Risk Preparedness Program – ROJoson’s Paper – 2008
Manila Doctors Hospital
Risk Preparedness Program
A Concept Paper on Design and Development
Reynaldo O. Joson, MD
V- January 9, 2008
2008 Annual Planning Conference
Resolution to study “risk management”
President Sobrepeña asked Dr. Reynaldo Joson to make a concept paper on design
Existing program and activities:
Disaster Preparedness Committee – activated in 2005 – fully functional
Customer Relations Service and Business Development Division – procedures in handling complaints and possible medicolegal suits
Human Resource Division – procedures in handling legal suits arising from staff
Medical Services Division – procedures in handling complaints and possible medicolegal suits (presence of Medical Audit Committee)
Nursing Services Division – procedures in handling complaints and possible medicolegal suits (presence of Nursing Audit Committee)
Hospital lawyers – handling complaints and possible suits
Administrative Director and Hospital Director – procedures in handling complaints and possible legal suits
NOTE: Need to review, refine, coordinate, and integrate
Approach in the development of design and development by Dr. Rey Joson
Systemic perspective – hospital wide
Use of euphenismic and non-alarming terms
Emphasis on prevention
Emphasis on preparedness
Title or name of program:
Risk Management Program
Risk Preparedness Program
Crisis Management Program
Crisis Preparedness Program
Disaster Management Program
Disaster Preparedness Program
Recommendation: Risk Preparedness Program
Basis: Use euphenism / Non-alarming terms (risk best compared to crisis and disaster)
Encompassing (risk for all types – natural, man-made, medicolegal, non-medicolegal suits)
Preparedness concept – risk preferred over crisis as risk precedes crisis
Preparedness preferred over management as latter connotes response; preparedness connotes prevention and being ready and includes response.
Thus, Risk Preparedness Program
Concepts and Definition of Terms:
Risk is the possibility of an adverse deviation from a desired outcome. It is the probability and consequences of exposure to a hazard. Examples of consequences: death, injury, damage to infrastructure, loss of property, loss of income, contamination of environment, breakdown in essential services, breakdown in security, etc.
Risk preparedness process / program is a planned and systematic process / program to reduce and/or eliminate the probability of a “risk” that usually results in injuries, losses, and legal suits. It consists of three distinct, yet interrelated areas: 1) risk identification and loss prevention; 2) loss reduction; and 3) risk financing.
Hazard is any potential threat to health, safety, and property. Examples: natural hazards, technological hazards, biological hazards, societal hazards.
Vulnerabilities refers to the infrastructure, system, and people within the organization less able to cope with the impact of the hazards
Capacity refers to the capacity of the infrastructure, system, and people within the organization to respond to and recover from the emergencies (crisis and actual disaster).
Risk is directly proportional to hazards and vulnerabilities and inversely proportional to readiness for response.
Preparedness is a measure to build capacities to respond to and recover from emergencies. Elements of preparedness: policies, procedures, guidelines, plans, resources, authority, knowledge, skills, awareness.
Risk preparedness / management processes refer to risk assessment and analysis – risk communication – risk reduction – risk monitoring
Risk assessment processes refer to the following:
Prepares hazard profile.
Maps the distribution of hazards.
Identify elements / people exposed to hazards.
Predict consequences of hazards.
Risk reduction – protecting health, safety, and property by
Hazard reduction plan (reduce exposure)
Vulnerability reduction plan (reduce consequences)
Emergency preparedness plan (increase capacity for response and recovery)
Emergency is any actual threat to health, safety and property.
Disaster is an emergency in which the institution CANNOT cope.
Types / Categories of Risks in the Manila Doctors Hospital
1. Risk for natural disasters (earthquake, flood, tsunamis, fire, etc.)
2. Risk for man-made disasters (fire, felony, bomb threat, terrorism, etc.)
3. Risk for medico-legal suits (arising from patient care)
4. Risk for non-medico-legal suits (not arising from patient care)
Situation in MDH:
Needs data on risk frequency / incidence / prevalence from 2005 to 2007
What were the consequences?
Status of all activities on risk preparedness and management
Risk Preparedness Program
Risk Preparedness and Response Plans
Risk identification and assessment
Operational needs assessment
Policies and Procedures
Training needs assessment
Resource needs assessment
Expected outcomes and impact of Risk Preparedness Program
Risks reduced to a minimum possible.
Reduced financial losses.
Reduced infrastructure losses.
Improved quality and safety services.
Improved customer satisfaction.
Improved business development.
Planning on Risk Preparedness Program
|Risk||Intervention||Responsible body||Resources needed||Time||Indicators|
|Natural disasters||Preparedness Program||Disaster Preparedness Committee||Committee works and activitiesRisk financing||March, 2008||No fire|
|Man-made disasters||Preparedness Program||Disaster Preparedness Committee||Committee works and activitiesRisk financing||March, 2008||Incidents near zero|
|Medico-legal suits||Preparedness Program||Medico-Nursing Safety Committee||Committee works and activitiesRisk financing||March, 2008||Potential medico-legal suits ≤ 10 / year
No medico-legal suit
|Non-medico-legal suits||Preparedness Program||Occupational Safety Committee||Committee works and activitiesRisk financing||March, 2008||Potential non medico-legal suits ≤ 3 / year
No non-medicco-legal suit
Recommendations on Committee and Membership:
Risk Preparedness Committee (mother committee – coordinating body)
Disaster Preparedness Committee
Medico-Nursing Safety Committee
Occupational Safety Committee
|Risk Preparedness Committee||Hospital Director||Division Heads||LawyerFinance Person|
|Disaster Preparedness Committee||Dr. Robbie Ruiz||FMDSecurity
Linen and Housekeeping
|Medico-Nursing Safety Committee||Dr. Roehl Salvador||MSDNSD
|Occupational Safety Committee||Mr. Benhur Bernardo||HRDIMSD
Today, September 12, 2012, I looked back at what I wrote in 2008.
Today, I will use the terms “Hospital Risk Management Program” instead of “Risk Preparedness Program.” Risk Preparedness Program is subsumed in Risk Management Program.
I will use Hospital Risk Management Program to mean the program is in a hospital setting.
I will use Hospital Risk Management Program to include the concepts of business continuity management program.
I will use Hospital Risk Management Program to include all types of emergencies-disasters-crises that can occur in a hospital setting that has to be prevented, mitigated, prepared, responded to with the end-goals of maintaining business continuity and hospital sustainability.
All types of emergencies-disasters-crises will include both natural and man-related ones. Man-related emergencies-disasters-crises will include legal and medicolegal suits and accounts receivables among other things.