WorldWideScience

Sample records for care risk management

  1. Risk Management for Point-of-Care Testing

    Science.gov (United States)

    2014-01-01

    Point-of-care testing (POCT) is growing in popularity, and with this growth comes an increased chance of errors. Risk management is a way to reduce errors. Originally developed for the manufacturing industry, risk management principles have application for improving the quality of test results in the clinical laboratory. The Clinical and Laboratory Standards Institute (CLSI), EP23-A Laboratory Quality Control based on Risk Management guideline, introduces risk management to the clinical laboratory and describes how to build and implement a quality control plan for a laboratory test. A simple, unit-use blood gas analyzer is utilized as an example for developing a laboratory quality control plan. The US Centers for Medicare and Medicaid Services (CMS) has revised the Clinical and Laboratory Improvement Amendments (CLIA) interpretive guidelines to provide a new quality control option, individualized quality control plans (IQCP), for decreasing the frequency of analyzing liquid controls from two levels each day of testing to manufacturer recommended frequencies in conjunction with a device’s built-in internal control processes and the risk of error when testing with that device. IQCPs have the advantage of allowing laboratories the flexibility to adopt alternative control processes in concert with traditional liquid controls to improve efficiency and cost effectiveness while providing optimal quality POCT results for patient care. PMID:27683462

  2. Managing corporate governance risks in a nonprofit health care organization.

    Science.gov (United States)

    Troyer, Glenn T; Brashear, Andrea D; Green, Kelly J

    2005-01-01

    Triggered by corporate scandals, there is increased oversight by governmental bodies and in part by the Sarbanes-Oxley Act of 2002. Corporations are developing corporate governance compliance initiatives to respond to the scrutiny of regulators, legislators, the general public and constituency groups such as investors. Due to state attorney general initiatives, new legislation and heightened oversight from the Internal Revenue Service, nonprofit entities are starting to share the media spotlight with their for-profit counterparts. These developments are changing nonprofit health care organizations as well as the traditional role of the risk manager. No longer is the risk manager focused solely on patients' welfare and safe passage through a complex delivery system. The risk manager must be aware of corporate practices within the organization that could allow the personal objectives of a few individuals to override the greater good of the community in which the nonprofit organization serves.

  3. Medical Assistant-based care management for high risk patients in small primary care practices

    DEFF Research Database (Denmark)

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective.......77) and general health scores (EQ-5D +0.03, CI 0.00 to 0.05) improved significantly at 24 months of intervention. Intervention costs summed up to 10 United States dollars per patient per month. Limitations: Limitations included a small number of primary care practices and a low intensity of intervention......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2...

  4. [Outsourcing in long-term care: a risk management approach].

    Science.gov (United States)

    Guimarães, Cristina Machado; Carvalho, José Crespo de

    2012-05-01

    This article seeks to investigate outsourcing decisions in supply chain management of healthcare organizations, namely the motives and constraints behind the decision, the selection criteria for activities to be outsourced to third parties, the type of possible agreements, and the impact of this decision on the organization per se. A case study of the start-up phase of a Long-term Care unit with an innovative approach and high levels of customization was conducted to understand the outsourcing process in a start-up context (not in the standard context of organizational change) and a risk evaluation matrix was created for outsourcing activities in order to define and implement a performance monitoring process. This study seeks to understand how to evaluate and assess the risks of an outsourcing strategy and proposes a monitoring model using risk management tools. It was shown that the risk management approach can be a solution for monitoring outsourcing in the organizational start-up phase. Conclusions concerning dissatisfaction with the results of outsourcing strategies adopted are also presented.

  5. [Risk management in anesthesia and critical care medicine].

    Science.gov (United States)

    Eisold, C; Heller, A R

    2017-02-16

    Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are continuing staff education, algorithms and standard operating procedures (SOP), working according to the principles of crisis resource management (CRM) and last but not least the continuous work-up of mistakes identified by critical incident reporting systems.

  6. Implications of Risk Evaluation and Mitigation Strategy (REMS) programs for managed care pharmacy.

    Science.gov (United States)

    Gandhi, Gaurang; Chon, Ashley; Johnson, Nik; Kidder, Phyllis A; Lee, Peter; Leung, Kevin; Ma, Ingrid; Ness, Stacey; Sampsel, Elizabeth; Schlaifer, Marissa; Seifert, Randall; Sternaman, Debora B

    2012-04-01

    In the last 2 decades, health care management has been challenged by more aggressive therapy, the increased number of specialty medications, and more stringent guidelines to monitor adverse events or health risk. To promote patient safety, various communication requirements are mandated to increase the risk awareness of patients and physicians. These include black-box warnings, "Dear Health Care Provider" letters, U.S. Food and Drug Administration (FDA) Talk Papers, MedGuides, and Risk Minimization Action Plans (RiskMAPs).

  7. Suicide risk in primary care: identification and management in older adults.

    Science.gov (United States)

    Raue, Patrick J; Ghesquiere, Angela R; Bruce, Martha L

    2014-09-01

    The National Strategy for Suicide Prevention (2012) has set a goal to reduce suicides by 20% within 5 years. Suicide rates are higher in older adults compared to most other age groups, and the majority of suicide completers have visited their primary care physician in the year before suicide. Primary care is an ideal setting to identify suicide risk and initiate mental health care. We review risk factors for late-life suicide; methods to assess for different levels of suicidality; and recent research developments regarding both effective assessment and management of suicide risk among older primary care patients. We highlight that broader scale screening of suicide risk may be considered in light of findings that suicidality can occur even in the absence of major risk factors like depression. We also highlight collaborative care models targeting suicide risk, and recent innovative interventions that aim to prevent the development of suicidal ideation and suicidal behavior.

  8. Risk management dilemmas in dementia care: an organizational survey in three UK countries.

    Science.gov (United States)

    Clarke, Charlotte L; Gibb, Catherine E; Keady, John; Luce, Anna; Wilkinson, Heather; Williams, Linda; Cook, Ailsa

    2009-06-01

    Aims and objectives.  The overall project aimed to understand the variability of the construction of risk in dementia care from the perspective of the person with dementia, family carers and practitioners with the intention of developing negotiated partnerships in risk management. This paper focuses on the objective of identifying the understandings of risk by practitioners. Background.  Risk management can result in a 'safety first' approach to care practices, but this may be disempowering for people with dementia. Design.  This paper describes the results of the first stage of the study: a survey to service managers or equivalent in health, social and voluntary sector care organizations in three countries of the UK. Methods.  Data from this stage was collection by postal questionnaire (n = 46). Results.  Risk was portrayed as a multidimensional concept and clustered around three themes: (1) Risk and Independence, (2) Risk and Resource, and (3) Organizational Risk Management. Conclusions.  Very wide understandings of risk are identifiable, ranging from avoidance of physical harm through to managed risk taking to improve quality of life, and to an appreciation of the impact of organizational and professional patterns of behaviour resulting in harm to the person with dementia. Relevance to clinical practice.  Obtaining information about the perspectives of others may help to illuminate some of the dilemmas experienced by staff in this study, and the development of risk assessment frameworks may assist staff to resolve some of these.

  9. Managing high-risk patients: the Mass General care management programme

    Directory of Open Access Journals (Sweden)

    Dennis L Kodner

    2015-09-01

    Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program

  10. Managing high-risk patients: the Mass General care management programme

    OpenAIRE

    Dennis L. Kodner

    2015-01-01

    The Massachusetts General Care Management Program (Mass General CMP or CMP) was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS) beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each). It started during the first phase at Massachusett...

  11. Legal aspects of orthodontic practice: risk management concepts. Disposing of your orthodontic practice: be careful.

    Science.gov (United States)

    Machen, D E

    1991-05-01

    In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party. Readers' comments may be addressed to Dr. Donald E. Machen, 5801 Beacon St., Pittsburgh, PA 15217.

  12. Legal aspects of orthodontic practice: risk management concepts. The uncooperative patient: terminating orthodontic care.

    Science.gov (United States)

    Machen, D E

    1990-06-01

    In this and succeeding issues of the American Journal of Orthodontics and Dentofacial Orthopedics, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party.

  13. Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities

    Science.gov (United States)

    O'Riley, Alisa; Nadorff, Michael R.; Conwell, Yeates; Edelstein, Barry

    2016-01-01

    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents’ responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting. PMID:27610048

  14. Identifying Primary Care Skills and Competencies in Opioid Risk Management

    Science.gov (United States)

    Chiauzzi, Emil; Trudeau, Kimberlee J.; Zacharoff, Kevin; Bond, Kathleen

    2011-01-01

    Introduction: Primary care physicians (PCPs) treat a high proportion of chronic pain patients but often lack training about how to assess and address issues associated with prescribing opioids when they are an appropriate component of therapy. The result may be that they may avoid treating these patients, which can lead to an undertreatment of…

  15. Transitioning to routine breast cancer risk assessment and management in primary care: what can we learn from cardiovascular disease?

    Science.gov (United States)

    Phillips, Kelly-Anne; Steel, Emma J; Collins, Ian; Emery, Jon; Pirotta, Marie; Mann, G Bruce; Butow, Phyllis; Hopper, John L; Trainer, Alison; Moreton, Jane; Antoniou, Antonis C; Cuzick, Jack; Keogh, Louise

    2016-01-01

    To capitalise on advances in breast cancer prevention, all women would need to have their breast cancer risk formally assessed. With ~85% of Australians attending primary care clinics at least once a year, primary care is an opportune location for formal breast cancer risk assessment and management. This study assessed the current practice and needs of primary care clinicians regarding assessment and management of breast cancer risk. Two facilitated focus group discussions were held with 17 primary care clinicians (12 GPs and 5 practice nurses (PNs)) as part of a larger needs assessment. Primary care clinicians viewed assessment and management of cardiovascular risk as an intrinsic, expected part of their role, often triggered by practice software prompts and facilitated by use of an online tool. Conversely, assessment of breast cancer risk was not routine and was generally patient- (not clinician-) initiated, and risk management (apart from routine screening) was considered outside the primary care domain. Clinicians suggested that routine assessment and management of breast cancer risk might be achieved if it were widely endorsed as within the remit of primary care and supported by an online risk-assessment and decision aid tool that was integrated into primary care software. This study identified several key issues that would need to be addressed to facilitate the transition to routine assessment and management of breast cancer risk in primary care, based largely on the model used for cardiovascular disease.

  16. [Study of Appropriate Risk Management for People Receiving Care at Home - Actions of the High-Risk People Receiving Care at Home in Times of Disasters].

    Science.gov (United States)

    Hata, Kiyomi; Hata, Masao

    2016-12-01

    Although preparation for frequently occurring disasters is required in the context of preparing a home care environment wherein people reside and receive care, existing preparations cannot be described as sufficient. Therefore, effective preparation has become a research focus. This study aimed to identify the risks faced by people receiving home care in disaster situations and to clarify the risk-related actions taken by various stakeholders in order to study appropriate risk management for people receiving care. We interviewed 8 individuals, including people receiving care and their family members, who were victims in the large-scale disasters associated with the Great Hanshin-Awaji Earthquake(1995)or later, conducted the factorsearch qualitative analysis, and mapped the actions taken by stakeholders. As a result, identified risks were classified into 5 categories and 13 subcategories. Risk actions taken by professionals and others could be elucidated from the stakeholder map. Our findings indicate the necessity of establishing risk management protocols for people receiving home care and preparing in ordinary times.

  17. Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

    Directory of Open Access Journals (Sweden)

    Szecsenyi Joachim

    2011-04-01

    Full Text Available Abstract Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD, patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio, we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey. Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.

  18. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management

    Directory of Open Access Journals (Sweden)

    Monica Zolezzi

    2017-02-01

    Full Text Available Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorst achieved similar knowledge scores, less than half (n = 38, 47% were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32% were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3. Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as major by nursing students. Future integration of interprofessional educational (IPE activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  19. Cost-Effectiveness of the Diabetes Care Protocol, a Multifaceted Computerized Decision Support Diabetes Management Intervention That Reduces Cardiovascular Risk

    NARCIS (Netherlands)

    Cleveringa, Frits G. W.; Welsing, Paco M. J.; van den Donk, Maureen; Gorter, Kees J.; Niessen, Louis W.; Rutten, Guy E. H. M.; Redekop, William K.

    2010-01-01

    OBJECTIVE - The Diabetes Care Protocol (DCP), a multifaceted Computerized decision support diabetes management intervention, reduces cardiovascular risk Of type 2 diabetic patients. We performed a cost-effectiveness analysis of DCP from a Dutch health care perspective. RESEARCH DESIGN AND METHODS -

  20. Cost-effectiveness of the diabetes care protocol, a multifaceted computerized decision support diabetes management intervention that reduces cardiovascular risk

    NARCIS (Netherlands)

    F.G.W. Cleveringa (Frits G.); P.M.J. Welsing (Paco); M. van den Donk (Maureen); K.J. Gorter; L.W. Niessen (Louis Wilhelmus); G.E.H.M. Rutten (Guy); W.K. Redekop (Ken)

    2010-01-01

    textabstractOBJECTIVE- The Diabetes Care Protocol (DCP), a multifaceted computerized decision support diabetes management intervention, reduces cardiovascular risk of type 2 diabetic patients. We performed a cost-effectiveness analysis of DCP from a Dutch health care perspective. RESEARCH DESIGN AND

  1. Risk management.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided.

  2. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals

    Directory of Open Access Journals (Sweden)

    Costello S

    2015-12-01

    Full Text Available Susan Costello School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia Abstract: Female genital mutilation/cutting (FGM/C is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. Keywords: female genital mutilation, female genital cutting, female circumcision, child protection, risk management 

  3. Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events

    Directory of Open Access Journals (Sweden)

    Turakhia Mintu P

    2008-07-01

    Full Text Available Abstract Background Adherence to clinical practice guidelines for management of cardiovascular disease (CVD is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S. general internists and family physicians in regard to cardiovascular risk management, and examine the association between physician characteristics and cardiovascular risk management. Methods A case vignette survey focused on cardiovascular disease risk management was distributed to a random sample of 12,000 U.S. family physicians and general internists between November and December 2006. Results Responses from a total of 888 practicing primary care physicians who see 60 patients per week were used for analysis. In an asymptomatic patient at low risk for cardiovascular event, 28% of family physicians and 37% of general internists made guideline-based preventive choices for no antiplatelet therapy (p Conclusion Despite the benefits demonstrated for managing cardiovascular risks, gaps remain in primary care practitioners' management of risks according to guideline recommendations. Innovative educational approaches that address barriers may facilitate the implementation of guideline-based recommendations in CVD risk management.

  4. Turning Risks into Opportunities in Contract Management: A Case Study in the Health Care Industry

    Directory of Open Access Journals (Sweden)

    Elizabeth McVicker

    2011-01-01

    Full Text Available Problem statement: This case study presented students with a situation based in the healthcare industry, highlighting the importance of contract review, clear communications and interestbased negotiations in order to avoid the costly consequences that could be associated with contract related disputes. The case allowed students to understand how clearly written contracts play a deciding role in the success of business partnerships. Students practiced negotiation skills while discussing the performance clauses of the contract and considering effective amendments to that contract with the purpose of extending a business relationship. Approach: The author interviewed a project manager working for a preferred implementation vendor which had a contract with a large hospital provider in Colorado and California. The purpose of the interview and the case study focused on contract law, contract management, enterprise risk management and negotiation skills. The case study is based on class room use with practical, real-life contract management scenarios. Results: The team projects submitted for this case study in case management highlighted the receptivity of students in understanding the benefit of preserving business relationships, avoiding litigation and carefully wording the specifics of complex contracts. The students excelled in practicing interest-based bargaining skills and writing contract amendments that reflected the specifics of the complex contract problem presented. Conclusion/Recommendations: Case studies focused on real business situations resonate well with upper division students in business law classes; the complexities of the situations and of the contract language did not deter students from brainstorming solutions to the problems presented and in writing amendments to the contract such that the business relationship was preserved. The results of the students’ work on this case study problem were presented to the

  5. Managers' practices related to work-family balance predict employee cardiovascular risk and sleep duration in extended care settings.

    Science.gov (United States)

    Berkman, Lisa F; Buxton, Orfeu; Ertel, Karen; Okechukwu, Cassandra

    2010-07-01

    An increasing proportion of U.S. workers have family caregiving responsibilities. The purpose of this study was to determine whether employees in extended care settings whose managers are supportive, open, and creative about work-family needs, such as flexibility with work schedules, have lower cardiovascular disease (CVD) risk and longer sleep than their less supported counterparts. From semistructured interviews with managers, we constructed a work-family balance score of manager openness and creativity in dealing with employee work-family needs. Trained interviewers collected survey and physiologic outcome data from 393 employees whose managers had a work-family score. Employee outcomes are sleep duration (actigraphy) and CVD risk assessed by blood cholesterol, high glycosylated hemoglobin/diabetes, blood pressure/hypertension, body-mass index, and tobacco consumption. Employees whose managers were less supportive slept less (29 min/day) and were over twice as likely to have 2 or more CVD risk factors (ORs = 2.1 and 2.03 for low and middle manager work-family scores, respectively) than employees whose managers were most open and creative. Employees who provide direct patient care exhibited particularly elevated CVD risk associated with low manager work-family score. Managers' attitudes and practices may affect employee health, including sleep duration and CVD risk.

  6. Safe patient care – safety culture and risk management in otorhinolaryngology

    Directory of Open Access Journals (Sweden)

    St. Pierre, Michael

    2013-12-01

    Full Text Available [english] Safety culture is positioned at the heart of an organization’s vulnerability to error because of its role in framing organizational awareness to risk and in providing and sustaining effective strategies of risk management. Safety related attitudes of leadership and management play a crucial role in the development of a mature safety culture (“top-down process”. A type marker for organizational culture and thus a predictor for an organization’s maturity in respect to safety is information flow and in particular an organization’s general way of coping with information that suggests anomaly. As all values and beliefs, relationships, learning, and other aspects of organizational safety culture are about sharing and processing information, safety culture has been termed “informed culture”. An informed culture is free of blame and open for information provided by incidents. “Incident reporting systems” are the backbone of a reporting culture, where good information flow is likely to support and encourage other kinds of cooperative behavior, such as problem solving, innovation, and inter-departmental bridging. Another facet of an informed culture is the free flow of information during perioperative patient care. The World Health Organization’s safe surgery checklist” is the most prevalent example of a standardized information exchange aimed at preventing patient harm due to information deficit. In routine tasks mandatory standard operating procedures have gained widespread acceptance in guaranteeing the highest possible process quality.Technical and non-technical skills of healthcare professionals are the decisive human resource for an efficient and safe delivery of patient care and the avoidance of errors. The systematic enhancement of staff qualification by providing training opportunities can be a major investment in patient safety. In recent years several otorhinolaryngology departments have started to incorporate

  7. Risk management and security services interaction--a must in today's health care environment.

    Science.gov (United States)

    Stultz, M S

    1990-01-01

    The author shows why risk managers and security directors are natural partners in the effort of a hospital to reduce risks from such occurrences as baby kidnappings, serial killers, thefts, and rapes/sexual assaults.

  8. The Care Manager's Dilemma: Balancing Human Rights with Risk Management under the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003

    Science.gov (United States)

    Prebble, Kate; Diesfeld, Kate; Frey, Rosemary; Sutton, Daniel; Honey, Michelle; Vickery, Russell; McKenna, Brian

    2013-01-01

    In New Zealand, the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 provides diversion for persons with an intellectual disability who have been charged with, or convicted of, a criminal offence. This unique Act moves the responsibility for such "care recipients" from the criminal justice system to a disability sector that…

  9. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model.Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation.Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes.Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  10. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model. Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation. Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes. Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  11. The Impact of Electronic Health Records on Risk Management of Information Systems in Australian Residential Aged Care Homes.

    Science.gov (United States)

    Jiang, Tao; Yu, Ping; Hailey, David; Ma, Jun; Yang, Jie

    2016-09-01

    To obtain indications of the influence of electronic health records (EHR) in managing risks and meeting information system accreditation standard in Australian residential aged care (RAC) homes. The hypothesis to be tested is that the RAC homes using EHR have better performance in meeting information system standards in aged care accreditation than their counterparts only using paper records for information management. Content analysis of aged care accreditation reports from the Aged Care Standards and Accreditation Agency produced between April 2011 and December 2013. Items identified included types of information systems, compliance with accreditation standards, and indicators of failure to meet an expected outcome for information systems. The Chi-square test was used to identify difference between the RAC homes that used EHR systems and those that used paper records in not meeting aged care accreditation standards. 1,031 (37.4%) of 2,754 RAC homes had adopted EHR systems. Although the proportion of homes that met all accreditation standards was significantly higher for those with EHR than for homes with paper records, only 13 RAC homes did not meet one or more expected outcomes. 12 used paper records and nine of these failed the expected outcome for information systems. The overall contribution of EHR to meeting aged care accreditation standard in Australia was very small. Risk indicators for not meeting information system standard were no access to accurate and appropriate information, failure in monitoring mechanisms, not reporting clinical incidents, insufficient recording of residents' clinical changes, not providing accurate care plans, and communication processes failure. The study has provided indications that use of EHR provides small, yet significant advantages for RAC homes in Australia in managing risks for information management and in meeting accreditation requirements. The implication of the study for introducing technology innovation in RAC in

  12. Development of a primary care-based complex care management intervention for chronically ill patients at high risk for hospitalization: a study protocol

    Directory of Open Access Journals (Sweden)

    Beyer Martin

    2010-09-01

    Full Text Available Abstract Background Complex care management is seen as an approach to face the challenges of an ageing society with increasing numbers of patients with complex care needs. The Medical Research Council in the United Kingdom has proposed a framework for the development and evaluation of complex interventions that will be used to develop and evaluate a primary care-based complex care management program for chronically ill patients at high risk for future hospitalization in Germany. Methods and design We present a multi-method procedure to develop a complex care management program to implement interventions aimed at reducing potentially avoidable hospitalizations for primary care patients with type 2 diabetes mellitus, chronic obstructive pulmonary disease, or chronic heart failure and a high likelihood of hospitalization. The procedure will start with reflection about underlying precipitating factors of hospitalizations and how they may be targeted by the planned intervention (pre-clinical phase. An intervention model will then be developed (phase I based on theory, literature, and exploratory studies (phase II. Exploratory studies are planned that entail the recruitment of 200 patients from 10 general practices. Eligible patients will be identified using two ways of 'case finding': software based predictive modelling and physicians' proposal of patients based on clinical experience. The resulting subpopulations will be compared regarding healthcare utilization, care needs and resources using insurance claims data, a patient survey, and chart review. Qualitative studies with healthcare professionals and patients will be undertaken to identify potential barriers and enablers for optimal performance of the complex care management program. Discussion This multi-method procedure will support the development of a primary care-based care management program enabling the implementation of interventions that will potentially reduce avoidable

  13. Prevalence, awareness, and management of CKD and cardiovascular risk factors in publicly funded health care

    NARCIS (Netherlands)

    Verhave, J.C.; Troyanov, S.; Mongeau, F.; Fradette, L.; Bouchard, J.; Awadalla, P.; Madore, F.

    2014-01-01

    BACKGROUND AND OBJECTIVES: It is uncertain how many patients with CKD and cardiovascular risk factors in publicly funded universal health care systems are aware of their disease and how to achieve their treatment targets. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CARTaGENE study evaluated B

  14. Fall-Risk Evaluation and Management: Challenges in Adopting Geriatric Care Practices

    Science.gov (United States)

    Tinetti, Mary E.; Gordon, Catherine; Sogolow, Ellen; Lapin, Pauline; Bradley, Elizabeth H.

