Risk identification can be defined as the process of establishing either anticipated or existing risks along with their characteristics and outcome possibilities. The main objective of risk identification is to come up with a list of all possible risks in an area.
In a scenario where a mother took her 4.5 month old child to emergence room and found to be having inguinal hernia, amongst the risks that could be identified include hernia itself, pains, delayed surgery, and discharging the child before accomplishing the recommended abdominal flat plate as ordered by a surgical consultant.
However after coming up with a list of risks, the next step in most cases depends on the nature of the risk (Kavaler & Spiegel, 2003).
Risk analysis involves definition as well as outlining dangers brought by the risk to either individual, government agencies or businesses. According to Kavaler & Spiegel, 2003 medical risks analysis can be of great help in aligning medical related objectives with the hospitals objectives. This analysis can either take quantitative or qualitative form.
For quantitative analysis, risks are analyzed numerically with the aim of establishing the likelihood of adverse circumstances and loses that might occur as a result of the event. However most risk analysis processes take qualitative form, as it does not use numerical probabilities along with loss predictions.
Qualitative analysis involves threat definition, vulnerability establishment as well as coming up with countermeasures in case of risk occurrence.
Qualitatively, hernia is abdominal defect that allows intestines to start sticking through a hole, it forms a noticeable bump. Intestines go back and come out again at other time; hence one runs the risk of the intestine becoming incarcerated.
Fundamentally in case this stacking happens, there are risks of cutting off the supply of blood to intestines, which might lead to the dying of intestines. In case this stage is reached, then more complicated surgery will be recommended (Kavaler & Spiegel, 2003).
Inguinal hernia has been found to affect mostly men of all ages, though peak incidences occur in the newborn, the aged, as well as young adults. According to the national survey research carried out in 1960, “hernias occur at a rate of 15 per 1000 population” (Washington, DC; Department of Health, Education and Welfare, 1960).
Till then, inguinal surgical repair occur at a very high rate in the field of healthcare. This is because; around 700,000 herniorrhaphies are carried out in the United State year after year.
Inguinal hernia along with hernia repair has lots of implications on the patients’ life quality and may also have substantial effects on informal caretakers. This is so when putting in mind that most patients suffering from inguinal hernia ends up being discharged just the very day the surgical operation took place.
As a result, a large percentage of recovery process occurs under home management. Though this has been occurring every now and then, there has been no risk management plans to assess the effects of this condition, as well as the effects of the type of surgical operation on patients as well as caretakers.
The effect of inguinal hernia on caretakers can be seen on the time as well as their concerns towards the patient’s activities, even after surgical operation has been done. Nevertheless, family members and caretakers living with the patient spend more time and efforts to ensure that chores are completed.
It has been indicated that few days after surgical operation, most caretakers and family members find it very hard to manage the situation; as a result it is necessary to provide support in the provision of homecare.
On the side of hernia patients, they experience chronic pains after surgical operations for hernia repair; as a result there is need for painkillers. However to prevent these pains it has been proposed that the surgeon should cut ilioinguinal nerves though this might lead to numbness.
In addition pains occur in case scar tissues are formed around the mesh, hence impinging nerves. This condition can either be treated by undergoing through another surgery or taking painkillers regularly. It has been argued that “The risk of chronic pain as a complication of hernia surgery increases 4-fold in operations for recurrent hernia, reflecting the technical difficulty and increased risk of nerve damage” (Medscape.org, 2011).
Moreover these pains have made many hernia patients to stop going to work, inability to climb stairs and standing for a longer time. In addition, “For some this caused a significant reduction in work and leisure activities and pain also affected their sleep, relationships with other people, mood and enjoyment of life” (Medscape.org, 2011).
Apart from pains, numb complications may also occur as a result of hernia surgery. This risk may arise after pain causing nerves have been deliberately or inadvertently cut. This problem is usually experienced in different positions of lower abdominal parts, depending on the types of nerves that were cut.
In people’s bodies, nerves and other internal parts like intestines are positioned differently; hence it is very hard for the surgeon to ascertain the position of every part. In case numbs have been cut, then the results will be numbness.
