Forty-plus years on from the recommendations of the Robens Committee’s for the improvement work place safety, were enacted in the Health and Safety at Work Act 1974 (HSAWA), the concept of risk assessment is well and truly embedded into healthcare quality management culture. The ongoing development and improvement of Healthcare services outlined in Building a Safer NHS; An Organisation with a Memory and A First Class Service focuses upon ways to prevent accidents or adverse incidents occurring and ensuring that when the worst happens lessons are learned and measures to prevent re-occurrences are introduced.
Official Definitions
Using the definition of the Health and Safety Executive, an accident is “any unplanned event that resulted in injury or ill health of people, or damage or loss to property, plant, materials or the environment or a loss of business opportunity”. Clearly ill health, damage and loss are not desirable incidents, ideally they should be avoided whenever possible. Within the spirit of Health and Safety regulations prevention is better than cure and the ‘go to’ technique for the prevention undesirable events is Risk Assessment.
Since the introduction of the Health and Safety at Work Act 1974 (HSAWA) records show that workplace safety has increased, proving that as required in this legislation by taking a proactive approach to identifying hazards (potential sources of harm or adverse health effects on a person or persons’) and managing the associated risks (probability or threat of damage, injury, liability, loss, or any other negative occurrence that may be avoided through pre-emptive action) will lead to increased safety and well-being for staff and patients.
Risk Assessment in the Management Process
In practical terms risk assessment is central to the management process of virtually every aspect of healthcare provision. It features in the planning, leading, monitoring and controlling processes for quality management. All policy writing should involve an element of risk assessment, with a focus on what the policy aims to achieve, what could go wrong and any adverse impact.
With this in mind risk assessment has a part to play in:
- Team selection;
- Training;
- Induction;
- Clinical supervision;
- Communications with patients;
- Financial management;
- Blood and saliva management;
- Computer display equipment;
- Quality Control etc.
In each area listed above and any other areas in which hazards are identified it is important to identify:
- Who is at risk?
- Any controls already in place.
- The likelihood and severity of the risk.
A risk assessment is a judgement about how a combination of circumstances impact on safety and wellbeing. In some cases this judgement can only be made accurately by someone with expert knowledge. The risk assessment judgement will focus on the likelihood and severity of the harm linked to the risk.
- The likelihood of harm can be assessed as Unlikely, Possible or Likely;
- The severity of harm can be assessed as Minor, Moderate, or Major.
When the harm is assessed as being -Likely and the severity -Major the activity should be suspended until control measures can be put into place to make the activity safer.
Reaping the Benefits
The benefits of risk assessments are greatest when they conducted by people with practical hands-on experience of the area being assessed, rather than a manager or supervisor who is not engaged in the activity. Whenever possible this activity should be covered by more than one individual, to add differing perspectives to the process. This could be an area Lead, a subject expert and an operator. Effective risk assessments are excellent investments in the welfare of patients and staff as well as in the success of the business.