    2006-01-01

    One third of older adults fall each year, placing them at risk for serious injury, functional decline, and health care utilization. Despite the availability of effective preventive approaches, policy and clinical efforts at preventing falls among older adults have been limited. In this article we present the burden of falls, review evidence…

  15. Managed care under siege.

    Science.gov (United States)

    Epstein, R A

    1999-10-01

    Managed Care Organizations (MCOs) are frequently criticized for their marketing mistakes. Often that criticism is leveled against an implicit benchmark of an ideal competitive market or an ideal system of government provision. But any accurate assessment in the choice of health care organizations always requires a comparative measure of error rates. These are high in the provision of health care, given the inherent uncertainties in both the cost and effectiveness of treatment. But the continuous and rapid evolution of private health care mechanisms is, in the absence of regulation, more likely to secure access and contain costs than any system of government regulation. State regulation is subject to the risk of capture and to the sluggish and acquisitive behavior of state run monopolies. The proposed fixes for the MCOs (rights to specialists, access to physicians outside the network, guaranteed emergency room access) are likely, when imposed from without, to cost more than they are worth. The long-term risk is that markets will fail under regulation, paving the way for greater losses from massive government control of the health care delivery system.

  16. European Practice Assessment of Cardiovascular risk management (EPA Cardio: protocol of an international observational study in primary care

    Directory of Open Access Journals (Sweden)

    van Lieshout Jan

    2009-01-01

    Full Text Available Abstract Background Despite important improvements in available prevention and treatment, cardiovascular diseases (CVD remain an important cause of morbidity and mortality. Not all high-risk patients and patients with CVD have healthy lifestyles and receive the best possible healthcare. Internationally comparative data are needed to compare cardiovascular risk management in different countries, and to examine the impact of improvement programs and others factors. Objectives This study aims to provide internationally comparative data on cardiovascular risk management provided in primary care and on health-related lifestyles of patients in Europe. The study will also explore the views of doctors and patients on innovative preventive services for CVDs. Design and methods An observational cross-sectional study is planned. In 10 European countries, stratified samples of 36 practices per country will be recruited. In each practice, three samples of 15 patients each will be sampled: patients with coronary heart disease, patients at high risk for CVD, and healthy adult patients. The quality of cardiovascular risk management has been specified in terms of 44 performance indicators that resulted from an international Delphi-procedure with general practitioners. Most indicators are based on medical records, and some on a structured interview with a contact person of the practice. Lifestyle (smoking, physical exercise, diet will be measured with previously validated questionnaires that are completed by patients. Additional measures include practice characteristics and exposure to programs to improve cardiovascular care.

  17. Coupling Direct Collection of Health Risk Information from Patients through Kiosks with Decision Support for Proactive Care Management

    Science.gov (United States)

    Lobach, David F.; Silvey, Garry M.; Willis, Janese M.; Kooy, Kevin R.; Kawamoto, Kensaku; Anstrom, Kevin J.; Eisenstein, Eric L.; Johnson, Frederick

    2008-01-01

    Data collection from patients for use in clinical decision making is foundational for medical practice. Increasingly, kiosks are being used to facilitate direct data collection from patients. However, kiosk-collected data are generally not integrated into the care process. In this project, 4,014 people initiated a kiosk-administered health risk assessment questionnaire using a free-standing public-access kiosk. For 201 of these initiated sessions, kiosk users supplied a Medicaid identification number which allowed their data to be integrated into a regional health information exchange and reviewed by a standards-based clinical decision support system. This system identified 479 survey responses which had been predetermined to warrant follow-up. Notices about these sentinel responses were emailed to care managers and sent to clinical sites. While this study demonstrates the feasibility of collecting and acting on patient-entered health data, it also identifies key challenges to providing proactive care management in this manner. PMID:18999181

  18. Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals.

    Science.gov (United States)

    Costello, Susan

    2015-01-01

    Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries.

  19. Audit of co-management and critical care outreach for high risk postoperative patients (The POST audit).

    Science.gov (United States)

    Story, D A; Shelton, A; Jones, D; Heland, M; Belomo, R

    2013-11-01

    Co-management and critical care outreach for high risk surgical patients have been proposed to decrease postoperative complications and mortality. We proposed that a clinical project with postoperative comanagement and critical care outreach, the Post Operative Surveillance Team: (POST), would be associated with decreased hospital length of stay. We conducted a retrospective before (control group) and after (POST group) audit of this hospital program. POST was staffed for four months in 2010 by two intensive care nurses and two senior registrars who conducted daily ward rounds for the first five postoperative days on high risk patients undergoing inpatient general or urological surgery. The primary endpoint was length of hospital stay and secondary endpoints were Medical Emergency Team (MET) calls, cardiac arrests and in-hospital mortality. There were 194 patients in the POST group and 1,185 in the control group. The length of stay in the POST group, median nine days (Inter-quartile range [IQR]: 5 to 17 days), was longer than the control group, median seven days (IQR: 4 to 13 days): difference two days longer (95.0% confidence interval [95.0% CI]: 1 to 3 days longer, P audit found that the POST service was not associated with reduced length of stay. Models of co-management, different to POST, or with different performance metrics, could be tested.

  20. Project Risk Management Phases

    OpenAIRE

    Claudiu-George BOCEAN

    2008-01-01

    Risk management is the human activity which integrates recognition of risk, risk assessment, developing strategies to manage it, and mitigation of risk using managerial resources. Notwithstanding the domain of activities where they are conducted, projects often entail risks, and risk management has been widely recognized as a success factor in project management. Following a concept clarification on project risk management, this paper presents a generic list steps in the risk management proce...

  1. Managed care demands flexibility, creativity.

    Science.gov (United States)

    1996-05-01

    The definition of hospice care is changing as home care providers come under managed care regulations. Hospice care for AIDS patients is demanding, requiring extra time from home care providers. The managed care cost-cutting measures require creativitity and patience. The Visiting Nurses and Hospice of San Francisco (VNH) has held seminars to help providers adapt to managed care.

  2. [Risk management in health care systems: the new legislative orientations in medical civil responsibility].

    Science.gov (United States)

    Tomassini, A; Signorelli, C; Colzani, E

    2004-01-01

    The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

  3. Management of coronary risk factors by registered nurses versus usual care in patients with unstable angina pectoris (a chest pain evaluation in the emergency room [CHEER] substudy).

    Science.gov (United States)

    Allison, T G; Farkouh, M E; Smars, P A; Evans, R W; Squires, R W; Gabriel, S E; Kopecky, S L; Gibbons, R J; Reeder, G S

    2000-07-15

    This study examined whether nurses could manage coronary risk factors in patients with unstable angina more effectively than physicians practicing usual care. Three hundred twenty-six patients were randomized in the emergency room to a 6-month program of risk factor management by a registered nurse versus participation in usual care. The nurse intervention consisted of a 30-minute counseling visit at 6 to 10 days after the chest pain episode and a second 30-minute session 1 month later. Multiple risk factors were assessed and addressed: smoking, blood lipids, blood pressure, blood glucose, physical inactivity, weight, psychological stress, and social isolation. Compared with usual care, nurse intervention patients significantly reduced both triglycerides (-29 +/- 8 vs 5 +/- 6 mg/dl; p chest pain is feasible and more effective than usual care in terms of fostering lifestyle changes that may lower coronary risk.

  4. NASA's Risk Management System

    Science.gov (United States)

    Perera, Jeevan S.

    2013-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  5. Managing Risks

    DEFF Research Database (Denmark)

    Alaranta, Maria Eliisa; Mathiassen, Lars

    2014-01-01

    the framework supported by their templates is straightforward and the time and resources required are minimal. When properly executed, adoption increases the likelihood of successful merger outcomes; the framework is thus a valuable addition to the management tool box and can be applied in collaboration...

  6. Health care marketing management.

    Science.gov (United States)

    Cooper, P D

    1979-01-01

    Health Care Marketing Management is the process of understanding the needs and the wats of a target market. Its purpose is to provide a viewpoint from which to integrate the analysis, planning, implementation (or organization) and control of the health care delivery system.

  7. Innovations in Quantitative Risk Management

    CERN Document Server

    Scherer, Matthias; Zagst, Rudi

    2015-01-01

    Quantitative models are omnipresent –but often controversially discussed– in todays risk management practice. New regulations, innovative financial products, and advances in valuation techniques provide a continuous flow of challenging problems for financial engineers and risk managers alike. Designing a sound stochastic model requires finding a careful balance between parsimonious model assumptions, mathematical viability, and interpretability of the output. Moreover, data requirements and the end-user training are to be considered as well. The KPMG Center of Excellence in Risk Management conference Risk Management Reloaded and this proceedings volume contribute to bridging the gap between academia –providing methodological advances– and practice –having a firm understanding of the economic conditions in which a given model is used. Discussed fields of application range from asset management, credit risk, and energy to risk management issues in insurance. Methodologically, dependence modeling...

  8. Risk factors, management and outcomes of patients admitted with near fatal asthma to a tertiary care hospital in Riyadh

    Directory of Open Access Journals (Sweden)

    Hasan M Al-Dorzi

    2014-01-01

    Conclusions: In our study, NFA risk factors were younger age and higher number of ED visits. NFA had significant morbidity. Reducing neuromuscular blockade duration during ventilator management may decrease neuromyopathy risk.

  9. Risk, governance and the experience of care.

    Science.gov (United States)

    Hillman, Alexandra; Tadd, Win; Calnan, Sian; Calnan, Michael; Bayer, Antony; Read, Simon

    2013-07-01

    Drawing on perspectives from the governmentality literature and the sociology of risk, this article explores the strategies, tools and mechanisms for managing risk in acute hospital trusts in the United Kingdom. The article uses qualitative material from an ethnographic study of four acute hospital trusts undertaken between 2008 and 2010 focusing on the provision of dignified care for older people. Extracts from ethnographic material show how the organisational mechanisms that seek to manage risk shape the ways in which staff interact with and care for patients. The article bridges the gap between the sociological analysis of policy priorities, management strategy and the organisational cultures of the NHS, and the everyday interactions of care provision. In bringing together this ethnographic material with sociological debates on the regulation of healthcare, the article highlights the specific ways in which forms of governance shape how staff care for their patients challenging the possibility of providing dignified care for older people.

  10. Care Risk Management Analysis of Midwives%助产士的护理风险及管理分析

    Institute of Scientific and Technical Information of China (English)

    徐惠英

    2012-01-01

    目的:研究分析助产士的护理风险以及对助产士的管理模式进行分析.方法:对2010年10月~2011年10月间入院生产的162例产妇的进行分组护理,分为实验组和对照组.对照组进行常规的助产士护理工作,实验组选用针对各项护理风险作出积极应对措施并且有特定制度管理的助产士进行护理工作;对比两组产妇对护理工作的满意度.结果:实验组产妇的生活质量远远高于对照组,差异具有统计学意义(P<0.05).另外实验组的产妇较之对照组的有更顺利的生产过程.结论:对助产士的护理工作应该提出一个健全的管理体制,针对各项可能的风险也应该做出完善的处理工作.%Objective:To study the midwife to midwife and nursing risk management mode are analyzed.Methods:In October 2010 to October 2011 hospital of 162 cases of production between maternal grouping of nursing, divided into the experimental group and the control group. The control group regular midwife nursing work, the selection the risk for nursing make active measures and have specific system management of the midwife care work; Compared to two groups of maternal care to job satisfaction.Results:The puerpera quality of life is far higher than those in the control group, a statistically significant difference (P<0.05). Other than the control group of the women have more smooth production process. Conclusion: The nursing work to midwife should present a sound management system, the possible risk in a perfect should also work.

  11. Risk management in anesthesia.

    Science.gov (United States)

    Cabrini, L; Levati, A

    2009-11-01

    Anesthesia is considered a leading discipline in the field of patient safety. Nevertheless, complications still occur and can be devastating. A substantial portion of anesthesia-related adverse events are preventable since risk factors can be detected and eliminated. Risk management (RM) in anesthesia includes preventive and remedial measures to minimize patient anesthesia-related morbidity and mortality. RM involves all aspects of anesthesia care. Classically, the following four steps are needed to prevent critical incidents or to learn from them: (1) detection of problems, (2) assessment, (3) implementation of solutions, and (4) verification of effectiveness. Problems and solutions can be identified into the fields of structures, processes and personnel. Authoritative agencies like the World Health Organization, the World Federation of Societies of Anesthesiologists, the Section and Board of Anesthesiology of the European Union of Medical Specialties and the Italian Scientific Society of Anesthesiologists (Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva SIAARTI) have proposed initiatives addressing safety in the operating room. The central role of a well-trained, constantly present anesthesiologist and the usefulness of checklists have been highlighted. Cost cutting and production pressure in medical care are potential threats to safety. A shared knowledge of the best standards of care and of the potential consequences of unscrupulous actions could make the daily management of conflicting interests easier. A correctly applied RM can be a powerful, highly beneficial aid to our practice.

  12. 伤口护理风险预案的制订及应用效果评价%The development and application of wound care risk protocol in risk management of wound care

    Institute of Scientific and Technical Information of China (English)

    蒋琪霞; 彭青; 周昕; 李晓华

    2012-01-01

    Objective To explore the effect of wound care risk protocol for risk management of wound care. Methods The risk factors of wound care were identified based on literature review and retrospective cases analysis. Then,the eight step wound care risk protocol was developed and applied in nursing management of wound care after nurse training. The patient satisfaction, the incidence and severity of adverse events were recorded before and after the implementation of wound care risk protocol. Results After the implementation of wound care risk protocol,the incidence of adverse events decreased from 7.805% to 2.037%(P<0.05). The patient satisfaction increased from(98.62±0.63)% to (95.61+0.81 )%(P<0.05). The severity of adverse events was lower than before (P<0.05). Conclusion The implementation of wound care risk protocol can reduce the incidence and severity of adverse events, and increase patient satisfaction. It is an effective method for risk management of wound care.%目的 探讨伤口护理风险预案在伤口护理风险管理中的作用.方法 通过文献检索和回顾性分析,找出伤口护理中常见的风险问题,制订相应的伤口护理风险预案,设定风险管理八步骤方法,培训护士掌握并应用.评价风险预案管理实施前后的患者满意率、不良事件发生率和等级.结果 风险预案实施后的不良事件发生率为2.037%,低于实施前的7.805%,差异有统计学意义(P<0.05);患者满意率为(98.62±0.63)%,高于实施前的(95.61±0.81)%,差异有统计学意义(P<0.05).不良事件等级的严重度低于实施前(P<0.05).结论 伤口护理风险预案有助于降低患者不良事件发生率及其严重度,可提高患者满意率,是伤口护理风险管理的有效方法.

  13. Jumping off and being careful: children's strategies of risk management in everyday life

    DEFF Research Database (Denmark)

    Christensen, Pia Haudrup; Mikkelsen, Miguel Romero

    2008-01-01

    of their health as strength and control, negotiated the conditions of playing, and attuned their responses to situations of potential social and physical conflict. In the paper this risk engagement is illustrated in a variety of contexts: children's decisions to wear or not to wear a bicycle helmet; playing...... and games and routine pushing and shoving at school. In looking after themselves, children negotiate rules of participation and they safeguard personal and collective interests. Gender differences in these processes are addressed and discussed. The article argues that risk engagement is an important...

  14. RISK MANAGEMENT IN PHARMACEUTICALS

    Directory of Open Access Journals (Sweden)

    V. SIVA RAMA KRISHNA

    2014-04-01

    Full Text Available Objective: To review the risk in pharmaceutical industries and the risk management process and tools. There is risk always in anything we do. All the industries on this globe perform actions that involve risks; risk is only dangerous when there is no anticipation to manage it. Risks if assessed and controlled properly will benefit the industries against the fall and makes stronger. Risk should not be assessed as bad, but should assess as an opportunity for making things resilient by proper management. Risk management can benefit industries from disasters either natural or human. The impact of the risk should be assessed in order to plan alternatives and minimize the effect of the impact. Risk in pharmaceutical industry is very high because it involves research, money and health. The impact is severe and the probability of the risk is more often in pharmaceutical industry. A risk management plans and control measures will help the companies to do better at the time of uncertainties and create positive opportunities to turn those risks into benefits which maximize quality. Materials and Methods: The information was collected and compiled from scientific literature present in different databases and articles, books. Results: The risk management process and tools helps to minimize the risk and its effects. Conclusion: The risk management is at the core of any organization. Risk management should be part of organization culture. The risk management is a wise investment if properly processed.

  15. Future developments in health care performance management

    Directory of Open Access Journals (Sweden)

    Crema M

    2013-11-01

    Full Text Available Maria Crema, Chiara Verbano Department of Management and Engineering, University of Padova, Vicenza, Italy Abstract: This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. Keywords: health care, lean management, clinical risk management, quality, health care processes

  16. Development of a primary care-based complex care management intervention for chronically ill patients at high risk for hospitalization: a study protocol.

    NARCIS (Netherlands)

    Freund, T.; Wensing, M.J.P.; Mahler, C.; Gensichen, J.; Erler, A.; Beyer, M.; Gerlach, F.M.; Szecsenyi, J.; Peters-Klimm, F.

    2010-01-01

    ABSTRACT: BACKGROUND: Complex care management is seen as an approach to face the challenges of an ageing society with increasing numbers of patients with complex care needs. The Medical Research Council in the United Kingdom has proposed a framework for the development and evaluation of complex inte

  17. Managing as blended care.

    Science.gov (United States)

    Mintzberg, H

    1994-09-01

    As part of a research project on managerial work based on a new model of the roles, the head nurse of a hospital unit was observed during a working day. Her work is described, with reference especially to the roles of leading, linking, controlling, and doing. Conclusions are drawn about the advantages of a craft style of management as opposed to the more traditional "boss" or professional styles. The author also discusses what those in general management can learn from those in nursing management, which seems best practiced out in the open, on one's feet, as a kind of blended care.

  18. Depression in primary care: assessing suicide risk

    Science.gov (United States)

    Ng, Chung Wai Mark; How, Choon How; Ng, Yin Ping

    2017-01-01

    Major depression is a common condition seen in the primary care setting. This article describes the suicide risk assessment of a depressed patient, including practical aspects of history-taking, consideration of factors in deciding if a patient requires immediate transfer for inpatient care and measures to be taken if the patient is not hospitalised. It follows on our earlier article about the approach to management of depression in primary care. PMID:28210741

  19. Managed care and economic dynamics.

    Science.gov (United States)

    Riggs, J E

    1996-09-01

    Over the past several decades, health care delivery in the United States evolved in an environment lacking marketplace constraints. The unforeseen result was the current health care crisis--uncontrolled costs, shrinking access, and redundant technological capabilities. Managed care is a strategy to impose fiscal constraints on health care delivery. A diagrammatic analysis of the economic dynamics between consumers and producers in an open marketplace is compared with that of patients, providers, and payers under the health care scheme that produced the health care crisis and under managed care. Patient demands, expectations, and needs for health care are not subject to fiscal constraint under managed care since the dislinkage between consumer and payer still exits. Managed care does not impose true open marketplace fiscal constraints on health care delivery. Furthermore, any solution to the US health care crisis that used true marketplace fiscal constraints would necessitate fundamental changes in societal values concerning individual rights to health care.

  20. 口腔护理管理中风险管理的应用价值%Application Value Analysis of Risk Management in Oral Care Management

    Institute of Scientific and Technical Information of China (English)

    李珊珊; 谢丽

    2016-01-01

    目的:探讨风险管理在口腔护理管理中的应用价值。方法:从笔者所在科2012年1月-2014年收治的口腔疾病患者中随机抽取116例进行研究,并根据其诊疗顺序随机分为两组,对照组58例行常规护理管理,观察组58例在此基础上行风险管理,对比两组患者实施护理管理前后的护理质量评分、护理事故的发生率和护理满意度。结果:和实施前比较,两组患者的基础护理质量、诊疗管理和消毒质量的评分均明显提高,且观察组三项指标的评分明显高于对照组,组间比较差异有统计学意义(P<0.05)。对照组患者的护理不良事件为20.69%,明显高于观察组的3.45%;且其护理满意度为84.48%,明显低于观察组的96.55%,组间比较差异均有统计学意义(P<0.05)。结论:在口腔护理管理中,应用护理风险管理可以明显提高护理质量,减少护理事故的发生,提高患者的满意度,减少护理纠纷,具有较高的临床应用价值。%Objective:To explore the value of risk management in the oral care management.Method:From January 2012 to 2014,116 cases with oral diseases were randomly selected,and according to the order of its diagnosis and treatment were randomly divided into two groups,each group with 58 cases,the control group was taken routine nursing management,the observation group was taken risk management on the basis of the control group,the nursing quality score,the incidence of nursing accidents and nursing satisfaction before and after the implementation of the nursing management in the two groups were compared.Result:compared with before the implementation,the nursing quality management,diagnosis and treatment and disinfection quality score in two groups were significantly improved,and the score 3 index in the observation group were obviously higher than that in the control group,the differences between two groups were significant(P<0.05).The nursing

  1. Research in application effect of risk management in obstetric care%产科护理中风险管理的应用效果研究

    Institute of Scientific and Technical Information of China (English)

    汪海燕

    2010-01-01

    Objective To explore the risk management factors and preventive measures in obstetric care. Methods The implementation of risk management in our hospital was retrospectively analyzed. Results Maternal satisfaction degree was significantly increased, complaints and errors of nursing care were significantly decreased. Conclusions Strengthening of risk management in obstetric care can benefit to eliminate and prevent unsafe factors, so that obstetric care quality is improved.%目的 探讨产科护理中的风险管理因素和防范措施.方法 对我科自2008年以来实施的风险管理方法进行回顾性分析.结果 实施风险管理后孕产妇满意度明显提高,护理投诉和护理差错发生率明显下降.结论 对产科的潜在风险因素进行综合分析,加强风险管理,能明显提高护理服务质量.

  2. Risk, rationality and learning for compassionate care; the link between management practices and the 'lifeworld' of nursing.

    Science.gov (United States)

    Goodman, Benny

    2014-09-01

    The nursing care experiences of older people in the United Kingdom, has been much reported in the national and international press. Reasons for that poor quality of care in hospitals often focus on the 'culture' of organisations, as well as focusing on individual failings. However, discussions about culture change are partial explanations without a deeper analysis of how cultures and leadership operates in socio-political contexts which characterise nurses' 'habitus' and 'lifeworlds'. Therefore the solutions may not address wider determinants of care such as risk governance, managerialism, instrumental rationality and of course staffing and skill mix. Instead, organisations may be exhorted to change their cultures, without addressing these wider determinants and thus poor care practices may continue to occur. If targets are abolished, this may still leave a layer of managerialist thinking. This impacts on education because students, who are 'working and learning', experience occupational socialisation through immersion in the lifeworlds of their clinical colleagues. What is required is much less manageralism in the care of older people. Instead, there is a need for clinical leadership, based on critical reflective understanding of the occupational socialisation of nurses operating in a context of risk and rationality and organisational objectives; collegiate political and moral action by health professionals and society on behalf of the older person, and support for front line staff who require more autonomy and control over care practices.

  3. Agile risk management

    CERN Document Server

    Moran, Alan

    2014-01-01

    This work is the definitive guide for IT managers and agile practitioners. It elucidates the principles of agile risk management and how these relate to individual projects. Explained in clear and concise terms, this synthesis of project risk management and agile techniques is illustrated using the major methodologies such as XP, Scrum and DSDM.Although the agile community frequently cites risk management, research suggests that risk is often narrowly defined and, at best, implicitly treated, which in turn leads to an inability to make informed decisions concerning risk and reward and a poor u

  4. Risk management in Takaful

    OpenAIRE

    2010-01-01

    Risk management is of vital importance in Islam and Takāful provides a way to manage risks in business according to Sharī’ah principles. This research paper attempts to identify various types of risks involved in Takāful business that affect operational and investment functions of Takāful operators across the globe. It lays down criteria for Takāful operator to manage those risks effectively. However, Takāful operators often face difficulty in managing market and credit risks as Sharī’ah comp...

  5. Risk Management Implementation Tool

    Science.gov (United States)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

  6. Identifying and Managing Risk.

    Science.gov (United States)

    Abraham, Janice M.

