RIS MANAGEME K PLA NT N

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Guided By: Dr.Bhupinder Chaudhary

Presented By: Ms.Dipti Manvar Dr.Anuj Mistry Dr.Rajnikant Darji Ms.Pooja Chaturvedi Dr.Dhara Patel Dr.Sahista Bhatt 4/19/12 & Dr.Ankur Mehta

OBJECTIVE:
Identification and prevention of risk exposures within the organization that could:

Cause injury to patients, visitors and employees & Jeopardize the safety and security of the environment Result in costly claims and lawsuits

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Organization:

CEO- Ex-officio Director of Risk Management Security Manager Disaster & Fire safety officer Legal maters officer Infection control Head (Microbiologist) Finance Manager 4/19/12

Plan

Risk Management

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Legal Issues Mgt Patient rights Pregnancy act MLC

Infection Control Commit tee BMWM Preventi ve

Security Mgt

Disaster/Fire Mgt Plan Coding Race Pass

Technol ogy Theft Pilferag e Terroris m Risk

Management
Click laws Labor to edit Master subtitle style Nursing College Analysi Fire Conflict s Safe Staff Insuran storage security ce insuranc HR Materials Finance e Mgt Mgt Mgt 4/19/12 Accreditati on Audits Tool application Quality Mgt

Risk Tolerated Last Yr.

No. of Failing case
12

10

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Rs.2,66,500

Strategy
Objectives Disaster/Fire Mgt Hr Mgt Infection Control Legal Issues Security Mgt Material Mgt Quality Audits/solutn. Finance Mgt. Management Reviews Training 4/19/12 Sep No Marc Apri MAY June July Aug t Oct v DecJan Febh l May

Of the 25 most costly insured world catastrophes in the past 40 years, 2/3rd have occurred since 2001.

The Taj was insured by Tata AIG, received an interim claim of Rs.130 Terror insurance premium 15 4/19/12 Source:insurance cr,as of Dec,2009. lack/yr.

Leading Causes of Fire & Property Loss %(2003-2007) Source:www.iupindia

.org

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10 Source:insurance

Disaster Risk Management Plan

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Risk Identification

Natural disaster risk:

Earthquakes Cyclones Typhoons Hurricanes Tornados Epidemics Caused by warfare NBC Building collapse

Man-made disaster risk:

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Risk Mitigation

To identify response time To justified appropriateness of the method

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Risk Monitoring and Control

Risk Reassessment Status Meetings Risk Audits Variance and Trend Analysis Technical Performance Measurement Reserve Analysis

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Risk Strategy

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Fire Management Plan

Properties that are prime importance to access the risk

Commodity Combustibility Physical properties of the substances

Heat release rate Heat of combustion (Btu/lb or Kg)*burning rate (lb/min or kg/s) Exposed surface for burning

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Types of Fire

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Fire Prevention Methodology

Structural fire protection is achieved by:

Passive fire protection

Use of integral , fire resistant rated wall

Active fire protection

Manual and automatic detection and suppression of fires

Education

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Building owner and operator have understanding of the applicable building and

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Sprinkler System Flow Rates

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Risk Inspection

Occupancy Building size, number of fire compartment Fire certificate information Sprinkler installation or not The construction of the building frame, combustibility of sandwich panel cores Potential for rapid spread of fire and

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Risk management planning related to HR Department in Hospital

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Introduction

Most valuable assets. Maximize the productivity of an organisation by optimizing the effectiveness of its employee. Hiring the right people and training them well.

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What are the Risk in

How to Prevent risk?

Training and development programme Alertness about the hospital related risk Security and safety environment for all employees Try to avoid before occurrence.

Performance and appraisal management. 4/19/12

Ideal plan for HR risk management in Hospital

Hospital manager and HR manager are followed such plan.

Inform about probability of risk Identify the risks in hospital Meeting with each HOD of diff. departments Make a plans and accept the right plan to handle the risk Implementation 4/19/12

Risk Mitigation

Activity or group activity that add to project schedule if certain event occur. Take feed back from each employee Ask and solve their queries. Improvement to handle the risk.

