Development of risk inventory for hospitals in India

With the ever-increasing hazards and associated risks in healthcare, the healthcare facilities should have a comprehensive enterprise risk management program. Risk management in Indian Healthcare is nascent and not structured. With the increasing potentially compensable events, workplace violence, cybersecurity threats, complex accreditation standards, old infrastructure and ever-changing legal and political scenarios, the risk inventory is expanding, leading to litigations due to lack of mitigation strategies. This study focuses on developing a comprehensive organization wide enterprise risk inventory for the healthcare facilities in India. Secondary data from published studies were collated and 25 risk factors were identified. Interviews with 12 domain experts further identified 38 context and country-specific risks. The identified 63 risks were sent to 20 senior healthcare risk managers. Forty-three risks were unique and were validated by the senior healthcare risk managers. Twenty risks out of 63 identified had similar meaning. These 20 risks were reworded, rephrased and merged into eight risks by the senior healthcare risk managers. The 51 risks were endorsed by the 12 domain experts. The identified risk factors were surveyed among the risk managers from various hospitals to understand the importance and ranking of the risk in the Indian context. Sentinel events/Never events appeared in different rank orders and seems to be among the top five risks as perceived by professionals in India. Second highest ranked risk was ‘Staff attrition’. The data analysis showed the different attributes of survey participants, such as the size of the organization with respect to bed capacity and length of time working in the field of risk management. The results provide valuable insights into the perception of risk based on hospital size and the educational background of risk managers. This inventory may help hospitals develop strategies for mitigating, controlling and monitoring risks for better hospital management.