Any potential for harm or loss must be considered a risk. Unfortunately, every industry, from banking, transportation, and manufacturing to healthcare, is susceptible to dangers or occupational safety hazards. While eliminating all risks is impossible, mitigating them through strategic planning and preparation is possible.

This article covers some of the most common healthcare risks or hazards that put patients and providers in danger. It also outlines some enterprise risk management strategies you can deploy to mitigate the risk. Most importantly, we outline the goals and reasons why risk management in healthcare is crucial for the patients, workers, and the organization.

Understanding Risk Management

Also known as “medical risk management,” risk management in healthcare refers to a set of procedures implemented by a healthcare organization to guarantee that its operations are secure and fiscally sound.

Simply put, it involves all the processes, administrative, and clinical systems used to monitor, assess, detect, and mitigate various hazards. It provides a framework for avoiding and responding to potential dangers.

Possible Healthcare Risks and Hazards

To better understand risk management in healthcare, you must identify some risks and hazards.

Besides, in managing risks, one must first assess current procedures and practices, then spot potential threats, and finally implement measures to mitigate those dangers.

Generally, healthcare risk can be simple as:

  • Faulty equipment
  • Medical malpractice
  • Chemical spill
  • Sharp objects  

However, these risks can be categorized into different broad groups, including:

Operational Risk

Some examples of operational hazards are as follows:

Inadequate training: Instilling a risk consciousness culture among employees relies heavily on their having received adequate training. Inadequately educated workers may pose a threat to public health and safety.

Personnel shortage: Many medical mistakes is linked to a lack of staff, which can contribute to overwork and fatigue.

Procedures: Every facet of administrative and therapeutic processes has the potential for disaster. Everything from surgical checklists to using sharps and disinfecting protocols can present severe risks to healthcare providers.

Clinical Risks

Clinical risks cover preventable harm to patients and employees from medical mistakes (called “near misses”) and actual harm.

Risk management procedures are accountable for protecting patients from adverse outcomes like medical mistakes. Clinical risk managers investigate the reasons for medical errors to devise strategies for eliminating them.

Strategic Risks

These risks prevent any healthcare facility from achieving its goals- a good example is a conflict of interest. And this is where risk management comes in handy,

If you have risk managers on your executive team, they can help you spot trouble spots and weigh in on big decisions when issues emerge. Even a single lawsuit can severely harm a healthcare provider’s image.

Human Risks

Medical malpractice claims may arise from understaffing, which can exacerbate problems with hiring, staffing, and workplace injuries. It is also a part of healthcare risk management to keep an eye on day-to-day operations to ensure that staff members comply with established guidelines and have received the necessary continuing education and certifications.

Technological Risks

Healthcare practitioners and their patients are in grave danger from increasing ransomware attacks on hospitals’ electronic billing systems.

To keep patient information safe, risk management needs the help of IT. Providers may also be affected by the possibility of medical errors brought on by the inappropriate use of sophisticated medical diagnostic tools.

Financial Risks

Malpractice lawsuit payouts, insurance premium hikes, expensive financial expenditures, and inadequate insurance reimbursements are all potential sources of financial distress that may face a healthcare facility.

Therefore, risk management in healthcare assesses the total risk profile of a hospital or healthcare business to determine whether or not there is a positive financial benefit from increasing patient safety.

Failing to abide by healthcare regulatory bodies like Medicare and HIPAA can have devastating financial and legal consequences for a healthcare practitioner.

One way in which failure to comply with Medicare requirements might result in financial hardship is through the delay or elimination of service reimbursement altogether. Responsible risk management includes checking certifications and licenses.

The healthcare business relies heavily on effective risk management of these and other threats to patient safety, legal liability, and financial sustainability. Hospitals, nursing homes, and other healthcare facilities can reduce their vulnerability to loss once they implement risk management methods.

Important Elements of Healthcare Risk Management

To significantly handle healthcare risks, you must consider the following:

Identifying the Risks

It can be challenging for healthcare organizations to identify all the hazards they face, especially with several dangers and new risks continually appearing.

