electrnic health recrds, lab, finance systems dwn time 3. Systems integratin 4. Systems needs Pr infrmatin system integratin internal, up and dwnstream Infrmatin systems bscelescence e.g. future electrnic health strategy 5. Systems prject Infrmatin systems prject implementatin failures/delays 6. Systems reliability Pr infrmatin systems reliability/cntinuity e.g. data integrity, lss, inability t retrieve stred data 7. Technlgy failure Failure f critical bimedical technlgy 8. Technlgy needs Lack f bimedical technlgy t supprt clinical needs; aging/bslescence Inadequate management f preventative maintenance 9. Technlgy use Misuse f technlgy/equipment 10. Other G. Facilities Strategically Invest in Facilities 1. Aging/maintenance Aging buildings; lack f resurces fr maintenance/redevelpment 2. Building access Unauthrized access; building security issue 3. Building prject/cnstructin Issues/delays with building prjects; fund apprvals; inadequate management e.g. cmpliance with cdes, envirnment 4. Hazardus materials Inadequate management f hazardus materials (e.g. chemical, waste) 5. Plant/systems failure Failure f critical systems/equipment e.g. HVAC, water, electricity, elevatrs 6. Prperty damage Lss/damage f prperty e.g. fire, fld, water, sewer, vandalism, theft 7. Visitr falls Visitr falls/slips/trips Grunds and building hazards 8. Other H. Regulatry Incrprate Perfrmance Agreements that Reflect Strategic Directins Page 5 f 7

6 1. Accreditatin Accreditatin results nt being at expected level 2. Credentialing Credentialing disputes with independent prviders 3. Perfrmance agreements Inability t meet accuntability agreements/targets e.g. waits, number f prcedures 4. Regulatins/legislatin Regulatry/legislative changes/uncertainties/cmpliance 5. Other I. Teaching Educate Health Care Prviders t Meet the Future Needs f Cmmunity; Multidisciplinary Educatin in Bth the Academic and Wrkplace Envirnment; Prvide Trainees with Exceptinal Learning Experience 1. Accreditatin (teaching) Unfavrable accreditatin review resulting in lss r decline f prgram 2. Cntracts (teaching) Failed/inadequate teaching cntract e.g. Failure t meet bligatins, inadequate indemnificatin, etc. 3. Student experience Pr student experience 4. Student perfrmance Pr perfrmance/cmpliance f students/bservers 5. Other J. Research Develp New Knwledge and Innvatins; Build a Strng Academic and Research Rle; Build Strng and Sustainable Research Prgram 1. Adverse events (research subjects) Adverse events f research subjects 2. Cnflict f interest Research cnflict f interest 3. Cntracts (research) Failed/inadequate research cntracts 4. Ethics Unethical/unapprved research 5. Funding (research) Funding instability; decreased funds, increased csts 6. Grant usage Inapprpriate use f grant mney 7. Inspectins (research) Unfavrable site inspectins 8. Intellectual prperty Lss f intellectual prperty Can be brader that just research 9. Miscnduct Research miscnduct Fabricatin/falsificatin f data/results 10. Other Page 6 f 7

7 K. Cmmunity Health Health Prmtin and Preventin; Effective Health Educatin, Prmtin, and Preventin Prgrams; Imprve Health and Well Being f Cmmunity in Targeted Areas; Reduce the Incidence f Preventable Disease in Targeted Areas; Prvide Quality Chrnic Disease Preventin and Management Prgrams, Palliative Care 1. Chrnic disease management Pr chrnic disease management 2. Demgraphics Unfavrable changes t ppulatin demgraphics e.g. aging, lifestyle trends 3. First respnder Inadequate first respnder resurces/cmpetency 4. Immunizatin Pr immunizatin rates 5. Prenatal care Pr access t prenatal care 6. Primary care Pr access t primary care 7. Other Page 7 f 7