LOGGING OFF RISKS
WITH RISK LOG
1
LEARNING OBJECTIVES
Key concepts
What is Risk?
Principles and guidelines of risk management
Risk appetite
Risk identification
Barrier based risk models
Risk register
2
KEY CONCEPTS
Hazard: Something has potential to cause
damage
Threat: Credible cause of a top event due to the
presence of a hazard
Top Event: The moment when control is lost over the
hazard
Consequences: Undesired results from the top event
Risk: Possibility of something bad happening
Eg: You are walking down a street, when you spot an aggressive dog tied to a post next to
the sidewalk. The dog barks at you and pulls on the leash, but cannot reach the sidewalk.
Hazard: The aggressive dog is a hazard.
Threat: A threat would be the breaking of the leash
Hazardous (top) event: Releasing the dog onto you.
Consequences: Getting bitten is the hazardous (top) event.
Risk: Defining the severity and probability of the hazardous (top) event happening, gives us
3
the risk.
4
RISK
An unwanted event with a certain probability and
consequence
Is a potential event
Is in the future
Has a probability of occurring
Has consequences
Probability Consequence Risk
(Repetition) (Impact)
5
RISK MANAGEMENT
It is understanding, proactive identification and
management of significant risks.
It is a systematic and ongoing activity through which
we:
Avoid unwanted events in the future
Allocate resources to key risks in a prioritized manner
Utilize a proactive approach rather than firefighting.
6
RISK MANAGEMENT
7
RISK MANAGEMENT
Principles and Guidelines
8
RISK APPETITE
Risk is different for different people
How much would u gamble if there was a 75% chance of doubling your money and
25% chance of loosing it all?
1.Would you bet your money for lunch
2. Would you bet your bank balance?
3. Would you bet all your assets incluidng your property?
4. Would you bet your friend’s and family’s wealth?
5. More?
9
RISK CONCEPT DIAGRAM
What can go wrong?
(Hazard Identification)
How often? How big?
(Frequency analysis) (Consequence analysis)
So what?
(Risk assessment)
What do I do?
(Risk mitigation)
10
RISK SOURCE
1. Incident or Incident review
2. Complaints or complaints review
3. Experience –
4. Claim or claims review
5. Root cause analysis review
6. Suggestions
7. Facilitated workshops
8. Audit/inspection reports
9. Accreditation or other stds non-compliance
10. Safety alerts
11
METHOD OF RISK IDENTIFICATION
• Incidents
• Complaints • Risk assessments
• Claims • Patient feedback
• Investigations
Reactive Internal Proactive External
Reactive External Proactive Internal
• Reports from other
• Structured walkaround
healthcare organizations
12
BARRIER BASED RISK MODELS
13
RISK MANAGEMENT is about looking
forward
14
Source: AACI
BARRIER BASED RISK MODELS
BOW- TIE METHOD – BASIC
MODEL
15
BARRIER BASED RISK MODELS
BOW- TIE METHOD – ADVANCED
MODEL
16
BOW- TIE METHOD
Examples for Hazard- Top Event
17
BOW- TIE METHOD
Examples: Threats - Patient Falls
18
BOW- TIE METHOD
Examples: Consequences
19
BOW- TIE METHOD
Examples of barriers
20
BOW- TIE METHOD -
21
RISK SCORING
RISK MATRIX
1 2 3 4 5
22
CONSEQUENCES CLASSES
23
CONSEQUENCES CATEGORIES
24
CONSEQUENCES CATEGORIES
25
CONSEQUENCES CATEGORIES
26
LIKELIHOOD CATEGORIES
27
RISK REGISTER
Risk register can be based on 8 risk domains across hospitals in
various departments.
28
RISK REGISTER
29
SUMMARY
Risk registers record all your risk and control knowledge together
with your appetite to manage risks and status of controls
Regular updates (either when a change occur or on a pre-defined
schedule) are key to keeping register live.
Constant communication and discussion regarding the status of
risks and controls
30
THANK YOU
31
