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Leadership and Management > Risk management > Flashcards

Risk management Flashcards

1
Q

What percentage of claims do paediatrics make up?

A

2% NHSLA 2016

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2
Q

What percentage of value of claims do paediatrics make up?

A

8% NHSLA 2016

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3
Q

What is a hazard?

A

Situations with the potential to cause harm. NPSA 2007

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4
Q

What is a risk?

A

A risk is the combination of likelihood and consequence of a hazard being realised. NPSA 2007

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5
Q

What is a clinical risk?

A

The chance of an adverse outcome resulting from clinical investigation, treatment or patient care. NPSA 2007

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6
Q

What is risk management?

A

Analysing the causes of errors and limiting the incidence of errors … creating systems better able to tolerate the occurence or errors. Ernstmann 2009

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7
Q

What is the risk score in the case study?

A

Risk score = conseuqnece x likelihood (NPSA 2007)
High risk = possible x major
12 = 3 x 4

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8
Q

What is leadership?

A

Leadership is a process whereby an individual influences a group of individuals to achieve a comon goal (Northouse 2010)

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9
Q

What is a transformational leader?

A

A transformational leader is a leadership style where the leader, by example, inspires followers to reach their full potential and be the best they can be (Steaban 2016)

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10
Q

What is a manager?

A

Managers plan, allocate resources, administer and control (Gill 2005)

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11
Q

What is the managing risk theory called?

A

Systems safety in healthcare (Vincent et al 2013)

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12
Q

What is systems safety in healthcare based on?

A

James Reason (2000) -> London protcol (Vincent et al 2013) -> NPSA (2010a) Contributory factors analysis tool

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13
Q

What is the Contributory factors analysis tool used for?

A 
Incident investigations (NPSA 2010a)
Identify latent conditions which underpin active failures (Vincent et al 2013)
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14
Q

What are the 6 factors from the root cause analysis?

A

Pirate traitors can walk over edge

  1. Patient Factors
  2. Task Factors
  3. Communication
  4. Work environment
  5. Oranganisational
  6. Education/training
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15
Q

What are the patient factors and why are they important?

A
  1. Seriousness of condition - septic shock in patients with febrile neutropenia most common cause of death in childhood cancer (Wright and langford 2010)
  2. Age related issues - age 13, parent not present, unable to explain need for antibiotics
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16
Q

What are the task factors and why are they important?

A
  1. Guidelines either not there or not adhered to - re: what to do if no IV giver
17
Q

What are the communication factors and why are they important?

A
  1. Lack of info to patients - re: no IV giver
  2. Ineffective communication to staff up, down and across - did staff who accepted patient know there was no IV giver? Could paeds oncology or A&E have started IV antibiotics?
18
Q

What are the work environment factors and why are they important?

A
  1. Inappropriate skill mix

2. Low staff/patient ratio - shortage of staff Band 2, 4, 5, 6, 7

19
Q

What are the organisational factors and why are they important?

A
  1. Lack of risk management plan - re: no IV giver
  2. Acceptance/toleration of inadequate adherence to current practice - acknowledgement that this could be precursor to a worse event
20
Q

What are the education/training factors and why are they important?

A
  1. Lack of knowledge - re: neutropenic sepsis

2. Lack of skills - re: IV giving

21
Q

What are the professional considerations?

A
  • NMC (2015) Duty of candour

- NMC (2015) The code - “recognise and work within the limits of your competence”

22
Q

What are the ethical considerations?

A
  • Non-maleficence is the principle of causing no harm (Beauchamp and Childress 2013) - importance of risk management and of not allowing patient to progress into neutropenic sepsis
  • Beneficence is the principle of acting to benefit other people (Beauchamp and Childress 2013) - find a way to give IV antibiotics
23
Q

What are the legal considerations?

A

Civil law - three elements to prove negligence - Dixons and Evans 2006)

  1. Duty of care
  2. Breach in duty of care by ommission or comission (e.g. not giving IV antibiotics)
  3. Causing forseeable harm
24
Q

What are the policy considerations?

A

A promise to learn (Berwick 2013)

  1. Patient safety above all other aims - ward metrics show patients think safety is variable
  2. Listen to patients and carers at all times - ward metrics show not listening or communicating to patients or carers
  3. Embrace transparency
25
Q

What are the 3 barriers you have chosen to discuss?

A
  1. Short staffed
  2. Low training budgets
  3. Culture
26
Q

Why is being short staffed a barrier and how can it be overcome?

A
  1. Nationwide vacancies
  2. Cap on agency nurses - £0 budget in case study
  3. Low morale

Transformational leader has the power to convince staff to stay and improve morale or those who remain and encourage new people to join the ward

27
Q

Why is being low training budgets a barrier and how can it be overcome?

A

£144 budget in case study

  1. Recession/financial cuts
  2. Cost of covering training hours
  3. Current pressures - low priority, reactive not proactive

Manager plans and allocates resources

28
Q

Why is culture a barrier and how can it be overcome?

A
  1. Auditing - staffing levels, skills mix etc
  2. Levels of maturity with respect to a safety culture (MAPSAF 2006), this ward is showing reactive i.e. do something when they have an incident, rather than generative or proactive i.e. identify risk before and plan ahead

Transformational leader would encourage generative practice and inspire the same attitude in others

29
Q

What implications does this have for your own practice?

A
  1. No blame culture
  2. Transformational leader
  3. Think more about what could go wrong, preoccupation with risk like high risk organisations e.g. aerospace
  4. Encourage risk management as saves money which could benefit the NHS in other ways

Leadership and Management (1 decks)

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