RISK MANAGEMENT

Risk Management at Hospital X- Incorrect Site Surgery

[Name of the Institutions]

Risk Management at Hospital X- Incorrect Site Surgery

Introduction

Kerry Acute and Community Services begun to develop as an ISA structure in March 2010. This precursor to a formal ISA was established with the intention to deliver greater integration of services.

Accordingly, the A/LHM for Kerry was assigned full responsibility for all health services within the county of Kerry leading a senior management team with membership across PCCC and Acute Services thus facilitating the development of an integrated service area and enhancing accountability and governance structures for Kerry Health services. In 2010, Kerry General Hospital continued to provide Acute Hospital services on an inpatient, outpatient, 5 day and day care basis as appropriate to the population of Kerry. In addition the Emergency Department managed approx 31,000 presentations including attendances to the Acute Medical Unit.

Following are the KGH Initiative taken regarding the theatre;

Modernisation of theatre functioning to synchronise staff rosters and support patient pathways as well as bed management.

Alignment of theatre capacity with resources incorporating changes in rostering arrangements.

Greater efficiencies in theatre functioning & surgical services delivery.

Adjustment to staff rosters in portering and nursing to reconfigure theatre services to be achieved under the auspices of PSA.

Theatre Stats for Surgery

The paper discusses the risk management issues for the KGH regarding the wrong in-site surgery. This paper uses the root cause analysis to analyse the issue.

Overview to the framework and tools used

Following are the different tools and framework used in order to improve the quality of service in healthcare settings.

AZ NZS 4360

The risk management process set out in the Standard is illustrated in the diagram:

Risk identification is often seen as the heart of risk management, but as the diagram shows, it is not the first step in the process. To be able to recognise a risk it is necessary to know what is at risk. The first step in the standard process is to define the context of the risk assessment, which falls into two parts, one descriptive and the other creative. To ensure that all significant risks are captured, it is necessary to know the objectives of the enterprise within which risks are to be managed. This is the descriptive part of the context analysis. (Lerberghe, 2000)

Where the enterprise is part of a larger organisation, it is common sense as well as good practice to understand the relationship between its objectives and those of the larger organisation. Checking the alignment between objectives at various levels in the organisation ensures that no important assumptions or unspoken objectives are ignored. (Institute for Healthcare Improvement, 2008)

In addition to checking with the level above, an enterprise's objectives must be reconciled with those of any stakeholders who have a say in its operations. Stakeholder analysis can play an important part in demonstrating the integrity of the process, but it has a vital functional role too. If objectives are defined without reference to the concerns of individuals or groups with influence over the enterprise's operations, it is ...