    1999-01-01

    The role of the college or university chief financial officer in institutional risk management is (1) to identify risk (physical, casualty, fiscal, business, reputational, workplace safety, legal liability, employment practices, general liability), (2) to develop a campus plan to reduce and control risk, (3) to transfer risk, and (4) to track and…

  7. European Practice Assessment of Cardiovascular risk management (EPA Cardio): protocol of an international observational study in primary care

    OpenAIRE

    van Lieshout Jan; Campbell Stephen; Ludt Sabine; Wensing Michel; Volbracht Eckhard; Grol Richard

    2009-01-01

    Abstract Background Despite important improvements in available prevention and treatment, cardiovascular diseases (CVD) remain an important cause of morbidity and mortality. Not all high-risk patients and patients with CVD have healthy lifestyles and receive the best possible healthcare. Internationally comparative data are needed to compare cardiovascular risk management in different countries, and to examine the impact of improvement programs and others factors. Objectives This study aims t...

  8. Exchange Risk Management Policy

    CERN Document Server

    2005-01-01

    At the Finance Committee of March 2005, following a comment by the CERN Audit Committee, the Chairman invited the Management to prepare a document on exchange risk management policy. The Finance Committee is invited to take note of this document.

  9. Credit Risk Management

    Directory of Open Access Journals (Sweden)

    Viorica IOAN

    2012-11-01

    Full Text Available The bank is exposed to credit risk, the risk of not being able to recuperate the debtor claims as a result of the activity of granting loans to the clientele. Also, credit risk may manifest due to investments in other local and foreign credit institutions. Credit risk may be minimized through the careful evaluation of credit solicitors, through their monitoring along the duration of the loan and through the establishing of risk exposure limits, of significant risk margins as well as the acceptable balance between risk and profit.

  10. Enterprise Risk Management Models

    CERN Document Server

    Olson, David L

    2010-01-01

    Enterprise risk management has always been important. However, the events of the 21st Century have made it even more critical. The top level of business management became suspect after scandals at ENRON, WorldCom, and other business entities. Financially, many firms experienced difficulties from bubbles. The problems of interacting cultures demonstrated risk from terrorism as well, with numerous terrorist attacks, to include 9/11 in the U.S. Risks can arise in many facets of business. Businesses in fact exist to cope with risk in their area of specialization. Financial risk management has focu

  11. Liquidity and Risk Management

    OpenAIRE

    Holmström, Bengt; Tirole, Jean

    2007-01-01

    This paper provides a model of the interaction between risk-management practices and market liquidity. On one hand, tighter risk management reduces the maximum position an institution can take, thus the amount of liquidity it can offer to the market. On the other hand, risk managers can take into account that lower liquidity amplifies the effective risk of a position by lengthening the time it takes to sell it. The main result of the paper is that a feedback effect can arise: tighter risk man...

  12. Managing depression in primary care

    Science.gov (United States)

    Collins, Kerry A.; Wolfe, Vicky V.; Fisman, Sandra; DePace, JoAnne; Steele, Margaret

    2006-01-01

    OBJECTIVE To investigate family physicians’ practice patterns for managing depression and mental health concerns among adolescent and adult patients. DESIGN Cross-sectional survey. SETTING London, Ont, a mid-sized Canadian city. PARTICIPANTS One hundred sixty-three family physicians identified through the London and District Academy of Medicine. MAIN OUTCOME MEASURES Practice patterns for managing depression, including screening, pharmacotherapy, psychotherapy, shared care, and training needs. RESULTS Response rate was 63%. Family physicians reported spending a substantial portion of their time during patient visits (26% to 50%) addressing mental health issues, with depression being the most common issue (51% to 75% of patients with mental health issues). About 40% of respondents did routine mental health screening, and 60% screened patients with risk factors for depression. Shared care with mental health professionals was common (care was shared for 26% to 50% of patients). Physicians and patients were moderately satisfied with shared care, but were frustrated by long waiting lists and communication barriers. Most physicians provided psychotherapy to patients in the form of general advice. Differences in practice patterns were observed; physicians treated more adults than adolescents with depression, and they reported greater comfort in treating adults. Although 33% of physicians described using cognitive behavioural therapy (CBT), they reported having little training in CBT. Moderate interest was expressed in CBT training, with a preference for a workshop format. CONCLUSION Although 40% of family physicians routinely screen patients for mental health issues, depression is often not detected. Satisfaction with shared care can be increased through better communication with mental health professionals. Physicians’ management of adolescent patients can be improved by further medical training, consultation, and collaboration with mental health professionals

  13. A collaborative cardiologist-pharmacist care model to improve hypertension management in patients with or at high risk for cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Irons BK

    2012-03-01

    Full Text Available Physician led collaborative drug therapy management utilizing clinical pharmacists to aid in the medication management of patients with hypertension has been shown to improve blood pressure control. With recommendations for lower blood pressures in patients with coronary artery disease, a cardiologist-pharmacist collaborative care model may be a novel way to achieve these more rigorous goals of therapy. Objective: The purpose of this project was to evaluate this type of care model in a high cardiac risk patient population. Methods: A retrospective cohort study determined the ability of a cardiologist-pharmacist care model (n=59 to lower blood pressure and achieve blood pressure goals (< 130/80 mmHg in patients with or at high risk for coronary artery disease compared to usual cardiologist care (n=58 in the same clinical setting. Results: The cardiologist-pharmacist care model showed a higher percentage of patients obtaining their goal blood pressure compared to cardiologist care alone, 49.2% versus 31.0% respectively, p=0.0456. Greater reductions in systolic blood pressure (-22 mmHg versus -12 mmHg, p=0.0077 and pulse pressure (-15 mmHg versus -7 mmHg, p=0.0153 were noted in the cardiologist-pharmacist care model. No differences in diastolic blood pressure were found. There was a shorter duration of clinic follow-up (7.0 versus 13.2 months, p=0.0013 but a higher frequency of clinic visits (10.7 versus 3.45, p<0.0001 in the cardiologist-pharmacist care model compared to usual care. The number of antihypertensive agents used did not change over the time period evaluated. Conclusion: This study suggests a team-based approach to hypertensive care using a collaborative cardiologist-pharmacist care model improves blood pressure from baseline in a high cardiac risk patient population and was more likely to obtain more stringent blood pressure goals than usual care.

  14. Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care

    NARCIS (Netherlands)

    Tiessen, Ans H.; Smit, Andries J.; Broer, Jan; Groenier, Klaas H.; van der Meer, Klaas

    2012-01-01

    Background: Treatment goals for cardiovascular risk management are generally not achieved. Specialized practice nurses are increasingly facilitating the work of general practitioners and self-monitoring devices have been developed as counseling aid. The aim of this study was to compare standard trea

  15. Future developments in health care performance management.

    Science.gov (United States)

    Crema, Maria; Verbano, Chiara

    2013-01-01

    This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance.

  16. Risk Management and Simulation

    DEFF Research Database (Denmark)

    Skovmand, David

    2014-01-01

    Review of: Risk Management and Simulation / Aparna Gupta. Boca Raton, FL: CRC Press, 2013, xxix + 491 pp., $99.95(H), ISBN: 978-1-4398-3594-4.......Review of: Risk Management and Simulation / Aparna Gupta. Boca Raton, FL: CRC Press, 2013, xxix + 491 pp., $99.95(H), ISBN: 978-1-4398-3594-4....

  17. Perspectives: Intellectual Risk Management

    Science.gov (United States)

    Hall, James C.

    2013-01-01

    Ask a college administrator about students and risk management, and you're likely to get a quick and agitated speech about alcohol consumption and bad behavior or a meditation on mental health and campus safety. But in colleges and universities, we manage intellectual risk-taking too. Bring that up, and you'll probably get little out of that same…

  18. Agricultural risk management

    DEFF Research Database (Denmark)

    Lund, Mogens; Oksen, Arne; Larsen, Torben U.;

    2005-01-01

    A new model for risk management in agriculture is described in the paper. The risk model is constructed as a context dependent process, which includes four main phases. The model is aimed at agricultural advisors, who wish to facilitate and disseminate risk management to farmers. It is developed...... and tested by an action research approach in an attempt to make risk management more applicable on family farms. Our obtained experiences indicate that farmers don’t apply probabilistic thinking and other concepts according to formal decision theory....

  19. Supply chain risk management

    Directory of Open Access Journals (Sweden)

    Christian Hollstein

    2013-03-01

    Full Text Available Background: Supply chain risk management increasingly gains prominence in many international industries. In order to strengthen supply chain structures, processes, and networks, adequate potentials for risk management need to be built (focus on effective logistics and to be utilized (focus on efficient logistics. Natural-based disasters, such as the case of Fukushima, illustrate how crucial risk management is. Method: By aligning a theoretical-conceptual framework with empirical-inductive findings, it may be hypothesized that logistical systems do have a positive effect on supply chain risk management activities.  Result/conclusion:  Flexibility and capacity, as well as redundancy and standardization, are often viewed as being conflictionary. It shows, however, that in the light of supply chain risk management, those factors may yield a common benefit if proper logistics systems are applied.  

  20. Individual Property Risk Management

    Directory of Open Access Journals (Sweden)

    Michael S. Finke

    2010-01-01

    Full Text Available This paper reviews household property risk management and estimates normatively optimal choice under theoretical assumptions. Although risk retention limits are common in the financial planning industry, estimates of optimal risk retention that include both financial and human wealth far exceed limits commonly recommended. Households appear to frame property losses differently from other wealth losses leading to wealth-reducing, excess risk transfer. Possible theoretical explanations for excess sensitivity to loss are reviewed. Differences between observed and optimal risk management imply a large potential gain from improved choice.

  1. Assessing the effect of increased managed care on hospitals.

    Science.gov (United States)

    Mowll, C A

    1998-01-01

    This study uses a new relative risk methodology developed by the author to assess and compare certain performance indicators to determine a hospital's relative degree of financial vulnerability, based on its location, to the effects of increased managed care market penetration. The study also compares nine financial measures to determine whether hospital in states with a high degree of managed-care market penetration experience lower levels of profitability, liquidity, debt service, and overall viability than hospitals in low managed care states. A Managed Care Relative Financial Risk Assessment methodology composed of nine measures of hospital financial and utilization performance is used to develop a high managed care state Composite Index and to determine the Relative Financial Risk and the Overall Risk Ratio for hospitals in a particular state. Additionally, financial performance of hospitals in the five highest managed care states is compared to hospitals in the five lowest states. While data from Colorado and Massachusetts indicates that hospital profitability diminishes as the level of managed care market penetration increases, the overall study results indicate that hospitals in high managed care states demonstrate a better cash position and higher profitability than hospitals in low managed care states. Hospitals in high managed care states are, however, more heavily indebted in relation to equity and have a weaker debt service coverage capacity. Moreover, the overall financial health and viability of hospitals in high managed care states is superior to that of hospitals in low managed care states.

  2. Managing acute care.

    Science.gov (United States)

    Russell, J S

    1993-02-01

    In the last few years, much medical-facility construction has been driven by what insurers want. Hospitals have built facilities for well-reimbursed procedures and closed money-losing ones. Health-maintenance organizations increasingly expect to hold down costs by making prepayment arrangements with doctors and their hospitals. President Clinton has pledged early action on health-care reform, which will likely change planners' priorities. Whether the nation goes to Clintonian "managed competition" or a Canadian-style nationwide single-payer system (the two most likely options), the projects on these pages reflect two large-scale trends that are likely to continue: the movement of more procedures from inpatient to outpatient facilities and the separation of treatment functions from ordinary office and administrative tasks so that the latter are not performed in the same high-cost buildings as technology-intensive procedures. Various schemes that make care more "patient-centered" have been tried and been shown to speed healing, even for outpatients, but such hard-to-quantify issues get short shrift in an era of knee-jerk cost containment. The challenge in tomorrow's healthcare universe--whatever it becomes--will be to keep these issues on the table.

  3. Internal Audit and Risk Management

    OpenAIRE

    Constantin Nicolae Vasile; Alexandru Georgiana

    2011-01-01

    Internal audit and risk management have the same goal: the control of risk. There are various roles for the internal audit in respect of risk management. The main limitations of internal audit in respect of risk management regards assuming risk management tasks. One of the main issues regarding risk management is to make sure that the key risks are taken into consideration and that the management and the board of the organization take action as needed. Internal audit could give advice to mana...

  4. Risk management in radiology departments

    Science.gov (United States)

    Craciun, Horea; Mankad, Kshitij; Lynch, Jeremy

    2015-01-01

    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as a result of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients. PMID:26120383

  5. Risk management in radiology departments

    Institute of Scientific and Technical Information of China (English)

    Horea; Craciun; Kshitij; Mankad; Jeremy; Lynch

    2015-01-01

    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as aresult of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients.

  6. QUARITE (quality of care, risk management and technology in obstetrics: a cluster-randomized trial of a multifaceted intervention to improve emergency obstetric care in Senegal and Mali

    Directory of Open Access Journals (Sweden)

    Gaye Alioune

    2009-09-01

    Full Text Available Abstract Background Maternal and perinatal mortality are major problems for which progress in sub-Saharan Africa has been inadequate, even though childbirth services are available, even in the poorest countries. Reducing them is the aim of two of the main Millennium Development Goals. Many initiatives have been undertaken to remedy this situation, such as the Advances in Labour and Risk Management (ALARM International Program, whose purpose is to improve the quality of obstetric services in low-income countries. However, few interventions have been evaluated, in this context, using rigorous methods for analyzing effectiveness in terms of health outcomes. The objective of this trial is to evaluate the effectiveness of the ALARM International Program (AIP in reducing maternal mortality in referral hospitals in Senegal and Mali. Secondary goals include evaluation of the relationships between effectiveness and resource availability, service organization, medical practices, and satisfaction among health personnel. Methods/Design This is an international, multi-centre, controlled cluster-randomized trial of a complex intervention. The intervention is based on the concept of evidence-based practice and on a combination of two approaches aimed at improving the performance of health personnel: 1 Educational outreach visits; and 2 the implementation of facility-based maternal death reviews. The unit of intervention is the public health facility equipped with a functional operating room. On the basis of consent provided by hospital authorities, 46 centres out of 49 eligible were selected in Mali and Senegal. Using randomization stratified by country and by level of care, 23 centres will be allocated to the intervention group and 23 to the control group. The intervention will last two years. It will be preceded by a pre-intervention one-year period for baseline data collection. A continuous clinical data collection system has been set up in all

  7. Managed care and the infectious diseases specialist.

    Science.gov (United States)

    Tice, A D; Slama, T G; Berman, S; Braun, P; Burke, J P; Cherney, A; Gross, P A; Harris, P; Reid-Hatton, M; Hoffman, R; Joseph, P; Lawton, S; Massanari, R M; Miller, Z I; Osheroff, W J; Poretz, D; Shalowitz, M; Simmons, B; Turner, J P; Wade, B; Nolet, B R

    1996-08-01

    There is growing demand to contain health care costs and to reassess the value of medical services. The traditional hospital, academic, and research roles of the infectious disease (ID) specialist are threatened, yet there is an increasing need for expertise because of growing antimicrobial resistance and emerging pathogens. Opportunities exist to develop and expand services for the care of patients infected with human immunodeficiency virus and in infection control, epidemiology, outcomes research, outpatient intravenous therapy, and resource management. It is important for ID physicians to appreciate the principles involved in managed care and the areas in which ID services can be valuable. To be effective, physicians need to know about tools such as practice guidelines, physician profiling, outcomes monitoring, computerized information management, risk sharing, networking, and marketing, as well as related legal issues. With a positive attitude toward learning, application, and leadership, ID physicians can redefine their role and expand their services through managed care.

  8. Risk management or political micromanagement?

    Science.gov (United States)

    Barton, E L

    1991-04-01

    A major healthcare issue of the 1990s is whether providers will create effective risk management programs to cope with government reform mandates or whether an increasingly costly and complex regulatory structure will force them to make changes. Compliance with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards on patient care will become increasingly important to healthcare risk management in the 1990s. The JCAHO standards create a benchmark from which government entities set their present standards and assemble agendas for the future. Another healthcare risk management factor is compliance with the National Practitioner Data Bank. The data bank is intended to protect healthcare consumers from providers who have demonstrated a tendency to commit malpractice. However, the data bank could cause problems for healthcare providers: Inaccurate or misleading data could unfairly haunt them. Healthcare risk managers should be familiar with the prohibitions on patient dumping found in the Consolidated Omnibus Budget Reconciliation Act of 1985. The amendments of the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) do not create strict liability, nor do they impose traditional tort standards that could guide courts in cases that will inevitably result from new rules, creating a "litigation time bomb." And OBRA '90 significantly revises the law. Other risk management issues include the manner in which facilities handle and dispose of medical waste and the manner in which they resolve disputes.

  9. Clinical risk assessment in intensive care unit

    Directory of Open Access Journals (Sweden)

    Saeed Asefzadeh

    2013-01-01

    Full Text Available Background: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin′s Social Security Hospital (Razi Hospital through Failure Mode and Effect Analysis (FMEA. Methods: This was a qualitative-quantitative research by Focus Discussion Group (FDG performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Results: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN was in respiratory care "Ventilator′s alarm malfunction (no alarm" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Conclusions: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care.

  10. Risk management for the emergency physician: competency and decision-making capacity, informed consent, and refusal of care against medical advice.

    Science.gov (United States)

    Magauran, Brendan G

    2009-11-01

    This article focuses on those times that the emergency physician (EP) and patient do not agree on a treatment option. Attention is placed on the risk management issues relevant to the patient's unexpected choice. Emphasis is placed on determining a patient's competency or capability of making clinical decisions, with particular focus on the EP deciding that patient competency requires a formal evaluation. The EP should have a strategy for assessing clinical decision-making capability and an understanding of what circumstances should act as a trigger for considering such an assessment. Attention to documentation issues around informed consent, common barriers to consent, refusal of care, and ED discharge against medical advice are examined.

  11. Adaptation and risk management

    Energy Technology Data Exchange (ETDEWEB)

    Preston, Benjamin L [ORNL

    2011-01-01

    Adaptation assessment methods are compatible with the international risk management standard ISO:31000. Risk management approaches are increasingly being recommended for adaptation assessments at both national and local levels. Two orientations to assessments can commonly be identified: top-down and bottom-up, and prescriptive and diagnostic. Combinations of these orientations favor different types of assessments. The choice of orientation can be related to uncertainties in prediction and taking action, in the type of adaptation and in the degree of system stress. Adopting multiple viewpoints is to be encouraged, especially in complex situations. The bulk of current guidance material is consistent with top-down and predictive approaches, thus is most suitable for risk scoping and identification. Abroad range ofmaterial fromwithin and beyond the climate change literature can be used to select methods to be used in assessing and implementing adaptation. The framing of risk, correct formulation of the questions being investigated and assessment methodology are critical aspects of the scoping phase. Only when these issues have been addressed should be issue of specific methods and tools be addressed. The reorientation of adaptation from an assessment focused solely on anthropogenic climate change to broader issues of vulnerability/resilience, sustainable development and disaster risk, especially through a risk management framework, can draw from existing policy and management understanding in communities, professions and agencies, incorporating existing agendas, knowledge, risks, and issues they already face.

  12. Risk management information for HIV infection.

    Science.gov (United States)

    Edwards, A J

    1990-01-01

    This article discusses HIV infection in terms of the risk manager's information needs in the health care environment. The malpractice problem, increasing workman's compensation suits, the greater role of the ombudsman, implementation of the National Practitioner Data Bank, and the Joint Commission on Accreditation of Health Care Organizations' (JCAHO) emphasis on clinical excellence are conditions which have given greater importance to the risk manager's position. Included in this article are hedges to retrieve various components of risk management and a select bibliography from AIDSLINE.

  13. Managed Care, Ethics, and Counseling.

    Science.gov (United States)

    Daniels, Jeffrey A.

    2001-01-01

    Addresses issues of managed care and ethics and how they relate to counseling. Specifically reviews a recent article published in "The Counseling Psychologist" (2000). Explores implications for counselors and counselor educators. (Author/GCP)

  14. Structuring managed care joint ventures.

    Science.gov (United States)

    Williams, L

    1995-08-01

    Providers that undertake joint ventures to secure managed care contracts must understand the important governance, operational, legal, and political issues involved. Careful planning in all these areas can help ensure that the joint venture will meet its goals and avoid problems such as inappropriately negotiated contracts and legal violations.

  15. The Management Object in Risk Management Approaches

    DEFF Research Database (Denmark)

    Christiansen, Ulrik

    . The paper synthesise by developing a framework of how different views on risk management enable and constrain the knowledge about risk and thus frame the possibilities to measure, analyse and calculate uncertainty and risk. Inspired by social studies of finance and accounting, the paper finally develops......Using a systematic review of the last 55 years of research within risk management this paper explores how risk management as a management technology (methodologies, tools and frameworks to mitigate or manage risks) singles out risks as an object for management in order to make action possible...... three propositions that illustrate how the framing of risk establishes a boundary for how managers might understand value creation and the possible future and how this impacts the possible responses to risk....

  16. Best practice of nurse managers in risk management

    Directory of Open Access Journals (Sweden)

    Veridiana Tavares Costa

    2013-09-01

    Full Text Available OBJECTIVE: to identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. METHOD: a case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analyzed through practical measures. RESULTS: educational actions, the critical analysis of the context, and the multiple dimensions of the management were evidenced as best practice. CONCLUSIONS: the broadening of understanding regarding risk management best practice offers further support for nurse managers to achieve excellence in their actions and thus provide safe and quality care.

  17. 分析产科护理的风险因子及其管理方略%Analysis the risk factors and management strategy of obstetric care

    Institute of Scientific and Technical Information of China (English)

    祝慧

    2015-01-01

    目的:研究科学合理的产科护理风险管理方略。方法研究我院2013年7月~2014年7月产科护理风险患者50例,回顾性分析其临床资料,研究产科护理可能存在的风险因子,制定相应的管理方略。结果在50例产科护理风险因子中,医院环境(36%)、患者及其家属(22%)、护理人员(18%)、医疗设施(14%)与消毒状况(10%)等5个因子是最为明显的。结论产科护理本身存在着诸多的风险因子,采取相应的管理方略,从而尽量地减少产科护理的风险几率,让孕产妇获得安全而又良好的护理服务。%ObjectiveTo study the scientific and reasonable obstetrics nursing risk management strategy. MethodsThe study in our hospital in 50 cases of obstetric nursing risk cases in 2013 July~2014 year in July, a retrospective analysis of clinical data, risk factors of obstetric care possible,formulate corresponding management strategy.ResultsIn 50 cases of obstetric nursing riskfactor, the hospital environment (36%), the patients and their family members (22%), the nursing staff (18%), (14%) medical facilities and the status of disinfection (10%) of 5 factors is the most obvious.ConclusionThe obstetric nursing itself there are many risk factors, to takecorresponding management strategy, so as to reduce the risk of obstetric care, let pregnant women receive safe and good nursing service.

  18. Pain management in neurocritical care.

    Science.gov (United States)

    Petzold, Axel; Girbes, Armand

    2013-10-01

    The core challenge of pain management in neurocritical care is to keep the patient comfortable without masking or overlooking any neurological deterioration. Clearly in patients with a neurological problem there is a conflict of clinical judgement and adequate pain relief. Here we review the presentation, assessment, and development of pain in the clinical spectrum of patients with associated neurological problems seen in a general intensive care setting. Many conditions predispose to the development of chronic pain. There is evidence that swift and targeted pain management may improve the outcome. Importantly pain management is multidisciplinary. The available non-invasive, pharmacological, and invasive treatment strategies are discussed.

  19. ARDS: Risk Factors, Prognostic Factors, Management and Outcomes. Incidence and Mortality of ARDS in Combat Casualty Care

    Science.gov (United States)

    2009-07-01

    important to both maintain readiness and force protection, as well as in the continued provision of clinical care during transport and in the provision...one level of care (10 subjects had multiple CPT codes). Number Code N 31.1 TEMPORARY TRACHEOSTOMY 18 33.21 BRONCHOSCOPY THRU STOMA 4 33.22 FIBER...support hospitals, is particularly important to both maintain readiness and force protection, as well as in the continued provision of clinical care

  20. Credit risk management in banks

    OpenAIRE

    Pětníková, Tereza

    2014-01-01

    The subject of this diploma thesis is managing credit risk in banks, as the most significant risk faced by banks. The aim of this work is to define the basic techniques, tools and methods that are used by banks to manage credit risk. The first part of this work focuses on defining these procedures and describes the entire process of credit risk management, from the definition of credit risk, describing credit strategy and policy, organizational structure, defining the most used credit risk mi...

