According to the first question in this study, healthcare organizations may face risks that may prevent the mission and achievement of the organization`s objectives, so the first step in risk management should identify risk resources with optimal tools.17 In this study, using an innovative approach, a framework for identifying and classifying risks at the executive levels of HCOs was proposed. The proposed framework consisted of three stages of inputs, processes and outcomes. Interview with experts,32,53 Questionnaire design,32,61 Delphi or Expert method,60 and focus group,38,44,46,49-51,53 identified a method applied for risk assessment at the level of OHC management. Based on certain risk assessment models, the effective causes and causes of errors are identified during this phase. The choice of risk criteria may also depend on the results of risk analysis and risk assessment.60 In healthcare, the risks of defective equipment and other hazards, medical malpractice, and procedures may vary, but are not limited to. Managing these and other risks is essential in the healthcare industry to keep people safe and reduce costs. Once risk management strategies are in place, hospitals, long-term care facilities and other health care organizations can minimize the risk of loss. Mitigation: Reduce the likelihood of risk occurring or the impact of the risk. Low-level tools: At this level, risk assessment tools assess the limited range of risk scenarios, but with more detail for the business. Some of the risk assessment tools used at this level are: Preliminary Risk Analysis Method (PRA),34 Defect Tree Analysis (ALE),54 Change Risk Assessment Model (CRAMS),46 Change Analysis (CHA),46 Human Reliability Assessment (HRA),8 Pareto Analysis (PA),26.30 Relative Classification/Risk Indexing (IR), 32.60 Technique 5 whys,8,36 Hazard Control Lists (HCl),35 Change Analysis (CA), 28 Strategic Risk Analysis (RAS).31 Risk management is the process of analyzing existing processes and practices, identifying risk factors and implementing procedures to manage those risks. Risk management in healthcare can mean the difference between life and death, making the stakes much higher. In some ways, managing healthcare risks is potentially more important than in any other industry. (i) studies on organisational management mechanisms and evaluation techniques and frameworks in health organisations or related organisations which may be imitated in the health organisation; (ii) articles in English; (iii) from 2000 to October 2018.
Reviewing other studies is one way to develop risk management programs. Compliance with guidelines from government organizations such as the Department of Health and Human Services, the Food and Drug Administration (FDA), and the American Society for Healthcare Risk Management (ASHRM) ensures compliance with risk management. As mentioned earlier, risk management plans are specific to different healthcare facilities. While it is a concern to avoid potential financial consequences, patients` needs are usually paramount. In clinical trials, for example, Institutional Review Boards (IRBs) monitor proposed research plans before they are implemented to ensure minimal risk to humans. Risk management plans should cover patient-specific risks and be well documented; They must also be accessible to those who work with patients. Risk management is important for all types of organizations, but it is especially important in healthcare because human lives are at stake. A good healthcare risk management plan can reduce patient health risks, as well as financial and liability risks. As always, a good risk management plan must be developed, implemented and monitored, regardless of the line of business. The number of outcome studies was not significant for the study period (2000-2018). The result of most studies was also partial and lacked the necessary completeness.
Most studies focused on risk identification and assessment and neglected the risk treatment and monitoring phases. Future studies must therefore be conducted with a holistic view of the risk management process in healthcare organizations. The applied objective of this study was to integrate existing research on the different areas of the RM cycle (risk identification, risk assessment and risk management) and ultimately to provide a centralized knowledge base for future research at the executive levels of THECS. It should be noted that the ohc leadership levels are the headquarters and deputies of the health authorities who provide advice and control over the health care units. For example, the Centers for Disease Control (CDC) recently published a study that found that prolonged use of urinary catheters is the main risk factor for catheter-associated urinary tract infections. Based on this information, a risk management plan has been implemented that requires physicians to regularly assess the catheter. The end result was a decreased risk for patients. This phase included the definition and implementation of measures to mitigate the identified level of risk and to verify that the residual risk level is acceptable.27 A general framework for RM should be established before implementing the risk process. This framework determines the organization`s strategy for identifying risks, assessing risks, and mitigating risks.13 This strategy describes how the RM process is to be implemented in the organization. It determines the resources required, the key roles and responsibilities in this regard, and how risks are to be identified. It shows what the decision-making process looks like using these strategies.13 The available evidence suggests that, despite the existence of a large number of RM techniques, some of them have been used in CMTs to date.14-16 In summary, it is essential to standardize the approach to health system efforts to improve safety, the quality and effectiveness of health care.
Risk prioritization strategies or a systematic approach to education, the use of risk stratification tools, and decision support or performance reporting have all been shown to be effective. We expect that the introduction of such systematic improvements will help coordinate the complex and interdisciplinary delivery of health care in order to apply existing knowledge to routine health care in order to improve health. Based on the results of the studies, a simple and comprehensive framework for RM in THE MANAGEMENT LEVELS OF CSOs was proposed. The proposed framework for this study consists of five phases, the main phases of which are adapted from the ISO13000 framework. Below is a framework and proposed techniques that can be used to implement risk management processes at the OHC management level. Finally, Table 5 examines the extent to which risk management is established in health care organizations based on the key phases of the proposed framework. Mid-level tools: Implementing risk assessment tools at this level provides the organization considering risk scenarios with modest information and detail. Some risk assessment tools used at this level are the Health Failure Mode and Effects Analysis (HFMEA), 25,42,50 HFMEA/FMEA/FMEA,8,25,26,28,30,37,38,49 Root Cause Analysis (CAR),38,43,50 Bowtie Model,48,51 Hazard and Operability Analysis (HAZOP).35 In general, the risk management scope required stability, but there are no robust and comprehensive risk assessment and risk management techniques fully applied to risk management in organizations.35 In general, the risk management framework has required stability, but there are no robust and comprehensive risk assessment and risk management techniques fully applied to risk management in organizations. can be. and managers of healthcare organizations must make the necessary decisions to determine the optimal risk management and assessment tool at a given time and based on the specific conditions and positions of the organization.
Therefore, Table 5 shows the limitations, strengths and weaknesses, as well as the factors that influence the choice of individual risk management and risk management models at the CSO management levels. Therefore, the content of this table can help risk analysts, health managers and other stakeholders make rational decisions about identifying risk management and assessment models at the OHC management levels. .