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Harry C. Abellana Jr.
I am a health care assistant going on duty at North Shore Hospital. It is one of the hospitals under the Waitemata District Health Board. It caters inpatient and outpatient care. It is also equipped to perform surgeries and emergency care.
Studying risk management is a very important key in being a manager. This would equip you with the vital skills and mind set to be sensitive to identify the different risks in the work place. You will be able to act quickly and find a solution if ever a problem is faced. All of your clients or patients are your responsibility. Their care is in your hands.
Purpose of Risk Management
Working at North Shore Hospital is a very eye-opening experience. The hospital caters to everyone and attends to any type of illness. With the vast patients that they are attending, risk is always present. An accident or wrong practice always lurks the corner. I can see that the purpose of risk management is to prevent and control the different risks being faced on a day-to-day basis. Without risk management, there will be chaos in the organisation and this will hinder the staff to do their work. Proper risk management is implemented so that the organisation itself can do their tasks efficiently and effectively.
Benefits of Risk Management
There are different things that North Shore Hospital is benefiting from their effective risk management. First is a good reputation. They have a good reputation of being one of the best public hospitals under the Waitemata District Health Board. This was achieved through proper planning and execution of their risk management protocols. Another benefit is maximizing the time and skills of the staff. Whenever there is a risk encountered, the staffs already know the steps on how to handle and solve the problem. Another is conserving and saving money. If the risk is attended to or moreover prevented from happening, this would lessen the downtime and resources to be used to control the problem. That is why risk management is truly beneficial at North Shore Hospital.
The Different Components of Risk Management
- Activities and Internal Environment
The working culture at North Shore Hospital is a very positive one. Each unit exhibits team work to get the job done. All of the healthcare staff works hand-in-hand to provide the best quality healthcare. The managers make sure that a safe and healthy working environment is maintained. Any misunderstanding should be sorted out immediately. It is the responsibility of the managers to take care of their employees. On the other hand, the employees are responsible for their patients. The nurses and healthcare assistants are the first line of the organisation to take care of the clients. They use both modern technology and trusty hand-written documents to store patient’s information. Computers are mainly used to guide the healthcare providers regarding the medication schedule and as a communication tool. This will lessen the occurrence of medication errors. They use the traditional patient’s chart to jot down objective observations like blood pressure, temperature, respiratory and heart rate. The organisation has plotted down their policies that would cover all risk possibilities that they may encounter. There are policies from the simplest thing like hand washing techniques up to the complicated things like medication error. They also give importance regarding the confidentiality of the patients. They always remind us that every time you perform basic care to the patients, you should make sure that all the curtains are closed and not to expose the clients. New Zealand is a diversified country. With the continuous influx of migrants, there are a lot of culture, religion and beliefs. The healthcare plan should be sensitive to the rights and beliefs of the patient. The decision of the family is also respected when drafting the care plan for the patient.
The basic objective of the Waitemata District Health Board, in which North Shore Hospital is under this health board, is to provide the best healthcare while respecting patient’s rights. They are committed to become a world-class healthcare facility. The organisation is aiming for a zero fall incident across all departments in all shifts. They are also an advocate to promote a smoke-free environment which should be achieved by the year 2024. They provide health teachings to patients who smoke and provide help and options on how to quit smoking. Proper hygiene, preventing cross contamination, limiting salt intake and recognizing the signs and symptoms of stroke are other objectives that the hospital is trying to disseminate to their patients. Their main objective is to promote a healthy lifestyle.
- Event Identification
One of the risk identification that the hospital is doing is practicing emergency evacuation in case a major catastrophic event happens. They do this announced or unannounced. This is beneficial to remind the group on what to do in time of tragedies to be effective and efficient in evacuating the facility and save lives. Another current event that they are closely monitoring and trying to prevent is the spread of the Ebola virus. It has become a worldwide threat. They are specifically meticulous for those persons with or without signs of feeling sick to inform the organisation if they travelled to Africa or to any known country which has a positive case of the Ebola virus. If a person is suspected to have contracted this disease, they are to isolated for close monitoring and to be provided with the proper treatment.
- Risk Assessment Reference
North Shore Hospital has a very simple yet very effective way to quickly inform the healthcare provider about the case of the patient. Posted on the wall on top or at the side of the patient is a reference chart. The chart consist information like name, age, language spoken, diet and nurse on charge for that shift. The unique thing about the chart is about the probability of the patient having a fall. It is measured by ticking the box if the patient is at high, medium or no risk of falling. There is also a picture of different walking assistive devices in which the proper tool to use is encircled. The picture helps a lot because it gives a clear picture not only by the name of the device. The chart also indicates if the patient is independent, needs supervision or how many persons should accommodate the patient if ever he or she needs assistance. This reference chart simply provides you the do’s and don’ts regarding the care of the patient.
- Response Plan
Every shift always starts with a hand over. This is vital because in this occasion, all the information about the patient is being given. Each patient is unique in terms of providing care. The healthcare team also do rounds to check on the patients. There are times in which a patient needs close monitoring. The nurse cannot do this alone. They call the help of the bureau. This may be internal or external. This procedure will lessen the risk of the patient to incur any incident. They assign a staff to do a one-on-one monitoring of the patient. This may be an additional cost to the organisation but the positive effect always outweighs the monetary impact. This is also a way as a quick response to unexpected shortage of staff. The nurse managers on duty can always count on the bureaus to provide them with the manpower needed for that shift. The allocation of patients to the nurses on duty is also planned out. There are 2 or more nurses assigned in a single room. All the severe cases and patients who has complex care plan are distributed to the nurses. The buddy system works well in the healthcare system because there will be somebody to assist or help you in case a problem occurs. Each room generally consists of four patients. A single room cannot be occupied by all dependent patients. Occasionally there are two independent patients and two who needs close monitoring or supervision.
