By: David John Vidanes
A WRITEN REPORT ON RISK MANAGEMENT
Every organization that has been put up will go through different challenges, problems and conflict that could expose to different risks such as interruption in its operation or worst the risk of closing down of a business. This event could happen from the biggest or to the smallest and simplest organization in any industry, be it on Business, Agriculture, Information technology and/or Healthcare. Different risks are not only present in organizations but also to personal level. Risks are everywhere and because of this “Risk Management” come into picture.
I’ve been part of Howard Hubbard Memorial Hospital back in the Philippines for two years. It is a 98 bed capacity industrial hospital and manages by DOLE Philippines. DOLE is a multinational company that mainly produces exports of different preserve fruits and also complies with different international standards organization like “ISO” or the International Organization in Standardization in its operation including its policies and procedures pertaining to risk Management. Risk management specific to safety in the workplace in my organization is done by group of people composed of high-level managers and mid-level managers (safety committee). They make necessary policies and procedures focused on eliminating if not reduction of identified risk. Risk management has proved its importance in the institution over the span of time that I work there. Risk management is the same as securing the future or it is a helping hand in attaining the goals and objectives set; therefor when one organization utilize the risk management this will result in progress and development. For example, an employee who neglects or skips a certain safety protocols has a higher risk of facing an accident that could decrease on his or her productivity which also result in the loss of a company, while on the other hand, a worker who adheres to all safety procedure have a lower percentage of facing work related accidents therefor he/she is an efficient worker and that is always good for a company.
Risk management stresses its importance by its benefits and contribution it brings to an organization. Obvious benefits of risk management in my previous organization are:
- Prevention of any possible undesirable event
- The decrease in the probability of an incident to happen
- Reduction of the most probable impact or effect of an incident that could happen
Hence, this report will focus with different risk in my previous workplace specifically on safety.
Prevention of harmful event is the common benefit since risk is defined as something that could happen in the future and leads to a loss of something of value, so managing risk is essentially prevention. One good example is the simple procedure done in the hospital I work is the Hand washing. Hand Washing before and after caring for a patient will “Prevent” Nosocomial Infection or the hospital acquired infection. It will safeguard the patients in the hospital and also the nurse who is caring for them.
The managers cannot control everything inside the organization; same is true with the elements outside the organization that could affect a business such as the Community and Politics. Thus, risk management can decrease this probability of uncontrolled accidents or events by identification and assessment of different risk, their causes, and formulation of preventive measures and protocols basing on the identified causes this steps will aid greatly on minimizing the likelihood of an incident. Example, in the community that I am in, cases of Dengue Hemorrhagic Fever is increasing over a short span of time; everyday each month there is prominent escalation of cases in the hospital. To decrease the incident of the disease, the hospital conducted Health teachings or Education to the community which contains the causes, mode of transmission, signs and symptoms and how to treat the disease. As a result, the community gains knowledge and awareness regarding the disease thus helped in the reduction of possible casualty.
Components Affecting Risk Management
A. Review activities and internal environment
The hospital that I work back in the Philippines is the only facility in my town located at the foot of Mt. Matutum an active volcano that is monitored by DOLE Philippines and the local government. The hospital have all the basic services required for it to operate such as:
- Laboratories to take and test blood samples from patients
- Imaging and Radiology for conducting X-rays and Ultrasound imaging
- Pharmacy for all the medication needs of the patients
- Intensive care units, Neonatal intensive care units
- Operation Theater, Emergency Department
- Ambulance services
- Medical and Surgical wards
- Pediatric wards
- OB-GYNE wards
- Out-patient department
- Isolation Rooms for infectious patients
- Individual private rooms complete with a television and Refrigerator
- Canteen or cafeteria
This given facilities and services comprise the 98 bed capacity industrial hospital. Staffs are all hardworking and friendly although sometimes conflicts in different departments is unavoidable but this minor conflicts are easily solved by the management. The facility is backed by DOLE Philippines in its finances; this includes the bills from electricity, water and telecommunication. Although the hospital is assisted by DOLE it still has a negative effect like, before we can purchase or request medical supplies for the day to day operation, it needs to be check and approved by a certain department in DOLE thus making thing complicated that sometimes result in the delayed in the resupplying of our stocks. The hospital mainly caters DOLE employee and their families since we are an industrial hospital of DOLE Philippines, aside from that we also take clients from the community. These clients keep the hospital staff busy from Monday to Sunday, day and night. The hospital staff encounters different people with different cases all throughout the day, especially in the emergency department where I am assigned. Most of the emergencies I handled are drunken patients who encountered vehicular accidents, a gunshot wound from an assassination attempt, heart attacks, patients with strokes, job related injuries from DOLE and all sorts of emergencies that one can imagine.
