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4H-Program Manajemen Risiko 2015 - Final
4H-Program Manajemen Risiko 2015 - Final
4H-Program Manajemen Risiko 2015 - Final
CHAPTER I
INTRODUCTION
A. Background
B. Goals
CHAPTER II
A. Main activities
2. Risk Assessment
a) Risk identification
b) Risk analysis
c) Risk evaluation
B. Detaild activities
2. Risk assessment
1) Risk identification
2) Risk analysis
3) Risk evaluation
3. Handling risk
Attached at Appendix
D. Goals
10
Month
Activities
01 02 03 04 05 06 07 08 09 10 11 12
1. Arrangement of
risk management X
coverage of RSHS
2. Assessment of
Risk in every x x
work unit
a) risk
identificatio X
n
b) risk
X
analysis
c) risk
X
evaluation
3. Handling risk in
X X X X X X X X X X
every work unit
4. Arranging RCA*
5. Arranging
FMEA**
6. Monitoring and
X X X X X X X X X X X X
Evaluation
7. Arranging report
of risk
X X X X
management at
work unit level
8. Arranging report
of risk
management at X X
the Hospital
level
11
1. Recording
12
2. Reporting
3. Evaluation
13
14
Appendix 1
Arrangement of Risk Registry
1. The content are various forms of risk that develop in related
unit
2. Give the score of impact from each risk with 1-5 (score 1 is very
light impact, score 5 is very severe impact)
3. Give the score of frequency from each risk with 1-5 (score 1 is
very rare, score 5 is very frequent)
4. risk value is impact score is multiplied by frequency score (from
1 to maximum 25)
5. define the ribbon color (blue, green, yellow, or red) for each risk
as shown in the tableof risk grading matrix:
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16
APPENDIX 2:
Simple investigation
17
Appendix 3
Comprehensive investigation/Root Cause Analysis
It is conducted by the Team of Patient Safety when the ribbon is
yellow or red. RCA is a structured method of evaluation for
identification of root cause of the unexpected event and adequate
action plan to prevent the similar events recurrently. Analytical
process method that can be used retrospectively to identify factors
causing unexpected events.
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1) 5 Why’s,
2) analysis of change
3) analysis of obstacle
4) FishBone analysis
19
APPENDIX 4
1.
20
2. Level of severity
21
1. Severity
2. Occurance
3. Detectability
22
APPENDIX 5
2. Facility of agriculture
4. Dam or irrigation
7. Factory of firecracker
8. Nuclear Reactor
9. Military silo
11. Etc.
23
HVA TOOLS
a. Known risk
b. Previous data
c. Statistic vendor/manufacturer
24
b. Frequency of training
c. Training Status
d. Insurance
c. Supply distribution
d. Staff availability
e. Public resources
26