  1. Nuclear risk management

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    This paper gives the list of contributions to Eurosafe 2001 which was organised around two round tables on the first day and five seminars on the second day. The first round table dealt with the technical, organisational and societal aspects of risk management aimed at the prevention of accidents in nuclear power plants. The second round table focused on radiological risks from the normal operation of nuclear installations. Special consideration has been given to the involvement of stakeholders. The five seminars were held in order to provide opportunities for comparing experiences and learning about recent activities of IRSN, GRS and their partners in the European Union and Eastern Europe: - Safety assessment and analysis of nuclear installations; -Nuclear safety research; -Environment and radiation protection; - Waste management; - Nuclear material security. (author)

  2. 重症监护室护理风险分析与防范管理%Risk Analysis and Prevention Management in Intensive Care Nursing

    Institute of Scientific and Technical Information of China (English)

    靳晶

    2015-01-01

    目的:分析重症监护室(ICU)存在的护理风险,探讨降低风险的管理措施。方法对ICU护理人员进行严格、系统的专业培训,强化其护理风险防范意识以及护理风险管理措施的实施并考核。比较干预前后的护理质量(基本理论水平、实践操作技能、护理记录的书写质量、患者满意度)和护理风险发生率(医疗差错发生率、院内感染发生率)。结果护理风险管理措施实施后,护理人员的基本理论水平、实践操作技能、护理记录的书写质量、患者满意度均明显提高(P<0.05)。医疗差错发生率、院内感染发生率明显下降(P<0.05)。结论 ICU科室加强护理风险防范管理,可提高护理业务水平,降低护理风险,减少医疗差错、降低院内感染的发生率,提高患者满意度。%Objective To analyze the nursing risk in Intensive Care Unit (ICU) of hospital, explore the management measures of nursing risk.Methods Nursing staff in ICU strict were accepted with systematic and comprehensive professional knowledge training, strengthen their nursing risk awareness and implemented the nursing risk management measures and then inspected it’s results. Compare the results of nursing risk management measures between the before and after, including the ICU nursing quality indicators (indexes: basic theoretical level and practical operation skills, writing of nursing record quality, patient satisfaction) and the incidence of nursing risk ( indexes: medical error rates, incidence of nosocomial infection).Results By the implementation of nursing risk management measures, the basic theory level of nursing staff and their practical operation skills, also nursing record writing quality and patient satisfaction were all increased significantly (P<0.05). Medical error rates, incidence of nosocomial infection were decreased significantly(P<0.05).Conclusion Implementing the nursing risk management

  3. Manual of Educational Risk Management.

    Science.gov (United States)

    Cody, Frank J.; Dise, John H., Jr.

    This is the first risk management publication for school administrators that attempts to be comprehensive by addressing all potential areas of risk to school districts and offering specific guidelines on how to manage those areas. Chapter 1 gives directions on how to use the manual. Chapter 2 contains a complete overview of risk management,…

  4. Effective risk management SOGO life cycle management

    OpenAIRE

    Ali, Mohamed Omar

    2012-01-01

    After new or upgrade projects the offshore installation gets maintenance or support through the life cycle management organization at Siemens. Small to medium modification projects are executed by the life cycle management. Risk assessment on these projects show different risks when it comes to estimation and pricing of projects, planning and executing, resource management, competence and knowledge.

  5. RISK MANAGEMENT IN CONSTRUCTION INDUSTRY

    OpenAIRE

    V. Sankara Subramaniyan; K. Veerakumar

    2017-01-01

    Construction industry is highly risk prone, with complex and dynamic project environments which create an atmosphere of high uncertainty and risk. The industry is vulnerable to various technical, socio-political and business risks. The track record to cope with these risks has not been very good in construction industry. Risk management is a concept which becomes very popular in a number of businesses. Many companies often establish a risk management procedure in their projects for improving ...

  6. Managing Risks and Beyond

    Science.gov (United States)

    2010-04-01

    situation occurring and its undesirable consequences          • Risk (Project Management Body of Knowledge  PMBOK ) – An uncertain even or condition that, if it...favorable or advantageous combination of circumstances – A chance for progress or advancement  • Opportunity ( PMBOK ) – A condition or situation favorable to...opportunities and reduce threats to project objectives      PMBOK – Includes Mitigation and Contingencies – Includes acceptance of the risk or issue

  7. Managing Corruption Risks

    DEFF Research Database (Denmark)

    Krause Hansen, Hans

    2011-01-01

    This article investigates the emerging engagement of private actors and specifically Western corporations in international anti-corruption, drawing on Foucauldian studies of governmentality. It explores this engagement as governing practices that have emanated quite independently from the inter......-state system commonly understood to be at the core of the anti-corruption regime. It demonstrates how corporate anti-corruption ties in with a relatively new way of perceiving corruption. In this framing, anti-corruption comes out as risk management, which is latched on to notions of corporate social...... responsibility and business ethics. Moreover, the constitution of corruption risk relates to the rise of new actors and networks engaged in a wider business of anti-corruption, including commercial and hybrid actors that supply corporations with managerial instruments, benchmarks for best practice, rankings...

  8. Communicating Risk to Program Managers

    Science.gov (United States)

    Shivers, C. Herbert

    2005-01-01

    Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

  9. Legal implications of managed care arrangements.

    Science.gov (United States)

    Knox, W A; Epstein, D M

    1994-09-01

    Prior to the 1980s, managed care was virtually nonexistent as a force in health care. Presently, 64 percent of employees in America are covered by managed care plans, including health maintenance organizations (20 percent) and preferred provider organizations (44 percent). In contrast, only 29 percent of employees were enrolled in managed care plans in 1988 and only 47 percent in 1991. To date, the primary reason for this incredible growth in managed care has been economic-market pressure to reduce health care costs. For the foreseeable future, political pressures are likely to fuel this growth, as managed care is at the center of President Clinton's national health care plan. Although there are numerous legal issues surrounding managed care, this article focuses primarily on antitrust implications when forming managed care entities. In addition, the corporate practice of medicine doctrine, certain tax issues, and the fraud and abuse laws are discussed.

  10. Managing Climate Change Risks

    Energy Technology Data Exchange (ETDEWEB)

    Jones, R. [CSIRO Atmospheric Research, PMB1 Aspendale, Victoria 3195 (Australia)

    2003-07-01

    Issues of uncertainty, scale and delay between action and response mean that 'dangerous' climate change is best managed within a risk assessment framework that evolves as new information is gathered. Risk can be broadly defined as the combination of likelihood and consequence; the latter measured as vulnerability to greenhouse-induced climate change. The most robust way to assess climate change damages in a probabilistic framework is as the likelihood of critical threshold exceedance. Because vulnerability is dominated by local factors, global vulnerability is the aggregation of many local impacts being forced beyond their coping ranges. Several case studies, generic sea level rise and temperature, coral bleaching on the Great Barrier Reef and water supply in an Australian catchment, are used to show how local risk assessments can be assessed then expressed as a function of global warming. Impacts treated thus can be aggregated to assess global risks consistent with Article 2 of the UNFCCC. A 'proof of concept' example is then used to show how the stabilisation of greenhouse gases can constrain the likelihood of exceeding critical thresholds at both the both local and global scale. This analysis suggests that even if the costs of reducing greenhouse gas emissions and the benefits of avoiding climate damages can be estimated, the likelihood of being able to meet a cost-benefit target is limited by both physical and socio-economic uncertainties. In terms of managing climate change risks, adaptation will be most effective at reducing vulnerability likely to occur at low levels of warming. Successive efforts to mitigate greenhouse gases will reduce the likelihood of reaching levels of global warming from the top down, with the highest potential temperatures being avoided first, irrespective of contributing scientific uncertainties. This implies that the first cuts in emissions will always produce the largest economic benefits in terms of avoided

  11. Big data in health care: using analytics to identify and manage high-risk and high-cost patients.

    Science.gov (United States)

    Bates, David W; Saria, Suchi; Ohno-Machado, Lucila; Shah, Anand; Escobar, Gabriel

    2014-07-01

    The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid progress has been made in clinical analytics--techniques for analyzing large quantities of data and gleaning new insights from that analysis--which is part of what is known as big data. As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States. We present six use cases--that is, key examples--where some of the clearest opportunities exist to reduce costs through the use of big data: high-cost patients, readmissions, triage, decompensation (when a patient's condition worsens), adverse events, and treatment optimization for diseases affecting multiple organ systems. We discuss the types of insights that are likely to emerge from clinical analytics, the types of data needed to obtain such insights, and the infrastructure--analytics, algorithms, registries, assessment scores, monitoring devices, and so forth--that organizations will need to perform the necessary analyses and to implement changes that will improve care while reducing costs. Our findings have policy implications for regulatory oversight, ways to address privacy concerns, and the support of research on analytics.

  12. Credit derivatives and risk management

    OpenAIRE

    Michael S. Gibson

    2007-01-01

    The striking growth of credit derivatives suggests that market participants find them to be useful tools for risk management. I illustrate the value of credit derivatives with three examples. A commercial bank can use credit derivatives to manage the risk of its loan portfolio. An investment bank can use credit derivatives to manage the risks it incurs when underwriting securities. An investor, such as an insurance company, asset manager, or hedge fund, can use credit derivatives to align its...

  13. Comparison of optimal cardiovascular risk factor management in patients with Type 2 diabetes who attended urban medical health center with those attended a tertiary care center: Experiences from Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Sedighe Moradi

    2016-01-01

    Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers.

  14. Methods of Financial Risk Management

    Directory of Open Access Journals (Sweden)

    Korzh Natalia

    2016-10-01

    Full Text Available The essence and nature of financial risks are investigated. Their classification is conducted. The features of financial risk management and the main methods of management are considered. The ways of risk compensation are identified. It is proved that the objective external risk basis is such market imperfections as externalities of enterprises and incomplete information about the operation of the business environment and internal objective basis risk – the objective function to maximise profits in a competitive environment. It is revealed that to compensate market imperfections business entities should develop a strategy that combines fill in missing information and neutralise or minimise externalities that tactically implemented in financial risk management programs.

  15. Primary care patient and provider preferences for diabetes care managers

    Directory of Open Access Journals (Sweden)

    Ramona S DeJesus

    2010-06-01

    Full Text Available Ramona S DeJesus1, Kristin S Vickers2, Robert J Stroebel1, Stephen S Cha31Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA; 2Department of Psychiatry and Psychology, Mayo Clinic, MN, USA; 3Department of Biostatistics, Mayo Clinic, Rochester, MN, USAPurpose: The collaborative care model, using care managers, has been shown to be effective in achieving sustained treatment outcomes in chronic disease management. Little effort has been made to find out patient preferences for chronic disease care, hence, we conducted a study aimed at identifying these.Methods: A 20-item questionnaire, asking for patients’ and providers’ preferences and perceptions, was mailed out to 1000 randomly selected patients in Olmsted County, Minnesota, identified through a diabetes registry to have type 2 diabetes mellitus, a prototypical prevalent chronic disease. Surveys were also sent to 42 primary care providers.Results: There were 254 (25.4% patient responders and 28 (66% provider responders. The majority of patients (>70% and providers (89% expressed willingness to have various aspects of diabetes care managed by a care manager. Although 75% of providers would be comfortable expanding the care manager role to other chronic diseases, only 39.5% of patient responders would be willing to see a care manager for other chronic problems. Longer length of time from initial diagnosis of diabetes was associated with decreased patient likelihood to work with a care manager.Conclusion: Despite study limitations, such as the lack of validated measures to assess perceptions related to care management, our results suggest that patients and providers are willing to collaborate with a care manager and that both groups have similar role expectations of a care manager.Keywords: care manager, collaborative care, patient preference, diabetes care

  16. A cooperative building up of care security: patient participation to risk management in radiotherapy; Co-construire la securite des soins: la participation des patients a la gestion des risques en radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Pernet, A.; Mollo, V. [Laboratoire d' ergonomie, Centre de recherche sur le travail et le developpement, CRTD-EA 4132, 75 - Paris (France); Giraud, P. [Service d' oncologie radiotherapie, Hopital europeen Georges-Pompidou, 75 - Paris (France); Universite Paris Descartes, 75 - Paris (France)

    2010-10-15

    Based on observations of radiotherapy consultations, interviews of professionals (physicians and operators), of ex-patients and patients under treatment, and on analysis of questionnaires sent to patients, this study aimed at understanding how, and to which levels, participation of patients can optimize risk management. It outlines the major role of therapeutic information and education of patients, but also of health professionals, in order to reach a shared cooperative management of cares. Short communication

  17. Managed consumerism in health care.

    Science.gov (United States)

    Robinson, James C

    2005-01-01

    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  18. Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montréal

    Directory of Open Access Journals (Sweden)

    Provost Sylvie

    2011-11-01

    Full Text Available Abstract Background The goal of this project is to evaluate the implementation of an integrated and interdisciplinary program for prevention and management of cardiometabolic risk (PCMR. The intervention is based on the Chronic Care Model. The study will evaluate the implementation of the PCMR in 6 of the 12 health and social services centres (CSSS in Montréal, and the effects of the PCMR on patients and the practice of their primary care physicians up to 40 months following implementation, as well as the sustainability of the program. Objectives are: 1-to evaluate the effects of the PCMR and their persistence on patients registered in the program and the practice of their primary care physicians, by implementation site and degree of exposure to the program; 2-to assess the degree of implementation of PCMR in each CSSS territory and identify related contextual factors; 3-to establish the relationships between the effects observed, the degree of PCMR implementation and the related contextual factors; 4-to assess the impact of the PCMR on strengthening local services networks. Methods/Design The evaluation will use a mixed design that includes two complementary research strategies. The first strategy is similar to a quasi-experimental "before-after" design, based on a quantitative approach; it will look at the program's effects and their variations among the six territories. The effects analysis will use data from a clinical database and from questionnaires completed by participating patients and physicians. Over 3000 patients will be recruited. The second strategy corresponds to a multiple case study approach, where each of the six CSSS constitutes a case. With this strategy, qualitative methods will set out the context of implementation using data from semi-structured interviews with program managers. The quantitative data will be analyzed using linear or multilevel models complemented with an interpretive approach to qualitative data analysis

  19. NGNP Risk Management Database: A Model for Managing Risk

    Energy Technology Data Exchange (ETDEWEB)

    John Collins; John M. Beck

    2011-11-01

    The Next Generation Nuclear Plant (NGNP) Risk Management System (RMS) is a database used to maintain the project risk register. The RMS also maps risk reduction activities to specific identified risks. Further functionality of the RMS includes mapping reactor suppliers Design Data Needs (DDNs) to risk reduction tasks and mapping Phenomena Identification Ranking Table (PIRTs) to associated risks. This document outlines the basic instructions on how to use the RMS. This document constitutes Revision 1 of the NGNP Risk Management Database: A Model for Managing Risk. It incorporates the latest enhancements to the RMS. The enhancements include six new custom views of risk data - Impact/Consequence, Tasks by Project Phase, Tasks by Status, Tasks by Project Phase/Status, Tasks by Impact/WBS, and Tasks by Phase/Impact/WBS.

  20. Software And Systems Engineering Risk Management

    Science.gov (United States)

    2010-04-01

    Engineering Life Cycle Processes IS 15288 Systems Engineering Life Cycle Processes IS 16085 Risk Management Process Quality ISO TC 176 ISO 9001 Quality...carefully define their “Context” as there is little guidance • integrate RSKM into their ISO 9001 clause 8.5.3 Preventive action • avoid offers

  1. Managed care innovation and new product development.

    Science.gov (United States)

    Clark, C S; Schuster, T B

    1994-01-01

    This article explores recent innovative activity by managed care payor plans nationwide with particular emphasis on emerging, new relationships between the plans and their purchasers, enrollees, provider panels, and competitors. Because they already practice what advocates of health care reform are now preaching, many managed care plans are leading the charge to transform our health care delivery and financing systems.

  2. IMPLEMENTING A RISK MANAGEMENT STANDARD

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2013-01-01

    Full Text Available After risk management “conquered” more and more project managers’ minds and showed its benefits for business and programs, the need to have a global risk management standard has become a crucial issue in the world of risk management. But having a global risk management standard has been a big challenge, starting from the decision of developing the standard (March-June 2005, to the moment of publishing it, November 2009. So, developing the ISO 31000:2009 standard has been more or less like a bumpy ride. Apparently, the people involved in developing the global risk management standard understood from the very beginning that no challenges are too big, nor any tasks too small and that the task of having a new, comprehensive global risk management standard should be completed with excellence: defining the principles and the framework guiding the risk management process applicable for all type of organizations and for a wide range of activities. Coming up with a global standard should always be based on the real organizations’ needs and should fulfill real risk management requirements. The article is trying to present the pros and cons of risk management standard implementation, challenging the implementation process itself and the added value of implementing the standard due to the lack of implementation enablers, like risk culture, a real problem especially in an international environment.

  3. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    DEFF Research Database (Denmark)

    Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

    2014-01-01

    OBJECTIVES: In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). DESIGN: A one-year follow-up study. SETTING: A CR programme (Go......%). MAIN OUTCOME MEASURES: Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention.......01), self-care management (p 

  4. Improving Information Security Risk Management

    Science.gov (United States)

    Singh, Anand

    2009-01-01

    manaOptimizing risk to information to protect the enterprise as well as to satisfy government and industry mandates is a core function of most information security departments. Risk management is the discipline that is focused on assessing, mitigating, monitoring and optimizing risks to information. Risk assessments and analyses are critical…

  5. Challenges to sustainable risk management

    Energy Technology Data Exchange (ETDEWEB)

    Pinto, Ariel C., Aurora, Ashish, Hall, Dennis E.,

    2004-08-09

    This paper summarizes the intermediate lessons learned from the analyses of the risk management problems in three technological endeavors. These problems are: the absence of a structure for rewarding successful project risk management; the need for an ever-more accurate economic measure of risk; and the difficulty of transferring risks to contract-bound independent outsourcing entity. This paper also describes recent advancement towards providing answers to these challenges and future research endeavors in this field.

  6. TRManager – Technical Risk Manager

    OpenAIRE

    Gregory, Mark A.; Christopher White

    2009-01-01

    This paper presents research into the development of a new information management technique called Technical Risk Manager. Project management involves the use of processes and information management techniques to aid decision making in the pursuit of project success. Project success may be achieved by meeting time, cost or performance criteria. Current project management practices focus on achieving time and cost project success criteria by using three information management techniques develo...

  7. Burn Care on Cruise Ships-Epidemiology, international regulations, risk situation, disaster management and qualification of the ship's doctor.

    Science.gov (United States)

    Ottomann, C; Hartmann, B; Antonic, V

    2016-09-01

    With the increasing numbers of passengers and crew on board vessels that are becoming larger and larger, the demand for ship's doctors who can adequately treat burns on board has also increased. In the cruise ship industry it is usually those doctor's with internal and general medical training who are recruited from an epidemiological point of view. Training content or recommendations for the treatment of thermal lesions with the limited options available in ship's hospitals and where doctors with no surgical training operate do not yet exist. The guidelines recommended by the Cruise Lines International Association (CLIA) regarding medical staff have only included physicians with minor surgical skills until now. With the introduction of the ATLS(®) course developed by the American College of Surgeons, the requirements for the qualification of the ship's doctor on board cruise ships shall change from January 2017. The article discusses the question of whether having completed the ATLS(®) course, the ship's doctor is trained to adequately treat thermal lesions or severe burns persons on-board, and presents the current discussion on the training content for ship's doctors within the International Maritime Health Association (IMHA). It also provides an overview of existing international regulatory frameworks, the risks presented by a fire on board, the problem of treating burns victims out of reach of coastal rescue services, and alternative training concepts for ship's doctors regarding the therapy of thermal lesions on-board.

  8. From the description of activities to the identification of risks for clinical management: a proposal of building, merging and sharing knowledge representations of care processes.

    Science.gov (United States)

    Staccini, Pascal; Joubert, Michel; Collomp, Rémy; Quaranta, Jean-François; Fieschi, Marius

    2007-01-01

    Management of clinical processes and hospital activities takes advantage of business process reengineering methodology. It is now recognized that care process modeling must integrate the definition of goals and the assessment of risk. Two kinds of issues have been outlined: 1) the lack of an integrated model to identify and describe processes and their components according to a functional point of view; and 2) an increasing amount of documents that hospital staff members have to create, collect, index and maintain. As initial models focused only on a structural view of activities, we reviewed different sources of standards and norms to extract and classify a set of metadata aimed at describing any activity and its outcomes. The model includes links to structured terminologies to name attributes or value them. An object-oriented information model has been created and implemented to test the relevance and the feasibility of the modeling approach. Conceptually speaking, this model gives opportunity to bridge tacit and explicit knowledge. Practically speaking, limits to generalization remain partly due to the lack of a template processes database.

  9. DEFENSE PROGRAMS RISK MANAGEMENT FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2012-01-01

    Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.

  10. NGNP Risk Management Database: A Model for Managing Risk

    Energy Technology Data Exchange (ETDEWEB)

    John Collins

    2009-09-01

    To facilitate the implementation of the Risk Management Plan, the Next Generation Nuclear Plant (NGNP) Project has developed and employed an analytical software tool called the NGNP Risk Management System (RMS). A relational database developed in Microsoft® Access, the RMS provides conventional database utility including data maintenance, archiving, configuration control, and query ability. Additionally, the tool’s design provides a number of unique capabilities specifically designed to facilitate the development and execution of activities outlined in the Risk Management Plan. Specifically, the RMS provides the capability to establish the risk baseline, document and analyze the risk reduction plan, track the current risk reduction status, organize risks by reference configuration system, subsystem, and component (SSC) and Area, and increase the level of NGNP decision making.

  11. Knowledge management: an innovative risk management strategy.

    Science.gov (United States)

    Zipperer, Lorri; Amori, Geri

    2011-01-01

    Knowledge management effectively lends itself to the enterprise risk process. The authors introduce the concept of knowledge management as a strategy to drive innovation and support risk management. They align this work with organizational efforts to improve patient safety and quality through the effective sharing of experience and lessons learned. The article closes with suggestions on how to develop a knowledge management initiative at an organization, who should be on the team, and how to sustain this effort and build the culture it requires to drive success.

  12. Corporate risk management : an overview

    NARCIS (Netherlands)

    Oosterhof, Casper M.

    2001-01-01

    Corporate risk management and hedging are important activities within financial as well as non-financial corporations. Under the assumptions of Modigliani and Miller [1958], corporate risk management is a redundant activity. However, the existence of market imperfections can explain the corporate us

  13. MODELS OF BANKING RISKS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Bente Corneliu Cristian

    2009-05-01

    Full Text Available Banking risks management as a fundamental element of banking management aims at diminishing as much as possible the negative impact of risk factors, at minimizing losses by expenditures cut-off and maximizing direct and transferred influxes, changing the

  14. Selecting Copulas for Risk Management

    NARCIS (Netherlands)

    H.J.W.G. Kole (Erik); C.G. Koedijk (Kees); M.J.C.M. Verbeek (Marno)

    2006-01-01

    textabstractCopulas offer financial risk managers a powerful tool to model the dependence between the different elements of a portfolio and are preferable to the traditional, correlation-based approach. In this paper we show the importance of selecting an accurate copula for risk management. We exte

  15. Risk Management In SMEs

    OpenAIRE

    Agarwal, Riya

    2010-01-01

    Small and medium enterprises are the backbone for the development of the economy. They provide employment, contribute to GDP and an important source of revenue for the country especially India employing approximately 30 million people and generating 40% of the export surplus. However the SMEs have to face lot of operational risks- credit risk, liquidity risk, foreign exchange risk, interest rate risk, competition from the MNCs and foreign buyers. Despite the failure of several SMEs, those pul...

