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review the Risk Management Tool and follow the accompanying instructions on the tool.

 

Question:  list 15 “Top ” Risk area for medication error prevention intervention plan and describe the risk mitigating options and actions for the risk

 

Risk Management Tool

Purpose

A risk is an event or condition that, if it occurs, could have a positive or negative effect on the quality improvement (QI) project’s objectives. Risk management is the process of identifying, assessing, responding to, monitoring, and reporting risks. This Risk Management Tool defines how risks associated with a QI project will be identified, analyzed, and managed. It outlines how risk management activities will be performed, recorded, and monitored throughout the lifecycle of a project and provides a template and practices for recording and prioritizing risks.

Objectives

The primary objectives of using this tool regarding your QI project are to:

Ensure critical risks that have an impact on scope, schedule, budget, business performance, and/or change management are proactively identified, communicated, mitigated, and escalated in a timely manner.
Bring attention to key risks that have an impact on the project.
Produce meaningful information that allows you, the project manager, to focus efforts on the “right” (e.g., high likelihood and high impact) risks with an effective coordination of effort.
Ensure appropriate stakeholders are informed and, if applicable, participate in the mitigation.
Record, track, and monitor all risks in the project and document actions taken to mitigate those risks.

Guiding Principles

Work and communicate progress on the most severe risks first.
Set realistic due dates and then work to meet the dates.
Keep stakeholders informed on current risk status.
Document the planned risk mitigation history and actual mitigation of a risk. 
For high impact, impending risks, a rapid decision turnaround may be required, as determined by you, the risk/project manager. 

Risk Management Steps

Step 1: Risk Identification

Risk identification will involve the project team (if you have one) and appropriate stakeholders, and will include an evaluation of environmental factors, organizational culture, and the project implementation plan, including the project scope. Careful attention will be given to the project deliverables, assumptions, constraints, cost/effort estimates, change management plan, and other key project documents. Stakeholders will have an inside knowledge of areas that you don’t, so involving them in this activity is imperative. The stakeholder can act as the risk owner (a risk owner is one who is responsible for managing certain assigned risks) for specific risks if they occur.

Identify risks that may affect project outcome. A risk is any event that could prevent the project from progressing as planned, or from successful completion.
List them on the Risk Register (see below).

Step 2: Risk Analysis

After risks have been identified, they must be assessed for potential severity of loss and probability of occurrence. These quantities can be either simple to measure, in the case of the value wasted materials due to unnecessary redundancy, or impossible to know for sure, in the case of the probability of an unlikely event occurring. This is why, in the analysis process, making the best guesses possible to properly prioritize is important.

Use the Risk Prioritizing Matrix below to properly prioritize each risk, then enter the information onto the Risk Register in the appropriate columns.

Risk Prioritizing Matrix

Probability Low Severity Medium Severity High Severity

Low probability

6 5 4
Medium probability 4 3 2
High probability 2 1 1

Step 3: Managing Risk

Identify triggers. Triggers are indicators that a risk has occurred or is about to occur. The best triggers tell you well in advance that a problem will occur.

To identify triggers, talk with the people who are most likely to cause the risk to occur and those who are most likely to feel its impact. Ask them how they would know the problem is occurring. Start with how they would know the problem has already occurred and then work backward to determine how they would know before the problem actually occurred. As the project manager, consider how the risk would be reflected in the project schedule. Would the project schedule show overtime for a specific resource on earlier tasks? Would the project schedule show delays in specific tasks?

For each risk, determine possible triggers, when they are likely to occur and who would watch for them. Enter the relevant information into the Risk Register.

Identify an action plan. The next step is to create action plans to manage the risks. There are four basic ways to categorize and manage risk:

Avoidance – Change the project plan and project schedule to eliminate the risk or to protect the project objectives from the impact.
Transference – The risk is transferred, or shifted, to a third party. The risk is not eliminated but the ownership, impact, and responsibility for it are assumed by a third party. Buying insurance or outsourcing are examples of transference. 
Mitigation – Mitigation seeks to reduce the probability and/or consequences of an adverse risk event to an acceptable threshold by taking actions ahead of time, thereby decreasing the likelihood of the problem occurring. Typically, it is much more effective to reduce the probability of a risk even occurring than trying to repair the consequences after it has occurred. Mitigation is essentially a proactive strategy to reduce the chance of the risk occurring and/or reduce the consequences of the risk if it occurs. Examples of this could be safety training, or if the project is dependent on an outside vendor delivering something, then an action plan may be to include penalties for late deliveries in their contract, which would decrease the likelihood of the vendor delivering late. 
Acceptance – Acknowledge the existence of the risk and accept its consequences if it occurs. This also involves creating a contingency plan for when these risk events do occur. 

For each risk determine the appropriate action plan. If the plan is to mitigate the risk, you will need to identify ways to prevent the risk from occurring or what steps to take to reduce its impact or probability of occurring. For each major risk that is to be mitigated or that is accepted, a contingency plan will need to be developed in case the risk does occur. Record this information on the Risk Register.

Step 4: Risk Monitoring and Tracking

The level of risk on a project will be tracked, monitored, and controlled and reported throughout the project lifecycle. After the project is implemented and project activities are conducted and completed, risk factors and events will need to be monitored to determine if trigger events have occurred that would indicate the risk is now a reality. When this happens, employ your contingency plan and monitor the situation. Keep track of the status and evaluate the effectiveness of the plan. 

You will need to review this process regularly to monitor the status of existing risks and to pinpoint and assess new risks as they appear. Update the Risk Register with current information as needed. 

Maintain a “Top 10” Risk Register throughout the course of the project. 

SCIENCE
HEALTH SCIENCE
NURSING
NSG 577