Moving from reactive to proactive risk management

“Look at the word responsibility—“response-ability” is the ability to choose your response. Highly proactive people recognise that responsibility. They do not blame circumstances, conditions, or conditioning for their behaviour.”

― Stephen R. Covey, Author of The 7 Habits of Highly Effective People

At FV Hospital, patients are at the heart of our services. FV’s staff members are responsible for ensuring the safety of our patients by limiting all risks. To do this, the Risk Management and Patient Safety team work closely with other departments to identify risks. They also facilitate activities which support all aspects of risk management at the hospital. Risk management at FV Hospital includes both clinical and administrative systems. Many processes and reports are employed to detect, monitor, assess, mitigate, and prevent risks. The aim of this process is to ensure that risks are identified early, and the best way to deal with them carefully assessed. In addition, FV’s staff members each take on the role of identifying and reporting safety issues immediately to reduce the likelihood of the same risk occurring again. The overall aim is to identify factors which might negatively impact our hospital in providing quality, safe and effective healthcare services. There are two ways of managing risks: proactive and reactive risk management.

• Reactive risk management is a response which is dependent on accident evaluation and investigation.
• Proactive risk management is an adaptive strategy based on measurement and observation.

To be more specific, proactive risk management combines a mix of past, present and future evaluation before finding solutions to avoid risks. For FV Hospital, a place which strives to consistently achieve the top level of safety culture possible, proactive risk management should be practised continuously, rather than merely managing risks driven by events. However, moving from reactive to proactive management is quite challenging. At many hospitals, despite committed widespread efforts to assess and improve processes, lots of patients still suffer preventable harm every day. Hospitals find improvement difficult to sustain, and they suffer “project fatigue” because so many problems need attention. No hospitals or health systems have achieved consistent excellence throughout their institutions. “Collective mindfulness” is the most compelling way for organisations to mitigate safety issues. “Collective mindfulness” creates an environment in which all workers look for and report small problems or unsafe conditions before they pose a substantial risk to the organisation. Collective mindfulness is one of two specific mindfulness theories, the other being individual mindfulness. Individual mindfulness is when a staff member thoroughly understands the overall state of operations, and is equipped with the necessary skills to identify errors and processes which need improvement. Collective mindfulness extends from individuals to teams and is when the entire organisation is operating “mindfully”, making critical adjustments in a timely manner to manage the unexpected in a challenging and highly competitive environment. “Collective mindfulness” also provides a mental orientation, enabling continuous learning and evaluation by leaders. In this way, staff can be proactive in identifying potential errors or unsafe conditions before they pose substantial risk. In hospitals, reliability and general awareness of possible dangers are essential and taking anything for granted is risky. Therefore, in all activities, FV Hospital trains staff to anticipate what might happen, and what would be the preferred outcome. At every level, we take action to prevent risks, promote mindfulness and prime our network to respond promptly to ensure the most safe environment possible for our patients.