Fortunately, healthcare management can identify potential threats through institutional knowledge, which is achieved by engaging everybody involved- from administrators, payers, staff, and patients. Getting these groups’ feedback and risk concerns gives you a more comprehensive view of different dangers.

Assess, Quantify Set Priorities

In order to properly allocate assets and assign responsibilities, risks must be scored, ranked, and prioritized based on the probability of occurrence and impact if they do occur. To this end, you can employ heat maps and risk matrices, both of which facilitate the visualization of risks and the facilitation of dialogue and group decision-making.

Check into Sentinel Incidents and File Reports

Healthcare sentinel incidents are any unexpected emergencies resulting in severe physical or emotional injury and sometimes death of hospital patients.

To address safety issues and reduce future risks, every healthcare organization must immediately and thoroughly handle its sentinel occurrences. With a strategy in place, employees are more likely to respond rationally and openly, and any necessary corrective steps may be taken and assessed.  

Maintain Compliance Reporting

Sentinel events, prescription errors, and medical equipment malfunctions are just some of the instances that must be reported to the oversight authorities. Surgery on the wrong person, job injuries, pharmaceutical mistakes, and similar incidents must be recorded, coded, and reported.

What Are the Goals of Healthcare Risk Management?

It is unrealistic to expect a hospital to operate with zero errors. After all, we’re just human beings. But, risk management should be embedded into all company processes to raise awareness of risk among workers. As a result, this will promote an environment where mistakes are avoided.

Here are some of the aims of risk management in healthcare are:

Promoting Cautiousness or Awareness

Risk education is a vital component of healthcare risk management. The only way to ensure that everyone working in a hospital understands and follows protocols is to repeatedly train them to do so.

Image alt text: Healthcare risk awareness for better patient safety.

Author credit: Ministry of Health and Family Welfare (GODL-India), GODL-India <https://data.gov.in/sites/default/files/Gazette_Notification_OGDL.pdf>, via Wikimedia Commons

Improving Patient Safety

Medical blunders that have serious consequences, or “sentinel events,” include botched operations, incorrect dosages, and missed cancer diagnoses.

Although there is debate on the exact number of people who lose their lives each year due to preventable medical errors, research shows that the figure is very high. In fact, after heart disease and cancer, medical mistakes are the third most significant cause of death in the United States.

Providing Useful Data

You can quickly mitigate failures or errors, especially when the underlying reasons are identified and reported. Decision-makers can rely on suggestions from risk managers since they are always up-to-date on the organization’s risk profile. And use recommended safety data to reduce risk even more effectively.

Safeguarding Medical Records

There are strict patient privacy requirements that healthcare practitioners must follow. However, the growing adoption of EHRs has made patient data more susceptible to hacks.  

Further, ethical and legal concerns arise when healthcare providers use patient health information for the study. Experts in enterprise risk management must be cognizant of these concerns and implement measures to safeguard and responsibly utilize patients’ personal information.

Containing the Damage

Healthcare providers can risk criminal and civil penalties, public criticism, and brand damage in the event of a medical blunder. Risk managers in the healthcare industry focus on preventing medical mistakes whenever possible and minimizing their impact once they do happen. Risk administrators may arrange meetings with affected patients and their loved ones when blunders have been made to facilitate open dialogue.

Considering the Future

Value-based care, population health metrics, the use of artificial intelligence, climate change, and customer engagement are just a few factors altering the traditional healthcare model.

However, there is a financial risk, for instance, because value-based care alters how providers are rewarded for care. While AI will undoubtedly improve many aspects of management and research, it may also pose a privacy risk to patients. Therefore, enterprise risk management must consider all these changes during the processing and mitigation of risks.  

Conclusion

Risk management in healthcare is crucial because patients’ and providers’ lives are in line. However, risks to patients’ health and data privacy, costs, and legal liabilities can be mitigated with careful planning. A solid risk management strategy should be formulated, implemented, and constantly evaluated.