Introducing and populating risk registers in four clinical units in a teaching hospital – a quality and safety initiative.

Abstract

Robust risk management is critical in reducing preventable errors or adverse events in healthcare. Risk register compilation is one component in the risk management process and allows for risks to be identified that pose a threat to an organisation meeting its objectives. The change project involved the introduction and population of risk registers in four clinical units in a teaching hospital. This led to further compliance with national healthcare policy on risk register implementation throughout the organisation and created a more visible risk profile. Using the Health Service Executive (HSE) Change Model risk registers were introduced by initiating, planning, implementing and mainstreaming the change project. Tools such as force field, Strengths, Weaknesses, Opportunities and Threats (SWOT) and stakeholder analyses were employed. A multidisciplinary project team was established and team meetings were held every two to three weeks until risk registers were introduced. The organisation’s risk register template was made available on the hospital intranet for each unit manager to build the risk register. Workshops were held at clinical unit level and also at senior staff monthly meetings to educate staff regarding risk identification, qualitative analysis and evaluation. Action learning and the Plan, Do, Study, Act cycle were used to achieve implementation. Audit of team members’ knowledge and experience of risk registers showed improved knowledge following the project as was the risk awareness and safety culture of staff following workshops. More time is needed to allow for embedding to occur and an organisational risk register policy would further support a multidisciplinary approach to hospital wide introduction.