  16. Risk Management for Food Allergy

    DEFF Research Database (Denmark)

    Risk Management for Food Allergy is developed by a team of scientists and industry professionals who understand the importance of allergen risk assessment and presents practical, real-world guidance for food manufacturers. With more than 12 million Americans suffering from food allergies and little...... the epidemiology of food allergy, assessing allergen thresholds and risk, specifics of gluten management and celiac disease, and much more. The practical advice on factory risk management, catering industry practices, allergen detection and measurement and regulatory controls is key for food industry professionals...

  17. 糖尿病护理团队在风险管理中的作用探究%Diabetes Care Team to Explore the Effect in the Risk Management

    Institute of Scientific and Technical Information of China (English)

    李海霞; 赵伟

    2015-01-01

    糖尿病患者除积极进行治疗外,接受科学、有效的护理干预对稳定其病情和防控疾病进一步恶化具有重要意义。重视糖尿病护理团队在风险管理中的作用,有助于形成群体风险防范意识,使护理人员识别、评估、预防以及处理风险事件的能力增强,从而有利于减少糖尿病患者面临的护理风险因素,以确保其生命安全。该研究主要从合理建立糖尿病护理团队以奠定风险管理基础,糖尿病护理团队明确工作职责以增强风险管理意识以及糖尿病护理团队明确工作内容以提升处理风险能力三个方面,对糖尿病护理团队在风险管理中的作用进行探究。%In addition to active treatment in patients with diabetes, the acceptance of scientific and effective nursing intervention to stabilize their condition and further deterioration of the disease prevention and control is important. Emphasis on diabetes care team in risk management, contribute to the formation of risk awareness groups that nurses identify, assess, prevent and deal with the ability to enhance the risk event, which will help reduce risk factors for diabetes care faced to ensure their lives. This article from the diabetes care team to establish a reasonable risk management in order to lay the foundation, clear job responsibilities dia-betes care team to enhance the awareness of risk management and diabetes care team clear job content to enhance the ability to deal with three aspects of risk for diabetes care team in Risk Management role of inquiry.

  18. The Uncertainties of Risk Management

    DEFF Research Database (Denmark)

    Vinnari, Eija; Skærbæk, Peter

    2014-01-01

    Purpose – The purpose of this paper is to analyse the implementation of risk management as a tool for internal audit activities, focusing on unexpected effects or uncertainties generated during its application. Design/methodology/approach – Public and confidential documents as well as semi......-structured interviews are analysed through the lens of actor-network theory to identify the effects of risk management devices in a Finnish municipality. Findings – The authors found that risk management, rather than reducing uncertainty, itself created unexpected uncertainties that would otherwise not have emerged....... These include uncertainties relating to legal aspects of risk management solutions, in particular the issue concerning which types of document are considered legally valid; uncertainties relating to the definition and operationalisation of risk management; and uncertainties relating to the resources available...

  19. Legal aspects of orthodontic practice: risk management concepts. Performing a risk management audit of your practice.

    Science.gov (United States)

    Machen, D E

    1990-05-01

    In this and succeeding issues of the AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS, factual risk management scenarios will be presented. These scenarios are based on composites of actual court cases that have been tried to verdict or decision. Valuable risk management lessons may be learned from careful analysis of the course of the events described. Please be advised that the standard of care determined in any case is specific for that jurisdiction and that set of facts as established by expert testimony for the prevailing party. Readers' comments may be addressed to Dr. Donald E. Machen, 5801 Beacon St., Pittsburgh, PA 15217.

  20. RISK MANAGEMENT MEASURES IN CMMI

    OpenAIRE

    Mahmoud Khraiwesh

    2012-01-01

    Risk management is a continuous process that could endanger the objectives of a project or application.Risks are handled to reduce and avoid threats effects on the objectives of the project. The sources of riskare both internal and external to the project. This research will identify general measures for the specificgoal and its specific practices of Risk Management Process Area (PA) in Capability Maturity ModelIntegration (CMMI). CMMI is developed by Software Engineering Institute (SEI) in C...

  1. Managing risk in software systems

    Energy Technology Data Exchange (ETDEWEB)

    Fletcher, S.K.; Jansma, R.M.; Murphy, M.D. [and others

    1995-07-01

    A methodology for risk management in the design of software systems is presented. It spans security, safety, and correct operation of software within the context of its environment, and produces a risk analysis and documented risk management strategy. It is designed to be iteratively applied, to attain appropriate levels of detail throughout the analysis. The methodology and supporting tools are discussed. The methodology is critiqued relative to other research in the field. Some sample applications of the methodology are presented.

  2. Risks Management in Software Engineering

    Directory of Open Access Journals (Sweden)

    Dishek Mankad

    2012-12-01

    Full Text Available Risk management is an action that helps a software development team to understand what kinds of risks are there in software development. Risk is always concern with today’s and yesterday’s uncertainty. It is a potential problem. So, it might happen, it might not. It is better to identify its probability of occurrence.

  3. PROCESSES USED IN RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Corina-Maria, DUCU

    2014-11-01

    Full Text Available In today's world, entities must pay a particular attention to the risks they have to face, risks that affect the developed activities. This requires the development of some processes of risk management, internal control and corporate governance, whose main purpose is to reduce them to a significant level.

  4. INTERNAL AUDIT AND RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Elena RUSE

    2014-04-01

    Full Text Available The existence of risk in economic activity can not be denied. In fact, the risk is a concept which exists in every activity, the term of risk being identified with uncertainty, respectively the (unchance to produce an undesirable event. Internal audit and risk management aim at the same goal, namely the control of risks. Internal Audit performs several roles in risk management plan. The objectives of the internal audit function varies from company to company, but in all economic entities internal audit department aims to improve performance management, enterprise performance and thus improve the internal control system. This paper aims to demonstrate, among other things, that any event that may result in failure is unquestionably classified as risk.

  5. TRManager – Technical Risk Manager

    Directory of Open Access Journals (Sweden)

    Mark A. Gregory

    2009-06-01

    Full Text Available This paper presents research into the development of a new information management technique called Technical Risk Manager. Project management involves the use of processes and information management techniques to aid decision making in the pursuit of project success. Project success may be achieved by meeting time, cost or performance criteria. Current project management practices focus on achieving time and cost project success criteria by using three information management techniques developed in the 1950s: Gantt, PERT and Critical Path Method. Technical Risk Manager has been developed to provide an information management technique that may be used to aid project management decision making in the pursuit of achieving the performance project success criteria.

  6. Integrated supply chain risk management

    Directory of Open Access Journals (Sweden)

    Riaan Bredell

    2007-11-01

    Full Text Available Integrated supply chain risk management (ISCRM has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly applied, this process may optimise management decision-making and assist in the protection and enhancement of shareholder value.

  7. Concept of optimisation of the radiation protection system in the nuclear sector: management of individual cancer risks and providing targeted health care.

    Science.gov (United States)

    Ivanov, V K; Tsyb, A F; Agapov, A M; Panfilov, A P; Kaidalov, O V; Gorski, A I; Maksioutov, M A; Suspitsin, Y V; Vaizer, V I

    2006-12-01

    The paper discusses the provision of targeted health care to nuclear workers in Russia based on radiation-epidemiological estimates of cancer risks. Cancer incidence rates are analysed for the workers of the Institute of Physical Power Engineering (the first nuclear installation in the world) who were subjected to individual dosimetric monitoring from 1950 to 2002. The value of excess relative risk for solid cancers was found to be ERR Gy(-1) = 0.24 (95% CI: -4.22; 7.96). It has been shown that 81.8% of the persons covered by individual dosimetric monitoring have potential attributive risk up to 5%, and the risk is more than 10% for 3.7% of the workers. Among the detected cancer cases, 73.5% of the individuals show an attributive risk up to 5% and the risk is in excess of 10% for 3.9% of the workers. Principles for the provision of targeted health care, given voluntary health insurance, are outlined.

  8. Risk Management Issues - An Aerospace Perspective

    Science.gov (United States)

    Perera, Jeevan S.

    2011-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks--risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements.. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner, Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  9. Smart Grid Risk Management

    Science.gov (United States)

    Abad Lopez, Carlos Adrian

    Current electricity infrastructure is being stressed from several directions -- high demand, unreliable supply, extreme weather conditions, accidents, among others. Infrastructure planners have, traditionally, focused on only the cost of the system; today, resilience and sustainability are increasingly becoming more important. In this dissertation, we develop computational tools for efficiently managing electricity resources to help create a more reliable and sustainable electrical grid. The tools we present in this work will help electric utilities coordinate demand to allow the smooth and large scale integration of renewable sources of energy into traditional grids, as well as provide infrastructure planners and operators in developing countries a framework for making informed planning and control decisions in the presence of uncertainty. Demand-side management is considered as the most viable solution for maintaining grid stability as generation from intermittent renewable sources increases. Demand-side management, particularly demand response (DR) programs that attempt to alter the energy consumption of customers either by using price-based incentives or up-front power interruption contracts, is more cost-effective and sustainable in addressing short-term supply-demand imbalances when compared with the alternative that involves increasing fossil fuel-based fast spinning reserves. An essential step in compensating participating customers and benchmarking the effectiveness of DR programs is to be able to independently detect the load reduction from observed meter data. Electric utilities implementing automated DR programs through direct load control switches are also interested in detecting the reduction in demand to efficiently pinpoint non-functioning devices to reduce maintenance costs. We develop sparse optimization methods for detecting a small change in the demand for electricity of a customer in response to a price change or signal from the utility

  10. Recommendations for Insulin Dose Calculator Risk Management

    Science.gov (United States)

    2014-01-01

    Several studies have shown the usefulness of an automated insulin dose bolus advisor (BA) in achieving improved glycemic control for insulin-using diabetes patients. Although regulatory agencies have approved several BAs over the past decades, these devices are not standardized in their approach to dosage calculation and include many features that may introduce risk to patients. Moreover, there is no single standard of care for diabetes worldwide and no guidance documents for BAs, specifically. Given the emerging and more stringent regulations on software used in medical devices, the approval process is becoming more difficult for manufacturers to navigate, with some manufacturers opting to remove BAs from their products altogether. A comprehensive literature search was performed, including publications discussing: diabetes BA use and benefit, infusion pump safety and regulation, regulatory submissions, novel BAs, and recommendations for regulation and risk management of BAs. Also included were country-specific and international guidance documents for medical device, infusion pump, medical software, and mobile medical application risk management and regulation. No definitive worldwide guidance exists regarding risk management requirements for BAs, specifically. However, local and international guidance documents for medical devices, infusion pumps, and medical device software offer guidance that can be applied to this technology. In addition, risk management exercises that are algorithm-specific can help prepare manufacturers for regulatory submissions. This article discusses key issues relevant to BA use and safety, and recommends risk management activities incorporating current research and guidance. PMID:24876550

  11. RISKS IN INVESTMENT AND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ms. Tatiana A. Ykovleva

    2016-12-01

    Full Text Available The article discusses the features of investment risks and their causes, as well as provides a detailed classification of investment risks. The authors reveal the essence and content of the investment process, risk management, providing material for presentation in the form of a diagram. In conclusion, the article explains the use of the system of specialized institutions as a way to exclude the basic, or primary investment risk.

  12. Enterprise risk management and disclosure

    Directory of Open Access Journals (Sweden)

    Nicoleta Farcane

    2008-01-01

    Full Text Available Our paper deals with aspects regarding risk and uncertainty. Many risk management methods are today implemented in organizations. This perspective reveals that managers are linked in different forms to the activities they are managing, depending on the conditions and levels of uncertainty they are in. Actually, these multiple levels of uncertainty lead to the conclusion that any situation in an organizational system can be classified in two different models of organizational phenomena: the organizational phenomena that are putting managers and stakeholders in conditions of risk and the organizational phenomena that are putting them in condition of uncertainty. Using content analyze in this paper we survey the disclosure level of risk management information in the annual report of top Romanian listed companies.

  13. [Risk management in dentistry].

    Science.gov (United States)

    Admiraal, W J

    1993-01-01

    Riskmanagement means the prevention of all accidental damages, prevention of claims in general and prevention of paying excessive insurance premiums. The main objective of riskmanagement is promotion of quality care. The riskmanagement rules are presented and discussed.

  14. Applied software risk management a guide for software project managers

    CERN Document Server

    Pandian, C Ravindranath

    2006-01-01

    Few software projects are completed on time, on budget, and to their original specifications. Focusing on what practitioners need to know about risk in the pursuit of delivering software projects, Applied Software Risk Management: A Guide for Software Project Managers covers key components of the risk management process and the software development process, as well as best practices for software risk identification, risk planning, and risk analysis. Written in a clear and concise manner, this resource presents concepts and practical insight into managing risk. It first covers risk-driven project management, risk management processes, risk attributes, risk identification, and risk analysis. The book continues by examining responses to risk, the tracking and modeling of risks, intelligence gathering, and integrated risk management. It concludes with details on drafting and implementing procedures. A diary of a risk manager provides insight in implementing risk management processes.Bringing together concepts ...

  15. Risk Management and Value Creation

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Roggi, Oliviero

    of competitive advantage. Yet, surprisingly little research has analyzed whether the presumed advantages of effective risk management are associated with superior outcomes. Here we present a comprehensive study of risk management effectiveness and the relationship to corporate performance based on more than 33......,500 observations in 3,400 firms over the turbulent 20-year period 1991-2010. Determining effective risk management as the ability to reduce earnings and cash flow volatility, we find that both have significant positive relationships to lagged performance measures after controlling for industry effects, company...

  16. The Theme of Risk Management

    Directory of Open Access Journals (Sweden)

    Chua, D. K. H.

    2014-07-01

    Full Text Available The papers in this issue of the Journal come from different industry sectors, yet there can be a common theme that ties them together. Two of the papers address explicitly the issue of risk management, while the other three may be related to it in different degrees. One of the critical factors for project success is risk identification, as determined by Chua et al. (1999. The importance of risk management cannot be overemphasized. Failure to identify crucial risk elements in a project can lead to significant project failures in terms of cost and schedule.

  17. Knowledge management in support of enterprise risk management

    OpenAIRE

    Rodriguez, Eduardo; Edwards, John S.

    2014-01-01

    Risk management and knowledge management have so far been studied almost independently. The evolution of risk management to the holistic view of Enterprise Risk Management requires the destruction of barriers between organizational silos and the exchange and application of knowledge from different risk management areas. However, knowledge management has received little or no attention in risk management. This paper examines possible relationships between knowledge management constructs relate...

  18. Comparison of Optimal Cardiovascular Risk Factor Management in Patients with Type 2 Diabetes Who Attended Urban Medical Health Center with those Attended a Tertiary Care Center: Experiences from Tehran, Iran

    Science.gov (United States)

    Moradi, Sedighe; Haji Ghanbari, Mohammad Javad; Ebrahimi, Hedyeh

    2016-01-01

    Background: Diabetes is a leading cause of cardiovascular disease (CVD). Moreover, CVD accounts for primary cause of death among diabetic patients. Physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. Therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in Type 2 diabetic patients attending to an urban health center as a primary care center with Institute of Endocrinology and Metabolism Diabetes Clinic (IEMDC) as a tertiary center. Methods: This cross-sectional study was performed on 200 adult diabetic patients attending urban health center (Abouzar Health Center) and 201 diabetic patients in a tertiary center. The patients’ cardiovascular risk factors including lipid profile, systolic and diastolic blood pressure (BP), and smoking history were recorded. The number of patients who did not achieve the target according to the American Diabetes Association guidelines was determined and compared. Results: The patients in urban health center were older than those who attending IEMDC (P = 0.004). The duration of diabetes was longer among urban center patients (P glycosylated hemoglobin level, high-density lipoprotein level, and systolic BP. Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers. PMID:27761215

  19. Spirulina in health care management.

    Science.gov (United States)

    Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S

    2008-10-01

    Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management.

  20. Blogging and the health care manager.

    Science.gov (United States)

    Malvey, Donna; Alderman, Barbara; Todd, Andrew D

    2009-01-01

    The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.

  1. Glossary of Managed Care Definitions

    Science.gov (United States)

    ... care provided to a patient by a health care provider. The medical record includes notes from physician visits, hospitalization records, test results, and consultations by specialists. Each health care provider who treats a patient usually creates and maintains ...

  2. Failing ageing? Risk management in the active ageing society

    DEFF Research Database (Denmark)

    Rostgaard, Tine

    2015-01-01

    According to the European Commission's recent policy initiative on social investment, Danish Long term care offers new and innovative perspectives in ageing and the management of the risks associated thereof with the introduction of reablement (rehabilitering). From the perspective...

  3. Risk assessment and risk management of mycotoxins.

    Science.gov (United States)

    2012-01-01

    Risk assessment is the process of quantifying the magnitude and exposure, or probability, of a harmful effect to individuals or populations from certain agents or activities. Here, we summarize the four steps of risk assessment: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Risk assessments using these principles have been conducted on the major mycotoxins (aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, and zearalenone) by various regulatory agencies for the purpose of setting food safety guidelines. We critically evaluate the impact of these risk assessment parameters on the estimated global burden of the associated diseases as well as the impact of regulatory measures on food supply and international trade. Apart from the well-established risk posed by aflatoxins, many uncertainties still exist about risk assessments for the other major mycotoxins, often reflecting a lack of epidemiological data. Differences exist in the risk management strategies and in the ways different governments impose regulations and technologies to reduce levels of mycotoxins in the food-chain. Regulatory measures have very little impact on remote rural and subsistence farming communities in developing countries, in contrast to developed countries, where regulations are strictly enforced to reduce and/or remove mycotoxin contamination. However, in the absence of the relevant technologies or the necessary infrastructure, we highlight simple intervention practices to reduce mycotoxin contamination in the field and/or prevent mycotoxin formation during storage.

  4. Causal Models for Risk Management

    Directory of Open Access Journals (Sweden)

    Neysis Hernández Díaz

    2013-12-01

    Full Text Available In this work a study about the process of risk management in major schools in the world. The project management tools worldwide highlights the need to redefine risk management processes. From the information obtained it is proposed the use of causal models for risk analysis based on information from the project or company, say risks and the influence thereof on the costs, human capital and project requirements and detect the damages of a number of tasks without tribute to the development of the project. A study on the use of causal models as knowledge representation techniques causal, among which are the Fuzzy Cognitive Maps (DCM and Bayesian networks, with the most favorable MCD technique to use because it allows modeling the risk information witho ut having a knowledge base either itemize.

  5. Drought risk management in Mediterranean river basins.

    Science.gov (United States)

    Iglesias, Ana; Garrote, Luis; Martín-Carrasco, Francisco

    2009-01-01

    The Mediterranean region has an extensive hydraulic infrastructure and complex socioeconomic interactions among water users. In this region, competition for water among urban, agricultural, industrial, and environmental demands is strongest in times of water scarcity. Allocation of scarce water in the face of multiple demands is a challenging task that requires careful analysis. Precipitation decreases may likely be translated into drought periods in most cases. Nevertheless water scarcity (the shortage of water resources to serve water demands) not only depends on drought or precipitation deficits but also on water management. Adaptation options depend on the strategic contingency planning and management decisions that affect water resources systems. The risk management of water scarcity and drought depends on the level of water scarcity. Therefore, an adequate diagnosis of the water scarcity level is essential to anticipate the possible solutions. This study proposes a methodology for drought risk management based on the evaluation of 4 indicators of water scarcity to be used to define the thresholds of risk management actions. Based on the definition of thresholds, the study proposes the implementation of risk management actions that may be used for responding to each water scarcity situation.

  6. Complex Choices: Producers Risk Management Strategies

    OpenAIRE

    Pennings, Joost M.E.; Isengildina, Olga; Irwin, Scott H.; Good, Darrel L.; Garcia, Philip; Frank, Julieta; Kuiper, W. Erno

    2005-01-01

    Producers have a wide variety of risk management instruments available. How do producers make a choice of risk management instruments? Using the recently developed choice bracketing framework, we examine what risk management strategies producers use and identify the factors that drive their risk management decisions. Our results identify that producers use a wide variety of combinations of risk management instruments and that they bracket their choices into sets of alternative risk management...

  7. Managing Risk and Opportunity

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Garvey, Maxine; Roggi, Oliviero

    . Hence, the book addresses the potential for upside gains as much as the threats of downside losses that represent the conventional risk perspectives. It states the simple fact that you must be willing to take risk to increase strategic responsiveness and corporate manoeuverability. The text builds...... the arguments in logical steps explicating relevant techniques and practices along the way that invite to immediate applications and practical thinking....

  8. Legal risk management in shipping

    DEFF Research Database (Denmark)

    Siig, Kristina

    The book discusses the most typical legal challenges met in the chartering, broker, agent or port management part of the shipping industry. It discusses these issues in both English and Scandinavian law and gives indications on how to best ensure your legal risk management in these parts...

  9. The impact of a disease management program (COACH on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Selvaraj Francis Jude

    2012-10-01

    Full Text Available Abstract Background To evaluate the efficacy of Counselling and Advisory Care for Health (COACH programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm and primary care physicians assisted by nurse educators (PCP-NE arm. Methods This was a multi-centre, open label, randomised trial of a disease management programme (COACH among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE and 148 to care provided by primary care physicians (PCP alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio, Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36. Results Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS mean change from baseline LDL-C were −30.09% and −27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288, with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had

  10. Issue Management Risk Ranking Systems

    Energy Technology Data Exchange (ETDEWEB)

    Novack, Steven David; Marshall, Frances Mc Clellan; Stromberg, Howard Merion; Grant, Gary Michael

    1999-06-01

    Thousands of safety issues have been collected on-line at the Idaho National Engineering and Environmental Laboratory (INEEL) as part of the Issue Management Plan. However, there has been no established approach to prioritize collected and future issues. The authors developed a methodology, based on hazards assessment, to identify and risk rank over 5000 safety issues collected at INEEL. This approach required that it was easily applied and understandable for site adaptation and commensurate with the Integrated Safety Plan. High-risk issues were investigated and mitigative/preventive measures were suggested and ranked based on a cost-benefit scheme to provide risk-informed safety measures. This methodology was consistent with other integrated safety management goals and tasks providing a site-wide risk informed decision tool to reduce hazardous conditions and focus resources on high-risk safety issues. As part of the issue management plan, this methodology was incorporated at the issue collection level and training was provided to management to better familiarize decision-makers with concepts of safety and risk. This prioritization methodology and issue dissemination procedure will be discussed. Results of issue prioritization and training efforts will be summarized. Difficulties and advantages of the process will be reported. Development and incorporation of this process into INEELs lessons learned reporting and the site-wide integrated safety management program will be shown with an emphasis on establishing self reliance and ownership of safety issues.

  11. Issue Management Risk Ranking Systems

    Energy Technology Data Exchange (ETDEWEB)

    F. M. Marshall; G. M. Grant; H. M. Stromberg; S. D. Novack

    1999-06-01

    Thousands of safety issues have been collected on-line at the Idaho National Engineering and Environmental Laboratory (INEEL) as part of the Issue Management Plan. However, there has been no established approach to prioritize collected and future issues. The authors developed a methodology, based on hazards assessment, to identify and risk rank over 5000 safety issues collected at INEEL. This approach required that it was easily applied and understandable for site adaptation and commensurate with the Integrated Safety Plan. High-risk issues were investigated and mitigative/preventive measures were suggested and ranked based on a cost-benefit scheme to provide risk-informed safety measures. This methodology was consistent with other integrated safety management goals and tasks providing a site-wide risk-informed decision tool to reduce hazardous conditions and focus resources on high-risk safety issues. As part of the issue management plan, this methodology was incorporated at the issue collection level and training was provided to management to better familiarize decision-makers with concepts of safety and risk. This prioritization methodology and issue dissemination procedure will be discussed. Results of issue prioritization and training efforts will be summarized. Difficulties and advantages of the process will be reported. Development and incorporation of this process into INEEL's lessons learned reporting and the site-wide integrated safety management program will be shown with an emphasis on establishing self reliance and ownership of safety issues.

