Risk Management Policy and Procedure in Healthcare

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Purpose Statement

A risk management program is one of the practices that can significantly enhance the functioning of a medical facility, helping it to advance its strategic safety and quality goals. Best practices of risk management programs assist in preventing problems with patient records and administrative systems, thus, preventing deteriorations of quality of care delivery. Moreover, the policy enables the prevention of financial losses and other financial-related issues due to projecting and planning potential extra expenses which could not have been covered by the budget. Summarizing everything, a risk management system allows practitioners to establish procedures for risk detection, analysis, and prevention. Thus, it helps determine quality deteriorations and assists strategic administrative and financial goals achievement.

Key Risk Management Terms

Risk prevention: Risk prevention is a set of actions and measures taken in advance to prevent the raising of new risks or to hinder their development

Risk reduction: Risk reduction is the strategy to manage risks, focused on reducing the severity of the risk, lowering its frequency, or decreasing potential losses.

Regulatory compliance: Regulatory compliance is a complex of measures intended to meet requirements for quality, safety, risk management, and other provisions of regulatory organs

Patient safety: Patient safety is the strategy focused on the prevention of errors and adverse effects that may arise in the process of care delivery.

Adverse event: An adverse event is any undesired experience that was caused in the process of healthcare delivery and is associated with harm to a patient.

Near miss: Near miss is an unplanned event that potentially could cause harm to a patient but was avoided.

Risk Categories and Risk Identification Techniques

In healthcare, risks are characterized or ranked in two dimensions and six categories. Risks are determined by their impact, which can be insignificant or minor, moderate, or critical. They are determined by the potential harm to a patient, employee, reputation, facility, and other factors. At the same time, a risk with minor harm does not deteriorate health but may cause negligible financial loss, such as non-essential and non-harmful medication prescribed. Critical risks, such as misdiagnosing, may lead to a patient’s death (Janous, 2021). The other dimension is likelihood which helps to determine the chances of a risk’s occurrence. Some risks may be unlikely to occur, other has the potential to occur, and a number of risks are very likely to happen. For instance, if detailed, specialized knowledge is needed to perform an undesired action, or it can be done unintentionally only, such as sharing personal details, the probability of occurrence is unlikely. However, the likelihood is very high if an undesired action may be performed without much knowledge and by careless usage, such as not filling medical reports comprehensively.

There are several strategies intended to identify potential risks concerning techniques. The concurrent technique is focused on direct making risks up based on experience. Retrospective risk analysis is needed after incidents occurrence to learn from them. Incident reporting is a complementary strategy needed for the further drawing of risks that had led to the issue. Previous trends are the strategy for statistical analysis of data for past periods and forecasting risks based on trends found. Besides, there is a strategy called SWOT analysis, part of which is the identification of weaknesses of the company, which can be regarded as risks (Kay et al., 2018). Finally, affinity diagrams can be used to find relationships between processes and discover problematic areas.

There are several risk categories attributed to health care delivery. To begin with, there is a risk of non-compliance with laws, regulations, and standards. A particular example would be not following clinical practice guidelines or treatment protocols in the process of care delivery (Kay et al., 2018). Then, there is a risk of a data breach or the risk of privacy and confidentiality issues to raise. It may happen if healthcare providers share personal patient details with persons not participating in the treatment process.

The other risks are discovery and medical records, or, in other words, the risk of issues related to medical records maintenance, such as not keeping them for the term required or not filling them correctly. The described above risks are to be detected and prevented by audits, during which such cases as detailed can be found. Additionally, employment education can be promoted to lower the chance of the risk rising (Janous, 2021). The following risk is the violation of patients’ rights, manifested, for instance, in not meeting their basic needs. It can be reduced by fostering a reporting culture to ensure that any case is immediately detected.

Risk Manager’s Role in Program Implementation and Compliance

Risk managers’ responsibility is to select suitable process analysis and risk forecasting techniques. After that, managers are to decide that risk management strategy is the optimal one and must assist in its implementation. A risk management program of the company mostly depends on its effective organization, conducted by a risk manager. Thus, such employers have a key function concerning risk prevention and reduction. For instance, there is an issue related to the differentiation of patients, as there is a need to assist those that are endangered the most first. There is a related risk that medical personnel would have to waste time searching for those who need help under extreme conditions (McGowan et al., 2021). Color-coded wristbands are a method of risk prevention.


Janous, B. (2021). The importance of risk management in healthcare and how it applies to your company. Discovery Health. Web.

Kay, M., Chambers, R., & Caiman, K. (2018). Risk matters in healthcare: communicating, explaining and managing risk. CRC Press.

McGowan, J., Wojahn, A., & Nicolini, J. R. (2021). Risk Management Event Evaluation and Responsibilities. StatPearls. Web.

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