B. Setting objective
With all the activities and the environmental hazards inside the hospital, the objectives for a risk management is clearly focused on the safety of the staff and the clients inside the facility. The objective covers all the population inside the hospital whatever the purpose and transaction one at hand as long as this person is inside the hospital premises.
C. Event identification
Every day has different situations and different scenarios or situations; to keep tract with the happenings in the hospital, we have all sorts of different log books in almost all the areas. Aside from that, the facility has its own CCTV cameras and security personnel who patrols every now and then. “IR” or the incident report is the most common one; this is done by writing a report by the staff or staffs who are involved in an incident. Almost all of the activities in the hospital are recorded in the different log books by the staff to monitor; this will help the review of the causes and effects of an event or incident. One good example is when a staff was punctured accidentally by a needle used in a patient, the staff needs to write an Incident report containing the following: The nature of incident, place, time, date and on why did the staff think the incident happened. After which the staff needs to write in the log book specifically for all needle stick injuries.
The most perceivable risk in the hospital that I work before are:
- Risk for needle stick injury, Risk for acquiring infectious diseases
- Risk for earthquake and fire since we are literally at the foot of volcano and a very warm environment
- Risk for physical injury for staff assigned at the emergency department.
D. Risk Assessment
The identified risk then will go through assessment prioritization and careful study as to its impact and on how often these incidents happen. The risk management firstly prioritizes on the risk of the staff to acquire highly contagious diseases because every day, staff nurses interacts and personally care for these infected clients. Its likelihood to happen is high without proper precaution and will not only affect the organization but also the community. In an instance, a staff nurse is caring for a patient with tuberculosis, after a few weeks the nurse shows signs and symptoms and has acquired tuberculosis. The staff then is now capable of spreading the disease to his/her workplace and the community. The mentioned situation has immense damaging outcome that it needs to be prioritize. Risk for needle stick injury is also common but controllable if safety procedures and protocols are followed. The same goes with the risk for injury in emergency department, the nurse can always ask for assistance to a security in uncontrollable situations. The fire, earthquake and volcanic eruption on the other hand have a much greater impact than the rest but the likelihood of the event is less than the other identified risk.
E. Risk response plan
There are different strategies and plans formulated after careful assessment, study and prioritization. Different strategic plan were formulated in response to the risks. These are:
- To counteract the risk of obtaining an infectious disease, the use of personal protective equipment such a gloves, mask, gowns and goggles is strictly implemented. Hand washing every contact with a patient is also habitually done.
- For the risk of needle stick injury, the management posted several reminders and procedures in proper handling and disposal of sharp objects such as needles and surgical knives all over the hospital, specifically at the nurse station.
- On the emergency department, nurses assigned are reminded and thought to assess signs of possible aggravation of drunk and drug patients, security officers also take their rounds every now and then at the area.
- There is a yearly fire, earthquake and evacuation drills in the hospital which involves all the staff and patients. Aside from that all of the staff is thought on how to use a fire extinguisher and to do a first aid. Safety orientation to the new employees and reorientation yearly to the old staff is a continuous routine. All of these are strictly followed and implemented in the hospital I that I belong to before.
F. Control activities
The Safety committee had their regular meetings quarterly. In the meeting, they show reports of recent incidents that happen in the period. They check, verify and compare the data with the previous reports. They also held emergency or special meetings for emergency cases. Moreover the committee also sends personnel to different seminars and trainings to keep up to date in the different trends in occupational hazards and safety in general.
G. Information and communication
Information and communication is handled really well in my organization. Memos and new safety guidelines and being communicated well through series of orientation and meetings with different departments to make sure the information is being understood and clearly discussed with the staff. Different signage and posters are posted in different areas within the facility and can easily be seen by the clients, like the arrows pointing to the different emergency exits and posters of new information concerning the safety of the clients and staff on the hospital.
Safety committee monitors these protocols and procedures by doing daily or weekly checks or preventive maintenance on the different safety equipment such as the fire extinguishers, sprinkles smoke detectors and others. A personnel assigned makes sure that they are working properly and ready to use in emergencies. Evaluation is done through surveys and suggestions are always welcome to improve the situation or consequently to decrease the different risks.
Howard Hubbard Memorial Hospital is a small facility compared to other institute in the county, but I think even though we are just a small organization, the management has a clear understanding of different risk at hand and on how to manage those risk, sure there is still room for improvement but I can see that the management is open for suggestions and is capable of changing the situation. Risk Management in this report as I have said is focused on operational aspect specifically to safety risks since there is a negligible financial risk due to the financial support by a successful company.
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