  12. RISK MANAGEMENT MEASURES IN CMMI

    Directory of Open Access Journals (Sweden)

    Mahmoud Khraiwesh

    2012-02-01

    Full Text Available Risk management is a continuous process that could endanger the objectives of a project or application.Risks are handled to reduce and avoid threats effects on the objectives of the project. The sources of riskare both internal and external to the project. This research will identify general measures for the specificgoal and its specific practices of Risk Management Process Area (PA in Capability Maturity ModelIntegration (CMMI. CMMI is developed by Software Engineering Institute (SEI in Carnegie MellonUniversity in USA. CMMI is a framework for improvement and assessment of computer informationsystems. The method we used to define the measures is to apply the Goal Questions Metrics (GQMparadigm to the specific goals and its specific practices of Risk Management Process Area in CMMI.

  13. Primary care quality management in Uzbekistan.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Kringos, D.S.; Verschuuren, M.; Pellny, M.; Baymirova, L.

    2008-01-01

    The Uzbek government has a central role in primary care quality management. On paper, many quality management structures and procedures exist. Now, primary care practice should follow, as NIVEL research – done on the initiative of the World Health Organisation (WHO) – has shown. The results have bee

  14. Managing longevity risk

    NARCIS (Netherlands)

    Li, Hong

    2015-01-01

    The thesis first examines the choice of sample size for mortality forecasting, and then deal with the hedging of longevity risk using longevity-linked instruments. Chapter 2 proposes a Bayesian learning approach to determine the (posterior distribution of) the sample sizes for mortality forecasting

  15. Obesity in the intensive care unit: risks and complications.

    Science.gov (United States)

    Selim, Bernardo J; Ramar, Kannan; Surani, Salim

    2016-08-01

    The steady growing prevalence of critically ill obese patients is posing diagnostic and management challenges across medical and surgical intensive care units. The impact of obesity in the critically ill patients may vary by type of critical illness, obesity severity (obesity distribution) and obesity-associated co-morbidities. Based on pathophysiological changes associated with obesity, predominately in pulmonary reserve and cardiac function, critically ill obese patients may be at higher risk for acute cardiovascular, pulmonary and renal complications in comparison to non-obese patients. Obesity also represents a dilemma in the management of other critical care areas such as invasive mechanical ventilation, mechanical ventilation liberation, hemodynamic monitoring and pharmacokinetics dose adjustments. However, despite higher morbidity associated with obesity in the intensive care unit (ICU), a paradoxical lower ICU mortality ("obesity paradox") is demonstrated in comparison to non-obese ICU patients. This review article will focus on the unique pathophysiology, challenges in management, and outcomes associated with obesity in the ICU.

  16. Strategic management of health care information systems: nurse managers' perceptions.

    Science.gov (United States)

    Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha

    2009-01-01

    The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

  17. Symptom management in palliative care and end of life care.

    Science.gov (United States)

    Bookbinder, Marilyn; McHugh, Marlene E

    2010-09-01

    There is a need for generalist- and specialist-level palliative care clinicians proficient in symptom management and care coordination. Major factors contributing to this need include changed disease processes and trajectories, improved medical techniques and diagnostic testing, successful screening for chronic conditions, and drugs that often prolong life. The rapid progressive illnesses and deaths that plagued the first half of the twentieth century have been replaced in the twenty-first century by increased survival rates. Conditions that require ongoing medical care beyond a year define the current chronic illness population. Long years of survival are often accompanied by a reduced quality of life that requires more medical and nursing care and longer home care. This article reviews the management of selected symptoms in palliative and end of life care.

  18. Is ALARP applicable to the management of terrorist risks?

    Energy Technology Data Exchange (ETDEWEB)

    Guikema, S.D., E-mail: sguikema@jhu.ed [Department of Geography and Environmental Engineering, Johns Hopkins University, Baltimore, MD 21218 (United States); Department of Industrial Economics, Risk Management and Planning, University of Stavanger (Norway); Aven, T. [Department of Industrial Economics, Risk Management and Planning, University of Stavanger (Norway)

    2010-08-15

    In this paper, we discuss the applicability of the as low as reasonable practicable (ALARP) principle to terrorist risk management. ALARP is a commonly used framework for managing risk due to non-intelligent threats, but terrorism introduces difficult issues, both technically and socially. In particular, the probability of a terrorist attack is difficult to define, terrorist threats are adaptive, and some terrorist risk management actions raise issues of loss of civil liberties not raised by risk management measures for other types of risk. We discuss these issues and their implications for risk management. After showing how ALARP is used to manage the risk from other hazards in different economic sectors, we discuss both the benefits and difficulties associated with extending the ALARP framework for terrorist risk analysis. We conclude that the ALARP framework can be modified to make it appropriate for risk management for adaptive risks, provided that care is taken to explicitly consider adaptive reallocation of risk in response to risk management actions, to account for perceived or actual loss of civil liberties resulting from risk management actions, and to consider the difficulties associated with using probability to measure uncertainty in adversary actions.

  19. Multidisciplinary care and management selection in prostate cancer.

    Science.gov (United States)

    Aizer, Ayal A; Paly, Jonathan J; Efstathiou, Jason A

    2013-07-01

    The management of prostate cancer is complicated by the multitude of treatment options, the lack of proven superiority of one modality of management, and the presence of physician bias. Care at a multidisciplinary prostate cancer clinic offers patients the relative convenience of consultation with physicians of multiple specialties within the confines of a single visit and appears to serve as a venue in which patients can be counseled regarding the risks and benefits of available therapies in an open and interactive environment. Physician bias may be minimized in such an environment, and patient satisfaction rates are high. Available data suggest that low-risk patients who are seen at a multidisciplinary prostate cancer clinic appear to select active surveillance in greater proportion. However, relatively few studies have investigated the other added value that multidisciplinary clinics provide to the patient or health care system, and therefore, additional studies assessing the impact of multidisciplinary care in the management of patients with prostate cancer are needed.

  20. Risk Management Programs for Defense Acquisition Systems

    Science.gov (United States)

    2007-11-02

    The audit objective was to evaluate the effectiveness of risk management programs for Defense acquisition systems. Specifically, we determined whether DoD risk management policies and procedures for Defense acquisition systems were effectively implemented and what impact risk management programs bad on reducing program risks and costs. We also reviewed management controls as they applied to the audit objectives.

  1. No exodus: physicians and managed care networks.

    Science.gov (United States)

    O'Malley, Ann S; Reschovsky, James D

    2006-05-01

    After remaining stable since 1996-97, the percentage of U.S. physicians who do not contract with managed care plans rose from 9.2 percent in 2000-01 to 11.5 percent in 2004-05, according to a national study from the Center for Studying Health System Change (HSC). While physicians have not left managed care networks in large numbers, this small but statistically significant increase could signal a trend toward greater out-of-pocket costs for patients and a decline in patient access to physicians. The increase in physicians without managed care contracts was broad-based across specialties and other physician and practice characteristics. Compared with physicians who have one or more managed care contracts, physicians without managed care contracts are more likely to have practiced for more than 20 years, work part time, lack board certification, practice solo or in two-physician groups, and live in the western United States. The study also found substantial variation in the proportion of physicians without managed care contracts across communities, suggesting that local market conditions influence decisions to contract with managed care plans.

  2. Improving patient adherence to lifestyle advice (IMPALA: a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol

    Directory of Open Access Journals (Sweden)

    Grol Richard

    2008-01-01

    Full Text Available Abstract Background Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on diet, physical exercise, smoking and alcohol, have moderate, but potentially relevant effects in these patients, adherence to lifestyle advice in general practice is not optimal. The IMPALA study intends to improve adherence to lifestyle advice by involving patients in decision making on cardiovascular prevention by nurse-led clinics. The aim of this paper is to describe the design and methods of a study to evaluate an intervention aimed at involving patients in cardiovascular risk management. Methods A cluster-randomised controlled trial in 20 general practices, 10 practices in the intervention arm and 10 in the control arm, starting on October 2005. A total of 720 patients without existing cardiovascular diseases but eligible for cardiovascular risk assessment will be recruited. In both arms, the general practitioners and nurses will be trained to apply the national guideline for cardiovascular risk management. Nurses in the intervention arm will receive an extended training in risk assessment, risk communication, the use of a decision aid and adapted motivational interviewing. This communication technique will be used to support the shared decision-making process about risk reduction. The intervention comprises 2 consultations and 1 follow-up telephone call. The nurses in the control arm will give usual care after the risk estimation, according to the national guideline. Primary outcome measures are self-reported adherence to lifestyle advice and drug treatment. Secondary outcome measures are the patients' perception of risk and their motivation to change their behaviour. The measurements will take place at baseline and after 12 and 52

  3. Obstetrics Hospitalists: Risk Management Implications.

    Science.gov (United States)

    Veltman, Larry

    2015-09-01

    The concept of having an in-house obstetrician (serving as an obstetrics [OB] hospitalist) available 24 hours a day, 7 days a week provides a safety net for OB events that many need immediate intervention for a successful outcome. A key precept of risk management, that of loss prevention, fits perfectly with the addition of an OB hospitalist role in the perinatal department. Inherent in the role of OB hospitalists are the patient safety and risk management principles of improved communication, enhanced readiness, and immediate availability.

  4. Optimizing cardiothoracic surgery information for a managed care environment.

    Science.gov (United States)

    Denton, T A; Matloff, J M

    1995-11-01

    The rapid change occurring in American healthcare is a direct response to rising costs. Managed care is the fastest growing model that attempts to control escalating costs through limitations in patient choice, the active use of guidelines, and placing providers at risk. Managed care is an information intensive system, and those providers who use information effectively will be at an advantage in the competitive healthcare marketplace. There are five classes of information that providers must collect to be competitive in a managed care environment: patient satisfaction, medical outcomes, continuous quality improvement, quality of the decision, and financial data. Each of these should be actively used in marketing, assuring the quality of patient care, and maintaining financial stability. Although changes in our healthcare system are occurring rapidly, we need to respond to the marketplace to maintain our viability, but as physicians, we have the singular obligation to maintain the supremacy of the individual patient and the physician-patient relationship.

  5. Technical elements, demonstration projects, and fiscal models in Medicaid managed care for people with developmental disabilities.

    Science.gov (United States)

    Kastner, T A; Walsh, K K; Criscione, T

    1997-08-01

    We presented a general model of the structure and functioning of managed care and described elements (provider networks, fiscal elements, risk estimation, case-mix, management information systems, practice parameters, and quality improvement) critical to service delivery for people with developmental disabilities. A number of technical elements of managed care systems were delineated and reviewed in relation to the inclusion of people with developmental disabilities. Several managed care demonstration projects were described and, finally, a multi-year hypothetical budget model, including long-term care, was presented as a framework for considering how managed care affects specific service structures. Implications for people with developmental disabilities were discussed.

  6. Overview of the Hanford risk management plan

    Energy Technology Data Exchange (ETDEWEB)

    Halverson, T.G.

    1998-03-26

    The Project Hanford Management Contract called for the enhancement of site-wide decision processes, and development of a Hanford Risk Management Plan to adopt or develop a risk management system for the Hanford Site. This Plan provides a consistent foundation for Site issues and addresses site-wide management of risks of all types. It supports the Department of Energy planning and sitewide decision making policy. Added to this requirement is a risk performance report to characterize the risk management accomplishments. This paper presents the development of risk management within the context of work planning and performance. Also discussed are four risk elements which add value to the context.

  7. Integrated foreign exchange risk management

    DEFF Research Database (Denmark)

    Aabo, Tom; Høg, Esben; Kuhn, Jochen

    2010-01-01

    Empirical research has focused on export as a proxy for exchange rate exposure and the use of foreign exchange derivatives as an instrument to deal with this exposure. This empirical study applies an integrated foreign exchange risk management approach with a particular focus on the role of impor...

  8. Risk Management for e-Business

    Directory of Open Access Journals (Sweden)

    2007-01-01

    Full Text Available In the new Internet economy, risk management plays a critical role to protect the organization and its ability to perform their business mission, not just its IT assets. Risk management is the process of identifying risk, assessing risk, and taking steps to reduce risk to an acceptable level. The risk management is an important component of a IT security program. Information and communications technology management and IT security are responsible for ensuring that technology risks are managed appropriately. These risks originate from the deployment and use of IT assets in various ways, such as configuring systems incorrectly or gaining access to restricted software.

  9. Floods Risk Management in Colombia

    Directory of Open Access Journals (Sweden)

    Leonardo Güiza Suárez

    2013-10-01

    Full Text Available The last rainy season 2010-2011 resulted in Colombia in around 500 casualties and more than 3.6 million of victims. Although this rainfall term accounted for one of the strongest it was not an unprecedented event since for more than fifty years this phenomenon has been taking place in the same Colombian regions producing casualties and victims. This fact makes us to think about the public management by authorities regarding flooding prevention in our country. This article elaborates on this topic explaining the risk management system in case of flooding in Colombia. It shows some national figures of the main ravages brought about by the 2010 2011 rainy seasons. Finally the article analyzes two cases of study of how operational is this public policy in risk management: La Mojana and Canal del Dique regions. It was evident that the state failed in managing the risk management from flooding because despite the important investment, every year the victims, casualties and material damages are increasing steadily.

  10. Medicare Managed Care plan Performance, A Comparison...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The study evaluates the performance of Medicare managed care, Medicare Advantage, Plans in comparison to Medicare fee-for-service Plans in three states with...

  11. Home Care Nursing Improves Cancer Symptom Management

    Science.gov (United States)

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  12. Using care plans to better manage multimorbidity

    OpenAIRE

    Mark AJ Morgan; Coates, Michael J; Dunbar, James A

    2015-01-01

    Background The health care for patients having two or more long-term medical conditions is fragmented between specialists, allied health professionals, and general practitioners (GPs), each keeping separate medical records. There are separate guidelines for each disease, making it difficult for the GP to coordinate care. The TrueBlue model of collaborative care to address key problems in managing patients with multimorbidity in general practice previously reported outcomes on the managemen...

  13. Future developments in health care performance management

    OpenAIRE

    Crema M; Verbano C

    2013-01-01

    Maria Crema, Chiara Verbano Department of Management and Engineering, University of Padova, Vicenza, Italy Abstract: This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to...

  14. Primary care quality management in Slovenia.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Kringos, D.S.; Verschuuren, M.; Pellny, M.; Bulc, M.

    2008-01-01

    Of all GPs in Slovenia 86% are not interested in activities to systematically improve care. A clear national quality policy, further education for care managers and financial incentives for GPs could change the picture, as NIVEL research – done on the initiative of the World Health Organisation (WHO

  15. The complete idiot's guide to risk management

    CERN Document Server

    Cortez, Annetta

    2010-01-01

    Risk. It's what business is all about. The key to success is to anticipating and managing the risks that can impact business. The Complete Idiot's Guide(r) to Risk Management provides the key information necessary to manage business risk successfully.

  16. 12 CFR 917.3 - Risk management.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Risk management. 917.3 Section 917.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD GOVERNANCE AND MANAGEMENT OF THE FEDERAL HOME LOAN BANKS POWERS AND RESPONSIBILITIES OF BANK BOARDS OF DIRECTORS AND SENIOR MANAGEMENT § 917.3 Risk management. (a) Risk...

  17. Participative management in health care services

    Directory of Open Access Journals (Sweden)

    M. Muller

    1995-05-01

    Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

  18. Managing risks and hazardous in industrial operations

    Energy Technology Data Exchange (ETDEWEB)

    Almaula, S.C. [Woodward-Clyde International, Oakland, CA (United States)

    1996-12-31

    The main objective of this paper is to demonstrate that it makes good business sense to identify risks and hazards of an operation and take appropriate steps to manage them effectively. Developing and implementing an effective risk and hazard management plan also contibutes to other industry requirements and standards. Development of a risk management system, key elements of a risk management plan, and hazards and risk analysis methods are outlined. Comparing potential risk to the cost of prevention is also discussed. It is estimated that the cost of developing and preparing the first risk management plan varies between $50,000 to $200,000. 3 refs., 2 figs., 1 tab.

  19. Managing diversity in the health care workplace.

    Science.gov (United States)

    Davidhizar, R; Dowd, S; Newman Giger, J

    1999-03-01

    Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately.

  20. Improving patient adherence to lifestyle advice (IMPALA): a cluster-randomised controlled trial on the implementation of a nurse-led intervention for cardiovascular risk management in primary care (protocol).

    NARCIS (Netherlands)

    Loon, M.S. Koelewijn-van; Steenkiste, B. van; Ronda, G.; Wensing, M.J.P.; Stoffers, H.E.; Elwyn, G.; Grol, R.P.T.M.; Weijden, T.T. van der

    2008-01-01

    BACKGROUND: Many patients at high risk of cardiovascular diseases are managed and monitored in general practice. Recommendations for cardiovascular risk management, including lifestyle change, are clearly described in the Dutch national guideline. Although lifestyle interventions, such as advice on

  1. Total quality management in health care.

    Science.gov (United States)

    McDonald, S C

    1994-01-01

    Total quality management (TQM), continuous quality improvement (CQI) and quality control are terms that are becoming very familiar to workers in the health care environment. The purpose of this article is to discuss these terms and the concepts they describe. The origins of TQM and the keen interest in its application to the health care environment today are addressed. In other environments, TQM has shown significant increases in productivity while increasing effectiveness. Its application to the health care environment is the provision of the best possible care through continuously improving service to meet or exceed the needs and expectations of the customer. The customer in the health care environment could be the patient, staff, physician and community serviced by the hospital. Characteristics of the new organizational structure are reviewed. Established techniques and processes are commonly used to identify process-improvement opportunities to assist the manager in continuously evaluating quality trends.

  2. Human System Risk Management for Space Flight

    Science.gov (United States)

    Davis, Jeffrey

    2015-01-01

    This brief abstract reviews the development of the current day approach to human system risk management for space flight and the development of the critical components of this process over the past few years. The human system risk management process now provides a comprehensive assessment of each human system risk by design reference mission (DRM) and is evaluated not only for mission success but also for long-term health impacts for the astronauts. The discipline of bioastronautics is the study of the biological and medical effects of space flight on humans. In 1997, the Space Life Sciences Directorate (SLSD) initiated the Bioastronautics Roadmap (Roadmap) as the "Critical Path Roadmap", and in 1998 participation in the roadmap was expanded to include the National Space Biomedical Research Institute (NSBRI) and the external community. A total of 55 risks and 250 questions were identified and prioritized and in 2000, the Roadmap was base-lined and put under configuration control. The Roadmap took into account several major advisory committee reviews including the Institute of Medicine (IOM) "Safe Passage: Astronaut care for Exploration Missions", 2001. Subsequently, three collaborating organizations at NASA HQ (Chief Health and Medical Officer, Office of Space Flight and Office of Biological & Physical Research), published the Bioastronautics Strategy in 2003, that identified the human as a "critical subsystem of space flight" and noted that "tolerance limits and safe operating bands must be established" to enable human space flight. These offices also requested a review by the IOM of the Roadmap and that review was published in October 2005 as "A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA's Bioastronautics Roadmap", that noted several strengths and weaknesses of the Roadmap and made several recommendations. In parallel with the development of the Roadmap, the Office of the Chief Health and Medical Officer (OCHMO) began a process in

  3. Microbiological risk assessment for personal care products.

    Science.gov (United States)

    Stewart, S E; Parker, M D; Amézquita, A; Pitt, T L

    2016-12-01

    Regulatory decisions regarding microbiological safety of cosmetics and personal care products are primarily hazard-based, where the presence of a potential pathogen determines decision-making. This contrasts with the Food industry where it is a commonplace to use a risk-based approach for ensuring microbiological safety. A risk-based approach allows consideration of the degree of exposure to assess unacceptable health risks. As there can be a number of advantages in using a risk-based approach to safety, this study explores the Codex Alimentarius (Codex) four-step Microbiological Risk Assessment (MRA) framework frequently used in the Food industry and examines how it can be applied to the safety assessment of personal care products. The hazard identification and hazard characterization steps (one and two) of the Codex MRA framework consider the main microorganisms of concern. These are addressed by reviewing the current industry guidelines for objectionable organisms and analysing reports of contaminated products notified by government agencies over a recent 5-year period, together with examples of reported outbreaks. Data related to estimation of exposure (step three) are discussed, and examples of possible calculations and references are included. The fourth step, performed by the risk assessor (risk characterization), is specific to each assessment and brings together the information from the first three steps to assess the risk. Although there are very few documented uses of the MRA approach for personal care products, this study illustrates that it is a practicable and sound approach for producing products that are safe by design. It can be helpful in the context of designing products and processes going to market and with setting of microbiological specifications. Additionally, it can be applied reactively to facilitate decision-making when contaminated products are released on to the marketplace. Currently, the knowledge available may only allow a

  4. Job redesign and the health care manager.

    Science.gov (United States)

    Layman, Elizabeth J

    2007-01-01

    Health care supervisors and managers are often asked to redesign jobs in their departments. Frequently, little information accompanies the directive. This article lists sources of change in work and defines key terms. Also reviewed are factors that supervisors and managers can weigh in their redesigns. The article suggests actions aligned to common problems in the work environment. Finally, guidelines for a practical, step-by-step approach are provided. For health care supervisors and managers, the key to a successful job redesign is to achieve the unique balance of factors that matches the situation.

  5. Improving managed care value through customer service.

    Science.gov (United States)

    Tomczyk, Dennis J

    2002-06-01

    The ability of managed care providers to deliver high-quality customer service to managed care customers depends on their adoption of basic customer-service principles. To apply these principles effectively, providers need to understand and work to exceed the particular needs and expectations of these customers, which include boards of directors, senior executives, physicians, healthcare providers, clinical and patient financial services managers and staff, employers, brokers, and patients. Although these needs and expectations can be predicted to some extent, providers would be wise to implement regular surveys of customers and an open procedure for soliciting customer feedback about service issues. Better customer service for the broad range of managed care customers translates into higher levels of employer and patient satisfaction, which ultimately benefits providers.

  6. Risk Management Practices and Accounting Requirements.

    Science.gov (United States)

    Cheng, Rita Hartung; Yahr, Robert B.

    1989-01-01

    Reviews current school district risk management practices and the related accounting requirements. Summarizes the Governmental Accounting Standards Board's proposed accounting standards and the impact of these on school districts' risk management practices and on their financial statements. (11 references) (MLF)

  7. Integrative nature of financial risk management terminology

    OpenAIRE

    Akhmetova, Maynur

    2014-01-01

    Interdisciplinary approach to studying financial risk management terminology. Languages for special purposes of developed scientific fields are the most productive sources for borrowings for dynamically developing ones. Sources of term borrowings for financial risk management: their specific features and types.

  8. 风险管理在防范院前急救医患纠纷中的应用%Application of risk management in preventing medical dispute of prehospital emergency care

    Institute of Scientific and Technical Information of China (English)

    王鑫; 崔晓丽

    2015-01-01

    Objective To discuss the application of risk management in preventing prehospital medical dispute.Methods Since 2014, risk management had been implemented by Beijing emergency medical center for prehospital medical dispute. Risk factors that may result in medical dispute in pre-hospital care process was estimated and recognized. Frequency of medical dispute events, risk factor occurrence and call back satisfaction rates before and after the implementation of risk management were analyzed.Results After implementing the risk management plan, the complaint rate was lower in 2014 than in 2013, and the difference was statistically significant (χ2=7.181,P=0.007); the main causal factor of medical dispute was derived from hospital risk, 61 cases in 2013 (58.10%) and 27 cases in 2014 (44.26%); the secondary was the social risk factor, 28 cases in 2013(26.67%) and 22 cases in 2014 (36.07%); call back satisfaction rate was higher in 2014 than in 2013, and the difference was statistically significant(χ2=5.357,P=0.021). Among them, dissatisfaction events of medical behavior and treatment measure were reduced by 52.63% and 24.00% respectively.Conclusions By utilizing the risk management, prehospital medical dispute events can be decreased, first-aid personnel's risk prevention awareness can be raised, and it's also beneficial to prevent medical dispute event during prehospital emergency care.%目的 探讨风险管理在防范院前急救医患纠纷中的应用.方法 北京急救中心自2014年对院前急救医患纠纷实施风险管理,评估和识别院前急救过程中可能引起医患纠纷的风险因素,并分析实施风险管理前后的医患纠纷事件、风险因素发生次数及电话回访满意率.结果 实施风险管理后,2014年投诉量明显低于2013年,差异有统计学意义(χ2=7.181, P=0.007);造成医患纠纷最主要的风险因素是医方风险因素,2013年61起(58.10%),2014年27起(44.26%);其次为社会风险因素,2013年28起(26

  9. Multidisciplinary management of complex care.

    Science.gov (United States)

    Schofield, Deborah; Fuller, Jeffrey; Wagner, Scott; Friis, Leanne; Tyrell, Bill

    2009-02-01

    Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved. Ways of developing the capacity of the future workforce for work in multidisciplinary teams are discussed.

