Situational Analysis of Risk Management in Female Medical Ward at Hospital in the Northern Region of Thailand

Abstract

Risk management is important to ensure the quality of health services, especially the patient safety. The objective of this descriptive study was to analyze situations of risk management and describe solutions for risk management problems in the Female Medical Ward  at Hospital in the northern region of Thailand,  by studying the documents and information of risk management, interviewing six risk management committee members, and conducting a group meeting of 26 nursing staff working in the Female Medical Ward. Research instruments consisted of semi structured-questions developed from the conceptual framework of the Donabedian model for quality assessment (2003), which includes structure aspect, process aspect, and outcome aspect. Data was analyzed using content analysis.

          The results were as follows:

1. Regarding the structure aspect in the Female Medical Ward, there were risk management policies, which were guided by patient safety. However, they were not successfully implemented, due to the following reasons, there are budget problems, personnel, workplace, difficulty and inconvenience in using quality tools, and lack of knowledge on how to use quality tools. Suggestions included having a variety of clearly laid out channels of communication for risk management policy, preparing for budget, integrating risk management to routine work, assigning proper tasks and personnel according to workloads, and educating nursing personnel on how to use quality tools.
2. Regarding the process aspect, it was found that there are problems at every step of risk management, including risk search, risk assessment, risk management and evaluation. Suggestions included strategies to encourage and improve assessing and reporting risk, having risk management handbook or guidelines, having supervision and communication on risk guidelines or managing risk, continuous monitoring, evaluating, and improving risk management, and consistently coordinating a multidisciplinary team.
3. Regarding the outcome aspect, it was found that the planned outcomes were not achievable. Suggestions included encouraging staff to report incidents, monitoring risk reporting of staff for every shift, urging data recording, promoting a positive attitude toward reporting, and monitoring risk management indicators every month.

            The results patient safety  this study can be used by the hospital and nurse administrators to improve the risk management system in Female Medical Ward.