Regular updated plan and meeting. 4/19/12

Legal Aspects and Risk Management

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number of patients who believe they have sustained physical or psychological harm (a "bodily injury") as a result of the hospital's or a health care provider's negligence bring claims or lawsuits to recover damages. Factors contribute to patients' decision to sue Experiencing of an unexpected or less than perfect result, Click to edit Master subtitle style Feeling that they have been treated in an uncaring, rude, unsympathetic and/or less than professional manner. The most important factor that causes a patient to resort to litigation is a breakdown in the patientphysician relationship.
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Overview of the Legal System In the current health care environment, an increasing

Legal Issues In Hospital

Consumer Protection Act - Patients Right - Doctor-patient Relationship - Informed Consent

No Smoking Act Prenatal Sex Determination Act Medical Termination of Pregnancy Act
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Drug & Cosmetic Act

Consumer Protection Act,1986

Patients Rights: The hospital is ensuring that the rights of all patients are respected during their hospital stay & given all the information regarding treatment.

From risk mgt perspective, 4/19/12 all health care

Doctor Patient Relationship:

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Since the passing of the Consumer Protection Act in 1986, litigation against doctors is on the increase. The medical profession is definitely perturbed by this and a rethink is necessary on standards of medical practice or defensive medicine.

Informed Consent:
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No Smoking Act,1970
These Regulations cited as the NoSmoking Premises Regulations 2007 and subject to section 23 of the Act, come into operation at 04.00 hours on the 30th March 2008. No-smoking notice means a notice 4/19/12

Pre-natal Sex Determination Act,1996

The Pre-natal Diagnostic Techniques

(Regulation and Prevention of Misuse) Act,1994, was enacted and brought into operation from 1st January, 1996.

The Act prohibits determination and

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Medical Termination of Pregnancy,1971

A registered medical practitioner shall not be guilty of any offence under Indian Penal Code or under any other law for the time being in force, if any pregnancyis terminated by him in accordance with the 4/19/12 provisions of this Act.

Bio-medical Waste (management & handling) Act,1998

These rules apply to all persons who generate, collect, receive, store,transport, treat, dispose, or handle bio medical waste in any form. Under this act, take all steps to ensure that such waste is handled without 4/19/12

Drug & Cosmetic Act,1940

Under this act, there is prohibition of import & sale of certain drugs or cosmetics Schedule H & L drugs are sold only on prescription.

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Risk management plan in Hospital Acquired infection

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Introduction

HAIs are Infections that are acquired by the patient while he/she is in the hospital either from other patients, the hospital environment or members of the hospital staff.

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Recognition/identification of risk
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High risk procedures(key results area) like injections, surgical procedures ,dressing of wounds, investigation procedure, laboratory investigations, dialysis, organ transplantation unit, OT etc. In the service departments like house keeping, dietary and laundry services, CSSD,. Click to edit Master subtitle style

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Risk assessment
Rate of occurrence: Over 1.7million people worldwide suffer from HAI annually with cost ranging from4.5$billion to11$ billion. Due to edit Master subtitle style Click to HAI patients occupy beds for an average of 15 to 20 days. CIR=(NUMBER OF INFECTIONS/NUMBER OF ADMIDDIONS)*100

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Strategies to manage risk

universal precautions. Personal protective equipment(cap, mask, apron, gloves, boots gloves) Use of disinfectants Sterilization of reusable equipments Cleaning floors air conditioning, nursing care,

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Infection control committee

ROLE Chairperson Member Member Member DESIGNATION Microbiologist Chief of Nursing HOD Pathology Gynec Physician
Ad Hoc Dietary Supervisor, House Keeping Supervisor, Central Supply Supervisor, Employee Health Director

Member Click to edit Master subtitle style Cardiac Surgeon Member Orthopaedic Surgeon Secretary Infection Control Nurse Member Medical Director Member
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Senior Administrator