In situation where surgery is delayed, there are many risks that might occur. For instance, there might be incarcerations and triangulations. In case this stage is reached, emergency surgery has to be administered to the patient in spite of medical conditions and concomitant medication of the patient. However, in case this is not administered, there are higher chances that the patient will die, just as a 4.5 month old boy.
Risk Control Treatment selection with Implementation Plan
In controlling risks associated with hernia, the management can use positive as well as negative economic incentives for surgeons to be much careful when dealing with a hernia patient. Fines together with work standards should be used in encouraging this carefulness. However there should be sufficient proof to confirm that the surgeon was negligent; otherwise there will be individuals who will start playing other games.
Another control measure is ensuring that clinical staffs are engaged in activities of supporting the patients as well as caretakers with home based care after surgery operations.
This will be of great help particularly in helping patients undertaking home recovery, reducing anxiety among caretakers and improving their life quality in a family. This is because, most caretakers and family members of hernia patients have been looking for ways through which they can be informed on ways of reducing serious issues of concern.
To implement these control treatments Haimes, 1998) identified that the following risk management plan will be of great help in defining the implementation process.
- Assignment of roles and duties. In this step, different practitioners or people will be given different tasks as well as roles to play in the implementation process. For instance, who will be carrying out surgeries and who will be supporting home based recovery.
- Budget provisions for the activities involved in risk management. The risk management department should come up with a budget to be approved by the organization management. The department should be tracking out its actual expenses, and compare them with budget numbers that were approved by the management.
- Coming up with a risk management schedule. This should be revised in a manner that it includes time period required to undertake all activities of risk management over the life cycle of the project being undertaken. Good plans are always time bound after which their outcomes are evaluated and if possible revised or changed.
- Risk categorization; this will involve putting risks in different groups; this is mainly used when the organization is identifying potential risks. This is very helpful particularly in organizing and prioritizing identified risks. On the other hand the main source of risk categories can be the risk breakdown structure.
Risk Control Treatment Monitoring
After developing risk management plan, it is of great importance to monitor this plan through formal reviews, system testing as well as plans. Some tools that might be used in the monitoring process include consulting support workers, checklists, risk register, diagramming techniques and arranging case review meetings.
The support workers should always be consulted to provide more information concerning the efficiency of the loss prevention plan. This is because; they are the ones going to the field always.
Support workers have to be monitored and informed on the risks that involve hernia whenever they are going to see the client at his or her home. Support workers should also bring in feedbacks on what they have done and the patients’ response.
The most important tool in risk control treatment monitoring is through review meetings facilitated by risk control coordinators. This will include support workers, other stakeholders as well as volunteers involved in process of managing risks.
This will provide an avenue for everyone to air his or her views concerning how the plan is being implemented and other options through which the plan can be implemented and improved. This will be of great help particularly in reviewing the plan to make it more effective.
Checklists analysis can also function as a monitoring tool. Checklists highlight all possible risks that might have occurred at a particular place, and how the risk management plan has been applied in such circumstances.
This can be used to evaluate the level at which the plan has been either effective or ineffective in different circumstances as listed in the checklists. The management can use checklists to monitor their risk management plan (Borodzicz, 2005).
Diagramming techniques like cause and effect diagrams can also be helpful in uncovering how the plan has been implemented in a manner that cannot be described verbally. Another tool is checking the risk register which contains risk analysis as well as response plans. This will show how effective or ineffective the plan has been in particular areas.
Borodzicz, E. (2005). Risk, Crisis and Security Management. New York: John Wiley.
Haimes, Y. (1998). Risk Modelling, Assessment and Management. New York: John Wiley.
Kavaler, F. & Spiegel, D. (2003). Risk management in Health Care Institutions a strategic approach, (2nd Ed). New York: Jones & Bartlett Publishers.
Medscape.org. (2011). Inguinal Hernia: Anatomy and Management. Web.
Washington, DC; Department of Health, Education and Welfare. (1960). National Health Survey on Hernias. Series B, No. 25.