Good risk assessment practice in hospitals

Risk assessment is essential to ensure safety in hospitals. However, hospitals have paid little attention to risk assessment. Several problems have already been identified in the literature about current risk assessment practice, such as inadequate risk assessment guidance and bias in risk scoring. This research aimed to improve current risk assessment practice in hospitals in the National Health Service (NHS) in England. To address this aim, the research investigated current risk assessment practice and designed a new risk assessment approach by the use of mixed methods. One hundred hospitals’ risk assessment documents were reviewed to examine the current recommended risk assessment practice. Seventeen interviews and sixty-one questionnaires were conducted, a risk management system from a single hospital was reviewed, and strategic risks from thirty-four hospitals were reviewed, in order to examine how risks are assessed in actual practice. Following that, the proposed approach was designed by conducting requirements analysis and then evaluated by interviews and questionnaires with ten healthcare staff. The findings of this research reveal that hospitals conduct risk assessments in different ways (i.e. with a focus on individual patient-based, operational and strategic risks). There are also many problems involved in current risk assessment practice regarding both the foundations and use of risk assessment. For example, organisation-wide risk assessments predominantly rely on risk matrices which might lead to wrong risk prioritisation and resource allocation; and risks tend to reflect existing or past problems rather than being proactive. All these reveal a need to improve current risk assessment practice. This research makes an important contribution to the current understanding of risk assessment practice in hospitals by providing extensive evidence on both recommended and actual practice, and proposes a new risk assessment framework. The framework guides healthcare staff on how to conduct risk assessment in a more comprehensive way by encouraging its potential users to consider good risk assessment practice.

Name dc:type.qualificationname

Doctor of Philosophy (PhD)

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

University of Cambridge

Year dc:date.issued

2018

Author dc:creator

• Kaya, Gulsum Kubra

Advisors dc:contributor.advisor

• Ward, James
• Clarkson, John

• risk assessment
• patient safety
• hospital

Licence

• https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/4c398b80-f083-44b1-b2f6-0853cd4f516c/download
• https://www.rioxx.net/licenses/all-rights-reserved/

Language dc:language

en

Author Identifier

0000-0003-0663-3995

OAI identifier oai:identifier

oai:www.repository.cam.ac.uk:1810/273747