Risk mitigation

Training of nursing, medical technologist, radiology, respiratory therapy and other students. An action plan to control outbreaks of infection, disinfection/sterilization activities, Bio-medical Waste (BMW) management.
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Cont

Having a written document(manual) outlining the various infection control policies and procedures and updating periodically. Providing facilities to the hospital staff to maintain good infection control practices.
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Spillage management
mercury spillage Mercury spillage kit; Glows, forceps, hard paper, blue bag glass container with cover Click to edit Master subtitle style

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Blood spillage kit; Cap, mask, glows forceps, Click to edit Master subtitle style news paper or tissue, yellow, red and blue bag, hypocloride solution , mop
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Niddle prick injury

Procedure; Clean the finger with running water When blood stop coming out wash it with soap and clean with water inform sister in charge Note down in register Click to edit Master subtitle style Sister in charge will inform to the physician Physician will refer both staff and patient for test in ICTC After seeing reports physician will decide to give post exposure prophylaxis treatment
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Risk management related to Material in Hospital

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What is MATERIAL MANAGEMENT? What are the Risk for Materials? Theft.

Fire. Expiration of materials. Shortage and Surplus of materials. Purchase of Bad quality materials. Bad storage of materials etc.

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Ideal plan for material risk management in hospital

1. 2. 3.

4.

Identification of Risk Risk Assessment Development of strategies to manage it Risk Mitigation using Managerial Resources

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Development of strategies to manage it Risk transfer- general insurance of equipment Risk transfer- Contract base system develop Risk reduction-Biomedical engineer appoint.

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Risk Mitigation using Managerial Resources Levels of decision making are well understood and do not over-lap, but are approached as a multidisciplinary team effort. Practical and applicable education and training policy for the staff. Equipment maintenance policies are in place and are 4/19/12 adhered to.

Cont..

There is provision for documentation, archiving and timely retrieval of the records. There is adequate hand-over. All such incidents should also be maintained on a risk register for periodical analysis.

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Security - Risk Management Plans

n k tio s Ri ica tif en Id
As R se is ss k m en t

n sk tio i R a ig it M

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Recognition / Identification of Risk

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Embezzlement Pilferage Kickbacks Computer fraud Equipment theft Personal property theft Payroll fraud Cash theft Purchasing, Receiving, & Storing fraud Record & billing fraud

Risk Assessment
Sources of Fraud in the hospital (2009 2010)

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Development of Strategies

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Strategies
A.

Physical security
Control of human traffic Separate entry & exit points Identify and guide non-patient & nonvisitor traffic Controlling and checking of vehicles 4/19/12

1.

2.

3.

4.

B. Procedural Security 1. Establish service rules and communicate them to all employees. 2. Establish policies & procedure manual for each department. 3. Establish committees. 4. Establish accountability & control over the flow of hospital supplies and materials. 5. Establish inventory control 4/19/12

Risk Mitigation
q

Equip security office with monitors for CCTV cameras Equip every entry / exit point by two guards round the clock Provide supervisors for every one or two floors Provide security drills to staff & have some percentage of female staff Place CCTV cameras at strategic locations Provide good communication system between security staff at various positions (walkie-talkie, mobiles, 4/19/12 whistles)

ONLY A PERSON WHO RISKS IS FREE To laugh is to risk appearing the fool. To weep is to risk appearing sentimental. To reach for another is to risk involvement. To expose your ideas, your dreams, before a crowd is to risk their loss. To love is to risk not being loved in return. To live is to risk dying. To believe is to risk despair. To try is to risk failure. But risks must be taken, because the greatest hazard in life is to risk nothing. The people who risk nothing, do nothing, have nothing, are nothing. They may avoid suffering and sorrow, but they cannot learn, feel, change, grow, love, live. Chained by their attitudes they are slaves; they have forfeited their freedom. Only a person who risks is free.

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Thank You!
Ask Question on your Risk 4/19/12