  10. 12 CFR 932.1 - Risk management.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Risk management. 932.1 Section 932.1 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.1 Risk management. Before its new capital plan may...

  11. Study of International Standards of Risk Management

    Directory of Open Access Journals (Sweden)

    Dykan Volodymyr L.

    2014-01-01

    Full Text Available The goal of the article lies in the study of existing international standards of risk management, an important factor of improvement of risk management in domestic corporations and enterprises and development of recommendations on application of international standards in Ukraine, in particular, within the framework of building corporate systems of risk management. The conducted study shows that approaches on organisation of the process of risk management, used in standards of risk management, are of general character and differ with the degree of detailing. Their undoubted value in development of risk management in Ukraine is identification of a general direction of building corporate systems of risk management in practice. The said approaches at the national and corporate levels of standardisation in Ukraine within the framework of building corporate systems of risk management would allow improvement of risk management in corporations and enterprises. The prospect of further studies of domestic specialists in the field of risk management is development of the domestic standard of risk management with consideration of modern domestic specific features of development of risk management in Ukraine and leading foreign experience.

  12. Dyspepsia management in primary care

    NARCIS (Netherlands)

    Thijs, JC; Arents, NLA; van Zwet, AA; Kleibeuker, JH

    2003-01-01

    Background: Dyspepsia is common in western society. Prompt endoscopy is imperative in all patients with sinister symptoms or if symptoms first appear after the age of 50-55 years, but the optimal management of younger patients with uncomplicated dyspepsia is still open to debate. Methods: The litera

  13. 42 CFR 441.476 - Risk management.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Risk management. 441.476 Section 441.476 Public... Self-Directed Personal Assistance Services Program § 441.476 Risk management. (a) The State must... plan for how identified risks will be mitigated. (d) The State must ensure that the risk...

  14. Best practice of nurse managers in risk management

    OpenAIRE

    2013-01-01

    OBJECTIVE: to identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. METHOD: a case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analy...

  15. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  16. The knowledge management on the elderly care

    Science.gov (United States)

    Arve, Seija; Ovaskainen, Païvi; Randelin, I.; Alin, Jouni; Rautava, Païvi

    2009-01-01

    Purpose The elderly care pathway from the public health emergency unit to the university hospital and back home needs rationalising. Another purpose is to utilise the information of the electronic patient record system in care coordination. Theory The processed knowledge from the electronic patient record system enables the geriatric professionals to deal with the information of the elderly care pathway effectively and to develop the care in a patient-centred way. Methods All the 75-year-old or older patients who had visited the emergency unit of Turku health care centre were analysed. The data were collected from the Pegasos® electronic patient record system. The method used was time-series analysis. Statistical analyses were run on SAS System for Windows, release 9.1. Results Twenty-three thousand-three hundred and seventy-two older patients visited the emergency unit and 25% of them were referred to hospital, less to the Turku city hospital, more to the university hospital. The information of transitions into the local organisations could be followed, but there were many information gaps in transitions to the university hospital. Conclusion Older people are cared for in the university hospital too often. The expensive care begins at the emergency unit and leads to the long-term institutional care. The care pathway of older patients has to be based on professional capability, co-operation and knowledge management.

  17. Understanding performance management in primary care.

    Science.gov (United States)

    Rogan, Lisa; Boaden, Ruth

    2017-02-13

    Purpose Principal-agent theory (PAT) has been used to understand relationships among different professional groups and explain performance management between organisations, but is rarely used for research within primary care. The purpose of this paper is to explore whether PAT can be used to attain a better understanding of performance management in primary care. Design/methodology/approach Purposive sampling was used to identify a range of general practices in the North-west of England. Interviews were carried out with directors, managers and clinicians in commissioning and regional performance management organisations and within general practices, and the data analysed using matrix analysis techniques to produce a case study of performance management. Findings There are various elements of the principal-agent framework that can be applied in primary care. Goal alignment is relevant, but can only be achieved through clear, strategic direction and consistent interpretation of objectives at all levels. There is confusion between performance measurement and performance management and a tendency to focus on things that are easy to measure whilst omitting aspects of care that are more difficult to capture. Appropriate use of incentives, good communication, clinical engagement, ownership and trust affect the degree to which information asymmetry is overcome and goal alignment achieved. Achieving the right balance between accountability and clinical autonomy is important to ensure governance and financial balance without stifling innovation. Originality/value The principal-agent theoretical framework can be used to attain a better understanding of performance management in primary care; although it is likely that only partial goal alignment will be achieved, dependent on the extent and level of alignment of a range of factors.

  18. Case management to improve major depression in primary health care : a systematic review

    NARCIS (Netherlands)

    Gensichen, J; Beyer, M; Muth, C; Gerlach, FM; Von Korff, M; Ormel, J

    2006-01-01

    Background. Deficits in the care of depression lead to poor medication adherence, which increases the risk of an unfavourable outcome for this care. This review evaluates effects on symptoms and medication adherence of case management in primary health care. Method. A systematic literature search wa

  19. Spreadsheet Risk Management in Organisations

    CERN Document Server

    Rittweger, Ben G

    2010-01-01

    The paper examines in the context of financial reporting, the controls that organisations have in place to manage spreadsheet risk and errors. There has been widespread research conducted in this area, both in Ireland and internationally. This paper describes a study involving 19 participants (2 case studies and 17 by survey) from Ireland. Three areas are examined; firstly, the extent of spreadsheet usage, secondly, the level of complexity employed in spreadsheets, and finally, the controls in place regarding spreadsheets. The findings support previous findings of Panko (1998), that errors occur frequently in spreadsheets and that there is little or unenforced controls employed, however this research finds that attitudes are changing with regard to spreadsheet risk and that one organisation is implementing a comprehensive project regarding policies on the development and control of spreadsheets. Further research could be undertaken in the future to examine the development of a "best practice model" both for t...

  20. Osteoporosis screening and risk management

    Directory of Open Access Journals (Sweden)

    Consuelo H Wilkins

    2007-10-01

    Full Text Available Consuelo H WilkinsDepartment of Medicine, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, USAAbstract: Osteoporosis is common among older adults and results in costly osteoporotic fractures. Screening for this metabolic bone disorder is warranted in most older adults and clinicians must be diligent in identifying persons at risk. The evaluation should include an assessment of risk factors for falls, a bone density test, and consideration of possible secondary causes of osteoporosis. Several medications are available to improve bone density and decrease fractures. Adequate calcium and vitamin D intake (and treatment of vitamin D deficiency are paramount in the management of osteoporosis.Keywords: Osteoporosis, Fractures, Vitamin D

  1. Integrated Foreign Exchange Risk Management

    DEFF Research Database (Denmark)

    Aabo, Tom; Høg, Esben; Kuhn, Jochen

    Empirical research has focused on export as a proxy for the exchange rate exposure and the use of foreign exchange derivatives as the instrument to deal with this exposure. This empirical study applies an integrated foreign exchange risk management approach with a particular focus on the role...... of import in medium-sized, manufacturing firms in Denmark (a small, open economy). We find a strong, negative relation between import and foreign exchange derivatives usage on the aggregate level. Our findings are consistent with the notion that firms use import to match the foreign exchange exposure...

  2. Calysto: Risk Management for Commercial Manned Spaceflight

    Science.gov (United States)

    Dillaman, Gary

    2012-01-01

    The Calysto: Risk Management for Commercial Manned Spaceflight study analyzes risk management in large enterprises and how to effectively communicate risks across organizations. The Calysto Risk Management tool developed by NASA's Kennedy Space Center's SharePoint team is used and referenced throughout the study. Calysto is a web-base tool built on Microsoft's SharePoint platform. The risk management process at NASA is examined and incorporated in the study. Using risk management standards from industry and specific organizations at the Kennedy Space Center, three methods of communicating and elevating risk are examined. Each method describes details of the effectiveness and plausibility of using the method in the Calysto Risk Management Tool. At the end of the study suggestions are made for future renditions of Calysto.

  3. Managing the myths of health care.

    Science.gov (United States)

    Mintzberg, Henry

    2012-01-01

    Myths impede the effective management of health care, for example that the system is failing (indeed, that is a system), and can be fixed by detached social engineering and heroic leadership, or treating it more like a business. This field needs to reframe its management, as distributed beyond the "top"; its strategy as venturing, not planning; its organizing as collaboration beyond control, and especially itself, as a system beyond its parts.

  4. Expanded managed care liability: what impact on employer coverage?

    Science.gov (United States)

    Studdert, D M; Sage, W M; Gresenz, C R; Hensler, D R

    1999-01-01

    Policymakers are considering legislative changes that would increase managed care organizations' exposure to civil liability for withholding coverage or failing to deliver needed care. Using a combination of empirical information and theoretical analysis, we assess the likely responses of health plans and Employee Retirement Income Security Act (ERISA) plan sponsors to an expansion of liability, and we evaluate the policy impact of those moves. We conclude that the direct costs of liability are uncertain but that the prospect of litigation may have other important effects on coverage decision making, information exchange, risk contracting, and the extent of employers' involvement in health coverage.

  5. Risk assessment and management of radiofrequency radiation exposure

    Science.gov (United States)

    Dabala, Dana; Surducan, Emanoil; Surducan, Vasile; Neamtu, Camelia

    2013-11-01

    Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

  6. Risk assessment and management of radiofrequency radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Dabala, Dana [Railways Medical Clinic Cluj-Napoca, Occupational Medicine Department, 16-20 Bilascu Gheorghe St., 400015 Cluj-Napoca (Romania); Surducan, Emanoil; Surducan, Vasile; Neamtu, Camelia [National Institute for Research and Development of Isotopic and Molecular Technologies, 65-103 Donath St., 400293 Cluj-Napoca (Romania)

    2013-11-13

    Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

  7. Managing project risks and uncertainties

    Directory of Open Access Journals (Sweden)

    Mike Mentis

    2015-01-01

    Full Text Available This article considers threats to a project slipping on budget, schedule and fit-for-purpose. Threat is used here as the collective for risks (quantifiable bad things that can happen and uncertainties (poorly or not quantifiable bad possible events. Based on experience with projects in developing countries this review considers that (a project slippage is due to uncertainties rather than risks, (b while eventuation of some bad things is beyond control, managed execution and oversight are still the primary means to keeping within budget, on time and fit-for-purpose, (c improving project delivery is less about bigger and more complex and more about coordinated focus, effectiveness and developing thought-out heuristics, and (d projects take longer and cost more partly because threat identification is inaccurate, the scope of identified threats is too narrow, and the threat assessment product is not integrated into overall project decision-making and execution. Almost by definition, what is poorly known is likely to cause problems. Yet it is not just the unquantifiability and intangibility of uncertainties causing project slippage, but that they are insufficiently taken into account in project planning and execution that cause budget and time overruns. Improving project performance requires purpose-driven and managed deployment of scarce seasoned professionals. This can be aided with independent oversight by deeply experienced panelists who contribute technical insights and can potentially show that diligence is seen to be done.

  8. Acquisition Program Risk Management: Does the Department of Defense Risk Management Practices Guide Provide an Effective Risk Tool for Program Managers in Today’s Acquisition Environment?

    Science.gov (United States)

    2012-05-01

    Management Definition ........................................................................................... 32 Table 16. Risk Management Tracking...Other (please specify) 5 Table 15. Risk Management Definition Question 7: Does your Program Office or Risk Management IPT track risks for cost...aligned to collect information on program risk definition. Question 6 was designed to collect information on risk management definition . Participants

  9. Risk management with options and futures under liquidity risk

    OpenAIRE

    Adam-Müller, A F A; Panaretou, A

    2009-01-01

    Futures hedging creates liquidity risk through marking to market. Liquidity risk matters if interim losses on a futures position have to be financed at a markup over the risk-free rate. This study analyzes the optimal risk management and production decisions of a firm facing joint price and liquidity risk. It provides a rationale for the use of options on futures in imperfect capital markets. If liquidity risk materializes, the firm sells options on futures in order to partly cover this liqui...

  10. Management of asthma in primary care

    NARCIS (Netherlands)

    Honkoop, Pieter Jacob

    2016-01-01

    Asthma is a common non-communicable respiratory disease. In this thesis we analysed three different management strategies for adult patients with asthma in primary care. In the first, we targeted the currently recommended aim of ‘Controlled asthma’, which means patients experience hardly any symptom

  11. Knowledge management: organizing nursing care knowledge.

    Science.gov (United States)

    Anderson, Jane A; Willson, Pamela

    2009-01-01

    Almost everything we do in nursing is based on our knowledge. In 1984, Benner (From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley; 1984) described nursing knowledge as the culmination of practical experience and evidence from research, which over time becomes the "know-how" of clinical experience. This "know-how" knowledge asset is dynamic and initially develops in the novice critical care nurse, expands within competent and proficient nurses, and is actualized in the expert intensive care nurse. Collectively, practical "know-how" and investigational (evidence-based) knowledge culminate into the "knowledge of caring" that defines the profession of nursing. The purpose of this article is to examine the concept of knowledge management as a framework for identifying, organizing, analyzing, and translating nursing knowledge into daily practice. Knowledge management is described in a model case and implemented in a nursing research project.

  12. Cattle farmers’ perceptions of risk and risk management strategies

    DEFF Research Database (Denmark)

    Bishu, Kinfe G.; O'Reilly, Seamus; Lahiff, Edward

    2017-01-01

    This study analyzes cattle farmers’ perceptions of risk and risk management strategies in Tigray, Northern Ethiopia. We use survey data from a sample of 356 farmers based on multistage random sampling. Factor analysis is employed to classify scores of risk and management strategies, and multiple...... utilization were perceived as the most important strategies for managing risks. Livestock disease and labor shortage were perceived as less of a risk by farmers who adopted the practice of zero grazing compared to other farmers, pointing to the potential of this practice for risk reduction. We find strong...... evidence that farmers engage in multiple risk management practices in order to reduce losses from cattle morbidity and mortality. The results suggest that government strategies that aim at reducing farmers’ risk need to be tailored to specific farm and farmer characteristics. Findings from this study have...

  13. [Integrated Management Area of Vascular Risk: A new organisational model for global control of risk factors].

    Science.gov (United States)

    Armario, P; Jericó, C; Vila, L; Freixa, R; Martin-Castillejos, C; Rotllan, M

    2016-11-17

    Cardiovascular disease (CVD), is a major cause of morbidity and mortality that increases the cost of care. Currently there is a low degree of control of the main cardiovascular risk factors, although we have a good therapeutic arsenal. To achieve the improvement of this reality, a good coordination and multidisciplinary participation are essential. The development of new organizational models such as the Integrated Management Area of Vascular Risk can facilitate the therapeutic harmonization and unification of the health messages offered by different levels of care, based on clinical practice guidelines, in order to provide patient-centred integrated care.

  14. Identifying risks in the realm of enterprise risk management.

    Science.gov (United States)

    Carroll, Roberta

    2016-01-01

    An enterprise risk management (ERM) discipline is comprehensive and organization-wide. The effectiveness of ERM is governed in part by the strength and breadth of its practices and processes. An essential element in decision making is a thorough process by which organizational risks and value opportunities can be identified. This article will offer identification techniques that go beyond those used in traditional risk management programs and demonstrate how these techniques can be used to identify risks and opportunity in the ERM environment.

  15. UK Oil and Gas Industry: Risks and Risk Management

    OpenAIRE

    2013-01-01

    Oil and gas industry is a developing industry, which faces multiple risks. A brief review of the industry is presented, followed by an overview of the risk management. A literature review which includes empirical studies and theories is provided. The purpose of this paper is the identification and quantification of risks in oil and gas industry. Also the impact of the existing risk management on the performance and value of the firms is examined. The data for the research were collected fro...

  16. Contradictions Between Risk Management and Sustainable Development

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, Odd Einar; Langhelle, Oluf; Engen, Ole A. [Univ. of Stavanger (Norway). Dept. of Media, Culture and Social Science

    2006-09-15

    The aim of this paper is to discuss how risk management as a methodology and mindset influence on priorities and decisions concerning sustainable development. Management of risks and hazards often rely on partial analysis with a limited time frame. This may lead to a paradoxical situation where risk management and extended use of risk analysis could hamper long term sustainable development. The question is: Does the use of risk and vulnerability analysis (RaV-analysis) hamper or contribute to sustainable development? Because risk management and assessment has a more narrow scope and a limited time perspective based on well established methodologies, the tangible impacts of risk reducing measures in a project is easier to calculate than long-term and intangible impacts on global development. Empirical evidence is still scarce, but our preliminary conclusion is that mainstream risk management and assessments is counterproductive to sustainable development.

  17. Manejo de riesgo (Risk Management). ERIC Digest.

    Science.gov (United States)

    Gaustad, Joan

    The ordinary conduct of school business is accompanied today by risks that were rare or unknown a few decades ago. This ERIC Digest in Spanish discusses how risk management, a concept long used by corporate decision makers, can help school boards and administrators conserve their districts' assets. Risk management is a coordinated effort to…

  18. Active Risk Management and Banking Stability

    NARCIS (Netherlands)

    Silva Buston, C.F.

    2013-01-01

    Abstract: This paper analyzes the net impact of two opposing effects of active risk management at banks on their stability: higher risk-taking incentives and better isolation of credit supply from varying economic conditions. We present a model where banks actively manage their portfolio risk by buy

  19. Analysis of foreign schools of risk management

    Directory of Open Access Journals (Sweden)

    I.M. Posokhov

    2013-12-01

    Full Text Available The aim of the article. The aim of the article is to study the scientific development of foreign scientific schools of risk management and analysis of their main publications; the allocation of foreign scientific schools of risk management. The results of the analysis. Research of modern risk management is carried out leading foreign schools. The most famous school in the theory of financial risk and risk management is American school. Among its current members are D. Galai, H. Greuning, A. Damodaran, P. Jorion, J. Kallman, M. Crouhy, M. Mccarthy, R. Mark, T. Flynn and other scientists. Important contribution to the development of the theory and practice of risk management made British scientists and economists – the representatives of English Schools of Risk Management: T. Andersen, T. Bedford, A. Griffin, A. Zaman, R. Cooke, P. Sweeting, P. Hopkin, a German P. Schroder and others. A significant advance to the theory of risk management of German scientific school, based on the classic work of Zadeh has received significant results of the risk assessment using fuzzy logic and fuzzy sets. Graduate School of Risk Management of the University of Cologne is training and research group funded by the German Research Foundation (DFG under the project «Theoretical and Empirical Basis of Risk Management». The aim of Graduate School of Risk Management is to promote young scientists. The school risk management of the University of Cologne outstanding research conducted by German and foreign professors, such as: K. Mosler, A. Kempf, C. Kuhner, T. Hartmann-Wendels, C. Homburg, D. Hess, D. Sliwka, F. Schmid, H. Schradin. The author noted the existence and fruitful work in the capital of Switzerland Laboratory of risk management (Risk Lab Switzerland and its leading scientists: P. Embrechts, A. Gisler, M. Wüthrich, H. Bühlmann, V. Bignozzi, M. Hofert, P. Deprez, and the Basel Committee on banking supervision – Developer international standards of Basel

  20. Risk Management and Financial Derivatives: An Overview

    NARCIS (Netherlands)

    S.M. Hammoudeh (Shawkat); M.J. McAleer (Michael)

    2012-01-01

    textabstractRisk management is crucial for optimal portfolio management. One of the fastest growing areas in empirical finance is the expansion of financial derivatives. The purpose of this special issue on “Risk Management and Financial Derivatives” is to highlight some areas in which novel econome

  1. Risk of aspiration in care home residents and associated factors

    NARCIS (Netherlands)

    Maarel-Wierink, C.D. van der; Putten, G.J. van der; Visschere, L.M. De; Bronkhorst, E.M.; Baat, C. de; Schols, J.M.

    2015-01-01

    Pneumonia is a prevalent cause of death in care home residents. Dysphagia is a significant risk factor of aspiration pneumonia. The purpose of the current study was to screen for risk of aspiration in care home residents in the Netherlands and assess potential risk factors of aspiration. Five experi

  2. Networked Risk Management : How to successfully manage risks in hyperconnected value networks

    NARCIS (Netherlands)

    Joosten, H.J.M.; Smulders, A.C.M.

    2014-01-01

    Networked Risk Management (NRM) is a methodology aimed at managing dynamic risks. The methodology facilitates the mind shift from risk management to success governance. The result is an accountable prioritisation of risks that could lead to being unsuccessful. NRM is applicable in combination with e

  3. The application of risk management in the subject of intensive care medicine for teaching practice nurses%护理风险管理在ICU实习护士带教中的应用

    Institute of Scientific and Technical Information of China (English)

    梁秀

    2013-01-01

    Objective To investigate the effect of applying the nursing risk management in the subjects of Intensive Care Medicine (ICU)when teaching practice nurses,so as to prevent or reduce adverse events dominated by practice nurses, and improve the quality of nursing teaching. Methods 138 nurses are divided into the experimental group and the control group. Traditional teaching method in clinical nursing is applied in the control group ,while the risk management methods are applied in practice nurse teaching in the experimental group,namely,to assess the potential risk factors in teaching, and then formulate the corresponding preventive measures. Compare results of professional theory exam and technical exam, and the incidence of adverse events led by practice nurses before and after applying the nursing risk management. Results the practice nurses applied nursing risk management have better results in professional theory exam and technical exam, and the incidence of adverse events led by them are lower than those applied traditional teaching methods.The comparison of before and after application of risk management: P<0.05,the difference is statistically significant. Conclusion The application of risk management can improve the quality of teaching and effectively reduce the occurrence of adverse events led by the practice nurse in the ICU nurse teaching.%目的:探讨护理风险管理在重症监护室(ICU)实习护士带教中的应用效果,降低不良事件发生率,提高护理带教质量。方法将138名实习护士分为试验组和对照组,对照组运用传统临床护理教学法,试验组将风险管理方法应用于实习护士的带教工作中,对实习护士带教中潜在危险因素进行风险评估,并制订相应的防范措施。比较实施风险管理前后实习护士的专科理论考核和技术考核成绩、实习护士主导不良事件的发生率。结果试验组实习护士专科理论和技术操作考核成绩均

  4. Skin tears: care and management of the older adult at home.

    Science.gov (United States)

    Holmes, Regina F; Davidson, Martha W; Thompson, Bonnie J; Kelechi, Teresa J

    2013-02-01

    Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.