- Control Activities
North Shore Hospital is equipped with all the modern risk managing devices like fire extinguishers, first aid kits and the likes. The expiry dates are checked regularly to maintain the effectivity of the devices. They also provide call bells to each patient. This will provide the patient easy access to the healthcare providers. The toilets are equipped with this feature. All over the floor there is an emergency bell. This would help alert all the healthcare staff that a major incident occurred. If the patient is not capable of pressing the call bell, they are attached to a monitoring alarm. If the patient gets up from bed, the alarm is triggered to alert the staff on duty that the patient needs help. Not only are the tools or the equipment being used are audited. The plans and protocols are also being updated from time to time. These plans are adjusted according to the flaws, if ever there are any, or new ideas and suggestions coming in that might be beneficial to the recent protocols; all of the plans and materials being used to control or prevent risks are continuously changing or updating to be more effective it its goals.
- Information and Communication
The hospital has good communication mediums to inform the staff and the general public about the health objectives. They use emails and online communications lines in order to inter act with each department. A paging system is used to announce any information that can be heard all throughout the facility. They also print out and post posters all over the facility. They are the appropriate size and clear. It contains the vital information that they want the people to know. It also contains call back information so that the public will have the chance to call them for questions and clarification. There are also leaflets and hand outs available. This is useful and handy. A patient can take these flyers with them and they can read it in their free time to better grasp the information being handed out. Help desk and information centre is also available. It is manned by a knowledgeable staff in which basic information can be answered right away.
Being a big hospital, it takes a group effort to maintain or prevent risks from occurring in the organisation. The company delegates to the members of the team the different aspects that need monitoring. They monitor cleanliness, fall incidents, cross contamination, intravenous lines infection and the likes. Each subject is randomly assigned to the members of the healthcare team for monitoring. They post the results of the evaluation at their bulletin board. The hospital makes it into a friendly competition. They commend the best ward for their efforts. This is a good way to motivate the crew to bring out the best performance and to provide the best care possible.
All organisations involving healthcare, may it be a hospital or a retirement village, has the best intention to their patients. They all have a common goal of taking care of people who lacks the ability to take care of themselves, may it be due to certain illnesses or old age. With the type of clientele that they have, risk is always present. That is why protocols are set to manage these risks. For me, the most important key is how to follow these protocols. They should be followed faithfully and put into practice. The organisation may have the perfect risk management procedures but without proper implementation, all of these would be useless.
This paper is very interesting. It varies from the typical subjects that were learned when taking the nursing course. It teaches us on what are the consequences if the different risks involved are not managed properly. Risk management should be inculcated to the practice of all employees, from the top management down to the rank and file. All should be responsible for their own actions because by being responsible risks can be prevented. We plan to become leaders and managers in the future. This would involve a lot more responsibilities. Mastering this talent will provide us with the proper knowledge, skill and attitude to become great leaders.
AOL Plc. (2014). Health Care Risk Management. Retrieved from http://www.aon.com/industry-expertise/healthcare.jsp
Waitemata District Health Board (2010-2014). About Waitemata District Health Board. Retrieved from http://www.waitematadhb.govt.nz/AboutUs/AboutWaitemataDistrictHealthBoard.aspx
- Business Risk
The most distinctive feature of the pharmacy is the operating hours. It is always open 24 hours a day, 7 days a week. This would accommodate all potential customers even after the regular office hours. The store is still serving customers when the competition is closed. The size of the store, branding, and investing in the interior furbishing is also appropriate. This prevents congestion inside the pharmacy. The more relaxed the customers are; the better buying experience they will have. The parking slots are a bonus feature especially for those clients with cars who are in a hurry for a quick buy. They would spend the money they have to buy products in the store rather than allocating it to pay for parking. The variety of products being offered also gives customers wider products choices. Location is also suitable to cater the target market.
- Insurance Risk
Running an all hours pharmacy is vulnerable to robbery, fire and medication error. The pharmacy should get an insurance plan to cover these identified risks since the pharmacy is always open. The shop is most at risk during night time in which most common mistakes occur maybe due to fatigue which would hinder the human senses.
The pharmacy should also protect their employees in case something happens to them in the work place. They should be accredited to the Accident Compensation Corporation or ACC to free the company from shouldering any extra expenses from unforeseen events.
Since the business involves three stakeholders, protecting their investments should also be protected. An investor’s insurance is beneficial when fixing the pharmacy’s assets especially when something goes wrong like a death of an investor or bankruptcy.
- Compliance Risk
You need to comply with different permits in order to run a pharmacy as per New Zealand’s laws. The Licence to Operate should be obtained. The licensing body of New Zealand is the Ministry of Health. The staff should also be qualified and have the NZQA qualifications especially the nurses and the pharmacists.
Ministry of Health – Manatu Hauora (2014). Applying for a pharmacy licence. Retrieved from http://www.health.govt.nz/our-work/regulation-health-and-disability-system/medicines-control/pharmacy-licensing/applying-pharmacy-licence
Newzealand.govt.nz. Small, medium and large business. Retreived from http://www.acc.co.nz/for-business/small-medium-and-large-business/index.htm
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