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UBC Theses and Dissertations

Risk management : a descriptive analysis as a basis for planning in British Columbia acute care hospitals Mysak, Marlene Hope


During the past five (5) to seven (7) years, the American hospital literature has reflected a growing interest in the concept of Risk Management. Today, Risk Management, as an administrative control mechanism, is well established in many hospitals in the United States. Risk Management focuses on a system of identifying, monitoring and taking corrective action for potential or actual problems (the risks) that may result in unwarranted and unplanned personal injury, property damage, or other form of loss. Ultimately, Risk Management is concerned with the hospital's overall objectives of providing safe, quality patient care while using available resources efficiently. The expression, Risk Management, has not been defined with any regularity or consistency with respect to British Columbia Acute Care Hospitals. A generalized concept of protection against risks has been evident for many years, although in Canada (and specifically, British Columbia), it has been approached functionally. For example, hospital administrators have been accustomed to providing a safe and secure environment through such means as guidelines, accreditation standards and quality assurance. In addition, they are obligated to consider legal issues relating to hospital care and to obtain appropriate insurance coverage for the various types of losses the hospital might be exposed to. A new interest in Risk Management appears to represent a possibly defensive position taken by those who anticipate increasing amounts of risk and subsequent litigation. The question to be studied in this paper is whether there is any need for British Columbia Acute Care Hospital Administrators to move from their present rather pragmatic decision-making process for problem solving in selected areas to the more assertive and defensive approach of Risk Management. The answers were be sought by: 1. Reviewing the pertinent American literature on risk management. 2. Considering whether this presented an applicable approach to the British Columbia situation by: a. reviewing pertinent Canadian (and specifically British Columbian) literature on the same topic. b. reviewing Canadian (and specifically British Columbian) health services against their ideological background. 3. Discussing selected Risk Management considerations with: a. British Columbia legal experts in the health field. b. British Columbia insurance experts in the health field. 4. Discussing selected Risk Management considerations vis a vis present practices and procedures with hospital administrators (at senior and department head level) in two (2) British Columbia Community General Hospitals and covering three (3) hospital departments. The information collected from these interviews was presented in a case study format. The discussions focus on the major differences between the Canadian and American hospital industries. In addition, the variances between the findings in the literature review and the responses by the case study participants will be described. The analysis will draw conclusions about the need for British Columbia hospital administrators to change their present practices and move to a system of Risk Management. Recommendations for planning the introduction and evaluation of Risk Management in British Columbia Acute Care Hospitals are presented at the end of the study.

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