Introduction to

Risk Management
Lecture 1

Dr: Naglaa Sayed Esa

naglaa24sayed@gmail.com
01002281221
 Intended Learning Outcome

By the end of this lecture, each participant will be able to:

- Recognize history of evolution of Risk Management

- Define Risk Management in Health Care

Babylonian code of Hammurabi
4000 years ago
 Babylonian code of Hammurabi
4000 years ago
• If a physician operates on a man for a sever wound
with a bronze lancet and causes a man’s death or
opens an abscess in the eye of a man with a bronze
lancet and destroys the man’s eye, they shall cut off
his fingers.
First do no harm

Hippocrates
The Father of Medicine
 The Evolution of Risk Management
1- Insurance Crisis of the 1970s.
2- Report of Institute of Medicine:
“To Err is Human”
- Purpose is to build a safer health care system.
- About one million medical errors \ year in USA.
- More than half of the adverse events resulted from medical errors
that could be prevented
 Institute of Medicine (IOM)
Statistical report

- In 1999/2000

- 98000 American patients die annually due to preventable, avoidable

medical errors.

- Deaths from medical errors are more than deaths due to Road
accidents, AIDS, and Breast Cancers.

- 65% of them were due to poor communication

• This number of deaths is more than that of motor vehicle
accidents, with total cost of $ 17- $ 29 billion ( from preventable
causes)

• The cost is less important than the fact that:

“ No one needs to die or suffer

from preventable medical errors”

.
3. Agency of Health care Research and Quality (AHRQ)

2004-2008

• Increase number of people treated in hospitals for illnesses and injures

from side effects and medication- related injures.

• Report of wrong site surgery.

• Increase number of near misses events in surgical interventions:

Wrong patient, wrong procedure, wrong side, or wrong part

Patient Safety
 Patient Safety “To Err is Human”

• Issue of IOM

• The chief department of NICU at John Hopkin’s hospital

• 80% of neonates in NICU die due to improper hand

washing by healthcare providers.

• Initiation of the check list use due to its importance.

Joint Commission (JC)

- National Patient Safety Goals in 2002

- 13 NPSG’s inside USA only

Joint Commission International (JCI)

- Initiated in 2003

- Mission: To improve Safety and Quality of care

- In 2007: IPSG’s are in Accreditation

- In 2015 & 2017: 6 IPSG’s

- Hospitals should fulfill 100% of IPSG’s to be JCI accredited.

 It is critical to monitor any adverse event from
a quality and legal standpoint
“Proactive Risk Management Program”
Based on common sense to:
1. Improve patient safety
2. Accountability
3. Communication
• At the same time:

You should learn from

mistakes
•In 2011, wrong patient got kidney
transplant in the University of
Southern California Hospital. This
resulted in shut down of the
program after realizing the error.
 Definition of Risk Management
in Health Care
1. An organized effort to identify, assess and reduce ,where
appropriate, risks to patients, visitors, staff, and
organizational assets.

2. A program designed to reduce the incidence of

preventable accidents and injuries to minimize the
financial loss to the institution should an injury or accident
occur.