Risk identification, assessment and management in public health practice: a practical approach in one public health department.

Abstract

The continuing identification, assessment and management of risks are key themes for clinical governance. These themes are being integrated into both primary and secondary care practice; however, integration into public health practice appears much slower. This paper describes the recent approach that we have taken in Sheffield, and proposes a model for public health departments to identify, assess and manage risks, which complements other risk management processes and is transferable to other settings. It assumes that public health practice is not a risk-free activity and holds that the process of identifying, assessing and managing risks is a key component to raising standards. A number of risk 'management' models were reviewed and a primary care approach was applied to public health practice. A list of potential risks was identified using a number of methods including reflective practice, information from complaints and/or critical incidents. Risks were assessed by likelihood and impact, and were captured in a risk framework. By March 2002, 21 risks had been identified and characterized, and progress had been made to manage 11 of these risks. This process, and the development of a risk framework, was useful in identifying a prioritized work programme to improve standards of public health practice in this department. This model can also be used not only for planning risk management activities, continual identification and assessment of risks but also to provide inspiration for other clinical governance activities including public health audit.