  5. Application of risk management in perioperative nursing care of patients with thoracolumbar burst fracture%风险管理在腰椎爆裂性骨折围手术护理的应用分析

    Institute of Scientific and Technical Information of China (English)

    李英

    2016-01-01

    Objective The perioperative nursing risk management in the lumbar spine burst fracture patients the application effect is analyzed.Methods During February 2012 to February 2012, our hospital to receive the 84 patients with lumbar spine burst fracture were randomly divided into experimental group and the control group, each group has 42 patients, control group patients with routine nursing, the experimental group patients on the basis of conventional nursing risk management, compare the situation of risk happened in two groups of patients.Results The experimental group patients the incidence of risk is much lower than the control group, the differences between the two groups,P < 0.05, the difference is statistically significant.Conclusion Risk management in perioperative care for patients with lumbar spine burst fracture application, obvious effect, is worth popularization in clinical.%目的:对风险管理在腰椎爆裂性骨折患者围手术护理中的应用效果进行分析。方法:选取2012年2月至2015年2月期间,我院接收的84例腰椎爆裂性骨折患者随机分成实验组和对照组,每组各有患者42例,对照组患者实施常规护理,实验组患者在常规护理的基础上进行风险管理,比较两组患者的风险发生情况。结果:实验组患者的风险发生率远远低于对照组,两组差异明显, P<0.05,差异具有统计学意义。结论:风险管理在腰椎爆裂性骨折患者围手术期护理中应用,效果显著,值得在临床上进行推广。

  6. Nurses' Psychosocial Barriers to Suicide Risk Management

    Directory of Open Access Journals (Sweden)

    Sharon Valente

    2011-01-01

    Full Text Available Suicide remains a serious health care problem and a sentinel event tracked by The Joint Commission. Nurses are pivotal in evaluating risk and preventing suicide. Analysis of nurses' barriers to risk management may lead to interventions to improve management of suicidal patients. These data emerged from a random survey of 454 oncology nurses' attitudes, knowledge of suicide, and justifications for euthanasia. Instruments included a vignette of a suicidal patient and a suicide attitude questionnaire. Results. Psychological factors (emotions, unresolved grief, communication, and negative judgments about suicide complicate the nurse's assessment and treatment of suicidal patients. Some nurses (=122 indicated that euthanasia was never justified and 11 were unsure of justifications and evaluated each case on its merits. Justifications for euthanasia included poor symptom control, poor quality of life, incurable illness or permanent disability, terminal illness, and terminal illness with inadequate symptom control or impending death, patient autonomy, and clinical organ death. The nurses indicated some confusion and misconceptions about definitions and examples of euthanasia, assisted suicide, and double effect. Strategies for interdisciplinary clinical intervention are suggested to identify and resolve these psychosocial barriers.

  7. Delivery and Payment Redesign to Reduce Disparities in High Risk Postpartum Care.

    Science.gov (United States)

    Howell, Elizabeth A; Padrón, Norma A; Beane, Susan J; Stone, Joanne; Walther, Virginia; Balbierz, Amy; Kumar, Rashi; Pagán, José A

    2017-01-28

    Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk. The program includes a social work/care management component and a payment system redesign with a cost-sharing arrangement between the health system and the Medicaid managed care plan to cover the cost of staff, clinician education, performance feedback, and clinic/clinician financial incentives. The goal is to enroll 510 high-risk postpartum mothers. Assessment The primary outcome of interest is a timely postpartum visit in accordance with NCQA healthcare effectiveness data and information set guidelines. Secondary outcomes include care process measures for women with specific high-risk conditions, emergency room visits, postpartum readmissions, depression screens, and health care costs. Conclusion Our evidence-based program focuses on an important area of maternal health, targets racial/ethnic disparities in postpartum care, utilizes an innovative payment reform strategy, and brings together insurers, researchers, clinicians, and policy experts to work together to foster health and wellness for postpartum women and reduce disparities.

  8. Hybrid Risk Management Methodology: A Case Study

    Directory of Open Access Journals (Sweden)

    Jacky Siu-Lun Ting

    2009-10-01

    Full Text Available Risk management is a decision-making process involving considerations of political, social, economic and engineering factors with relevant risk assessments relating to a potential hazard. In the last decade, a number of risk management tools are introduced and employed to manage and minimize the uncertainty and threats realization to the organizations. However, the focus of these methodologies are different; in which companies need to adopt various risk management principles to visualize a full picture of the organizational risk level. Regarding to this, this paper presents a new approach of risk management that integrates Hierarchical Holographic Modeling (HHM, Enterprise Risk Management (ERM and Business Recovery Planning (BCP for identifying and assessing risks as well as managing the consequences of realized residual risks. To illustrate the procedures of the proposed methodology, a logistic company ABC Limited is chosen to serve as a case study Through applying HHM and ERM to investigate and assess the risk, ABC Limited can be better evaluated the potential risks and then took the responsive actions (e.g. BCP to handle the risks and crisis in near future.

  9. Managing Research in a Risk World

    Science.gov (United States)

    Anton, W.; Havenhill, M.

    2014-01-01

    The Office of Chief Medical Officer (OCHMO) owns all human health and performance risks managed by the Human System Risk Board (HSRB). While the HSRB manages the risks, the Human Research Program (HRP) manages the research portion of the overall risk mitigation strategy for these risks. The HSRB manages risks according to a process that identifies and analyzes risks, plans risk mitigation and tracks and reviews the implementation of these strategies according to its decisions pertaining to the OCHMO risk posture. HRP manages risk research work using an architecture that describes evidence-based risks, gaps in our knowledge about characterizing or mitigating the risk, and the tasks needed to produce deliverables to fill the gaps and reduce the risk. A planning schedule reflecting expected research milestones is developed, and as deliverables and new evidence are generated, research progress is tracked via the Path to Risk Reduction (PRR) that reflects a risk's research plan for a design reference mission. HRP's risk research process closely interfaces with the HSRB risk management process. As research progresses, new deliverables and evidence are used by the HSRB in conjunction with other operational and non-research evidence to inform decisions pertaining to the likelihood and consequence of the risk and risk posture. Those decisions in turn guide forward work for research as it contributes to overall risk mitigation strategies. As HRP tracks its research work, it aligns its priorities by assessing the effectiveness of its contributions and maintaining specific core competencies that would be invaluable for future work for exploration missions.

  10. ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

    Science.gov (United States)

    Steinman, Theodore I

    2002-01-01

    The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

  11. Should health care managers adopt Theory Z?

    Science.gov (United States)

    Safranski, S R; Kwon, I W; Walker, W R; Unger, M

    1986-04-01

    Health care administrators should carefully consider the situations in which they apply management methods used in industry, since such methods may not be effective in motivating certain groups of hospital employees. Physicians, for example, may display little loyalty to the health care organization, even though as a group they exert significant influence on policies, standards, and administration. As a result, management styles such as Theory Z that focus on holistic concern, individual decision-making responsibility, and long-term employment guarantees may fail to interest them. Nurses also may be reluctant to commit themselves to an organization because of the high rate of turnover in their profession in recent years. Support staff, however, probably would be receptive to management techniques that offer security through long-term employment guarantees. Other factors necessary for the effective use of Theory Z industrial management techniques are a clear hierarchy with well-defined reporting relationships, moderately specialized career paths, and trust among employees that the organization's concern for their welfare is genuine. The key consideration, however, in applying any theory is that only those aspects which best serve the organization's needs should be adopted.

  12. RISK MANAGEMENT MECHANISM OF GRAIN PROCESSING ENTERPRISES

    Directory of Open Access Journals (Sweden)

    I. P. Bogomolova

    2013-01-01

    Full Text Available In article the main characteristics of a control system by risks (the purpose, properties, the principles, requirements are defined, and also the possible mechanism of risk management of the flour-grinding enterprises is considered.

  13. Supply chain risk management; Lieferung mit Risiko

    Energy Technology Data Exchange (ETDEWEB)

    Kersten, Wolfgang; Hohrath, Philipp [Technische Univ. Hamburg-Harburg, Hamburg (Germany). Inst. fuer Logistik und Unternehmensfuehrung; Scholl, Jan [Pleyma GmbH, Hamburg (Germany)

    2010-03-15

    In spite of the high risk involved, about 40 percent of all wind power systems do not have a supply chain risk management. This is due to the supply structures of this relatively young industry. (orig.)

  14. Strategic Risk Management and Corporate Value Creation

    DEFF Research Database (Denmark)

    Andersen, Torben Juul; Roggi, Oliviero

    is considered an important source of competitive advantage. However, surprisingly little research has analyzed if the presumed advantages of effective risk management lead to superior performance or assessed important antecedents of effective risk management capabilities. Here we present a comprehensive study...... volatility, we find that it has significant positive relationships to lagged performance measures after controlling for industry effects and company size. We also find that availability of slack resources and investment commitments affect the risk management capabilities and their relationship to performance....

  15. Managing Risk in Hodgkin Lymphoma.

    Science.gov (United States)

    Armitage, James O; Chen, Robert W; Moskowitz, Craig H; Sweetenham, John

    2015-02-01

    Approximately 90% of patients with limited-stage Hodgkin lymphoma are cured. The cure rate in advanced-stage Hodgkin lymphoma is dramatically better than it once was, but it is still lower than the rate in patients with limited disease. The choice of treatment is based on several factors, including symptoms, disease stage, extent of tumor burden, and prognosis. Positron emission tomography scanning can be used to assess the patient's stage of disease, which can allow further individualization of therapy. Traditional frontline treatment options include doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and, for high-risk patients, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP). Autologous stem cell transplantation cures approximately 50% of patients. The antibody-drug conjugate brentuximab vedotin is very active in relapsed/refractory Hodgkin lymphoma. Data presented at the 2014 meeting of the American Society of Hematology (ASH) showed that brentuximab vedotin was beneficial in several settings, including as consolidation therapy posttransplant in patients at high risk for relapse, as first-line salvage therapy in relapsed/refractory Hodgkin lymphoma prior to autologous hematopoietic cell transplantation, and in combination with bendamustine in relapsed/refractory disease. The ASH meeting also offered promising data on novel agents, such as the programmed cell death 1 (PD-1) inhibitors. In this monograph, 4 experts in the management of Hodgkin lymphoma discuss various aspects of the disease and provide their perspectives on the new data presented at the ASH meeting.

  16. Advances in migraine management: implications for managed care organizations.

    Science.gov (United States)

    Dodick, David W; Lipsy, Robert J

    2004-05-01

    Migraine headache is a disabling disease that poses a significant societal burden. Stratified care and early intervention are current strategies for migraine management. It has been shown that early treatment with triptans in select patients can improve treatment outcomes. Triptans are selective 5-HT receptor agonists that are specific and effective treatments in the management of migraine, and they meet the acute treatment goal of rapid relief with minimal side effects. Triptans are associated with improved quality of life. Factors such as speed of onset, need for a second triptan dose, and patient satisfaction should be considered in the selection of a specific triptan treatment. Appropriate treatment can decrease costs. The patient's migraine history and response to prior therapy should be considered when selecting acute treatment. Cost-effectiveness models can be used to understand the effect of treatment choices on health care budgets. The direct cost per migraine episode, driven primarily by the need for rescue medications, is important to include in economic models. All aspects of effectiveness (efficacy, tolerability, and cost) should be considered to reduce overall managed care expenditures for migraine treatment. The improved clinical profiles of the triptans provide substantial value to managed care organizations.

  17. Cumulative Risks of Foster Care Placement for Danish Children

    DEFF Research Database (Denmark)

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement...... is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American......Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor...

  18. Alzheimer's disease care management plan: maximizing patient care.

    Science.gov (United States)

    Treinkman, Anna

    2005-03-01

    Nurse practitioners have the potential to significantly impact the care of patients with dementia. Healthcare providers can now offer patients medications that will control symptoms and prolong functioning. As a result of ongoing contact with patients, NPs play an important role in assessing and screening patients for AD and educating the patients, families, and caregivers about the disease. Alzheimer's disease is a chronic, progressive illness that requires long-term management. Nurse practitioners should be familiar with available medications and appreciate the need to individualize therapy to maximize efficacy and minimize potential adverse drug reactions.

  19. Risk Management for the International Space Station

    Science.gov (United States)

    Sebastian, J.; Brezovic, Philip

    2002-01-01

    The International Space Station (ISS) is an extremely complex system, both technically and programmatically. The Space Station must support a wide range of payloads and missions. It must be launched in numerous launch packages and be safely assembled and operated in the harsh environment of space. It is being designed and manufactured by many organizations, including the prime contractor, Boeing, the NASA institutions, and international partners and their contractors. Finally, the ISS has multiple customers, (e.g., the Administration, Congress, users, public, international partners, etc.) with contrasting needs and constraints. It is the ISS Risk Management Office strategy to proactively and systematically manages risks to help ensure ISS Program success. ISS program follows integrated risk management process (both quantitative and qualitative) and is integrated into ISS project management. The process and tools are simple and seamless and permeate to the lowest levels (at a level where effective management can be realized) and follows the continuous risk management methodology. The risk process assesses continually what could go wrong (risks), determine which risks need to be managed, implement strategies to deal with those risks, and measure effectiveness of the implemented strategies. The process integrates all facets of risk including cost, schedule and technical aspects. Support analysis risk tools like PRA are used to support programatic decisions and assist in analyzing risks.

  20. Medicaid and Managed Care: Key Data, Trends, and Issues

    Science.gov (United States)

    ... are now in publicly traded plans (Figure 2). Distribution of Medicaid MCO Enrollment by Selected MCO Characteristics ... to managed care for this purpose. Managed care companies are also planning for 2014, positioning themselves to ...

  1. Risk Management and Uncertainty in Infrastructure Projects

    DEFF Research Database (Denmark)

    Harty, Chris; Neerup Themsen, Tim; Tryggestad, Kjell

    2014-01-01

    by addressing a more fundamental question about the role of knowledge in current risk management practices. Inquiries into the predominant approaches to risk management in large infrastructure and construction projects reveal their assumptions about knowledge and we discuss the ramifications these have...... for project and construction management. Our argument and claim is that predominant risk management approaches tends to reinforce conventional ideas of project control whilst undermining other notions of value and relevance of built assets and project management process. These approaches fail to consider...

  2. Better team management--better team care?

    Science.gov (United States)

    Shelley, P; Powney, B

    1994-01-01

    Team building should not be a 'bolt-on' extra, it should be a well planned, integrated part of developing teams and assisting their leaders. When asked to facilitate team building by a group of NHS managers we developed a framework which enabled individual members of staff to become more effective in the way they communicated with each other, their teams and in turn within the organization. Facing the challenge posed by complex organizational changes, staff were able to use 3 training days to increase and develop their awareness of the principles of teamwork, better team management, and how a process of leadership and team building could help yield better patient care.

  3. THE ANALYSIS OF RISK MANAGEMENT PROCESS WITHIN MANAGEMENT

    Directory of Open Access Journals (Sweden)

    ROMANESCU MARCEL LAURENTIU

    2016-10-01

    Full Text Available This article highlights the risk analysis within management, focusing on how a company could practicaly integrate the risks management in the existing leading process. Subsequently, it is exemplified the way of manage risk effectively, which gives numerous advantages to all firms, including improving their decision-making process. All these lead to the conclusion that the degree of risk specific to companies is very high, but if managers make the best decisions then it can diminish it and all business activitiy and its income are not influenced by factors that could disturb in a negative way .

  4. Risk management method for small photovoltaic plants

    Directory of Open Access Journals (Sweden)

    Kirova Milena

    2016-09-01

    Full Text Available Risk management is necessary for achieving the goals of the organization. There are many methods, approaches, and instruments in the literature concerning risk management. However, these are often highly specialized and transferring them to a different field can prove difficult. Therefore, managers often face situations where they have no tools to use for risk management. This is the case with small photovoltaic plants (according to a definition by the Bulgarian State Energy and Water Regulatory Commission small applies to systems with a total installed power of 200 kWp. There are some good practices in the energy field for minimizing risks, but they offer only partial risk prevention and are not sufficient. Therefore a new risk management method needs to be introduced. Small photovoltaic plants offer plenty of advantages in comparison to the other renewable energy sources which makes risk management in their case more important. There is no classification of risks for the exploitation of small photovoltaic systems in the available literature as well as to what degree the damages from those risks could spread. This makes risk analysis and evaluation necessary for obtaining information which could aid taking decisions for improving risk management. The owner of the invested capital takes a decision regarding the degree of acceptable risk for his organization and it must be protected depending on the goals set. Investors in small photovoltaic systems need to decide to what degree the existing risks can influence the goals previously set, the payback of the investment, and what is the acceptable level of damages for the investor. The purpose of this work is to present a risk management method, which currently does not exist in the Bulgaria, so that the risks and the damages that could occur during the exploitation of small photovoltaic plants could be identified and the investment in such technology – justified.

  5. Management of liver cirrhosis between primary care and specialists

    Institute of Scientific and Technical Information of China (English)

    Ignazio Grattagliano; Enzo Ubaldi; Leonilde Bonfrate; Piero Portincasa

    2011-01-01

    This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis","cirrhosis", "chronic hepatitis", "chronic liver disease","decompensated cirrhosis", "hepatic encephalopathy","hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology,Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications.Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.

  6. Pulmonary Hypertension in Pregnancy: Critical Care Management

    OpenAIRE

    Bassily-Marcus, Adel M.; Carol Yuan; John Oropello; Anthony Manasia; Roopa Kohli-Seth; Ernest Benjamin

    2012-01-01

    Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Im...

  7. INVENTORY AND RISK MANAGEMENT: DECREASING DELIVERY RISK OF PURCHASERS

    Directory of Open Access Journals (Sweden)

    Grzegorz MICHALSKI

    2008-12-01

    Full Text Available The basic financial purpose of an enterprise is maximization of its value. Inventory management should also contribute to realization of this fundamental aim. The enterprise value maximization strategy is executed with a focus on risk and uncertainty. This article presents the consequences for the recipients firm that can result from operating risk that is related to delivery risk generated by the suppliers. The present article offers a method that uses portfolio management theory to choose the suppliers.

  8. Model risk analysis for risk management and option pricing

    NARCIS (Netherlands)

    Kerkhof, F.L.J.

    2003-01-01

    Due to the growing complexity of products in financial markets, market participants rely more and more on quantitative models for trading and risk management decisions. This introduces a fairly new type of risk, namely, model risk. In the first part of this thesis we investigate the quantitative inf

  9. Corporate Risk Management in Slovenian Firms

    Directory of Open Access Journals (Sweden)

    Aleš S. Berk

    2009-09-01

    Full Text Available In today’s competitive environment the modern firm increasingly focuses on identifying, measuring and managing various risk exposures. Risk management is interwoven with the firm’s business strategy and impacts considerably on its competitive position. Thus, management should develop an integrated approach to address it. Although hedging using derivatives accounts for just one part of such an approach, the article solely covers financial risk management using derivatives. Namely, it is found that even Slovenian blue-chip firms still have room to improve as they have only recently started to use derivatives. The article reviews some of the most interesting characteristics and practices of modern Slovenian financial risk management departments and provides a practically oriented case-study which describes the important steps a risk manager must take to hedge commodity price exposure.

  10. Working group 7: pipeline risk management

    Energy Technology Data Exchange (ETDEWEB)

    Kariyawasam, Shahani; Weir, David

    2011-07-01

    This seventh working group of the Banff 2011 conference provided an understanding of risk management process in the pipeline industry, including system-wide risk assessment, risk based integrity systems and risk control techniques. The presentations furnished a basis on which to discuss programs, processes and procedures including reliability based decision support and performance measures that support a company's risk management policy. This workshop was divided into three sessions. The first session focused on the comparison between reliability methods and conventional deterministic methods in terms of accuracy, simplicity and sensitivity. Next, the importance of low probability high consequence events and the processes to prevent them were discussed. The last session discussed the consequences of management processes on failures and risks. The debates following these presentations tried to identify the best management practices to reduce risks, and the regulations and requirements to develop.

  11. Managing Risk Areas in Software Development Offshoring

    DEFF Research Database (Denmark)

    Persson, John Stouby; Schlichter, Bjarne Rerup

    2015-01-01

    Software companies are increasingly offshoring development to countries with high expertise at lower cost. Offshoring involves particular risk areas that if ignored increase the likelihood of failure. However, the offshoring client’s maturity level may influence the management of these risk areas....... Against this backdrop, we present an interpretive case study of how managers perceive and mitigate the risk areas in software development offshoring with a mature CMMI level 5 (Capability Maturity Model, Integrated) software company as the client. We find that managers perceive and mitigate most...... of the offshoring risk areas in accordance with the findings of previous research. However, the risk area of task distribution is a notable exception. In this case, managers perceive high task uncertainty, equivocality, and coupling across sites as risk mitigation rather than risk taking. The paper discusses how...

  12. Feedback on flood risk management

    Science.gov (United States)

    Moreau, K.; Roumagnac, A.

    2009-09-01

    For several years, as floods were increasing in South of France, local communities felt deprive to assume their mission of protection and information of citizens, and were looking for assistance in flood management. In term of flood disaster, the fact is that physical protection is necessary but inevitably limited. Tools and structures of assistance to anticipation remain slightly developed. To manage repeated crisis, local authorities need to be able to base their policy against flood on prevention, warnings, post-crisis analysis and feedback from former experience. In this objective, after 3 years of test and improvement since 2003, the initiative Predict-Services was developped in South of France: it aims at helping communities and companies to face repeated flood crisis. The principle is to prepare emergency plans, to organize crisis management and reduce risks; to help and assist communities and companies during crisis to activate and adapt their emergency plans with enough of anticipation; and to analyse floods effects and improve emergency plans afterwards. In order to reduce risks, and to keep the benefits of such an initiative, local communities and companies have to maintain the awareness of risk of the citizens and employees. They also have to maintain their safety plans to keep them constantly operational. This is a part of the message relayed. Companies, Local communities, local government authorities and basin stakeholders are the decision makers. Companies and local communities have to involve themselves in the elaboration of safety plans. They are also completely involved in their activation that is their own responsability. This applies to other local government authorities, like districts one's and basin stakeholders, which participle in the financing community safety plans and adminitrative district which are responsible of the transmission of meteorological alert and of rescue actions. In the crossing of the géo-information stemming from the

  13. Risk, innovation and change : design propositions for implementing risk management in organizations

    NARCIS (Netherlands)

    Staveren, van Martinus Theodorus

    2009-01-01

    This Ph.D. research generated unique design propositions for implementing existing risk management methodologies in organizations. The resulting design propositions incorporate a synthesis of risk management, innovation management and change management. True implementation of risk management is defi

  14. Obesity, weight management, and health care costs: a primer.

    Science.gov (United States)

    Bachman, Keith H

    2007-06-01

    Rational decision-making regarding health care spending for weight management requires an understanding of the cost of care provided to obese patients and the potential cost-effectiveness or cost savings of interventions. The purpose of this review is to assist health plans and disease management leaders in making informed decisions for weight management services. Among the review's findings, obesity and severe obesity are strongly and consistently associated with increased health care costs. The cost-effectiveness of obesity-related interventions is highly dependent on the risk status of the treated population, as well as the length, cost, and effectiveness of the intervention. Bariatric surgery offers high initial costs and uncertain long-term cost savings. From the perspective of a payor, obesity management services are as cost-effective as other commonly offered health services, though not likely to offer cost savings. Behavioral health promotion interventions in the worksite setting provide cost savings from the employer's perspective, if decreased rates of absenteeism are included in the analysis.

  15. 风险整合管理在伤口护理安全中的应用研究%Application of integrated risk management in safe wound care

    Institute of Scientific and Technical Information of China (English)

    蒋琪霞; 李晓华; 刘云; 彭青; 周昕; 易学明

    2013-01-01

    目的 医疗风险无处不在,伤口护理由于其专业的特殊性而存在高风险,安全管理是确保伤口护理专业健康发展的基础,也是伤口护理中心护教研协调发展的前提.文中探讨风险整合管理(Integrated risk management,IRM)理念和方法在伤口护理安全管理中的应用效果,以提高伤口护理的安全性和患者的满意率.方法 根据IRM理念,设计在伤口护理应用中的方法为评估(assessment,A)-识别(recognize,R)-报告(report,R)-确认(determine,D)-分析(analyze,A)-计划(plan,P)-告知(imformation,I)-实施(Implement,I)-评价(evaluation,E),简称ARRDAPIIE程序,培训护士掌握并应用.2008年1月至2009年12月为尝试观察期,2010年1月至2011年12月为改良实施期.评价指标:患者满意率、不良事件发生数和等级.结果 2008年1月至2011年12月,4年共入选风险伤口患者491例,伤口护理量14730人次,满意率调查表发出491份,当场回收491份,回收率100%.尝试期248例计伤口护理量7440人次,不良事件7人次,其中2人次为Ⅱ级,5人次为Ⅳ级,发生率0.094%;患者平均满意率(97.36±0.97)%.改良期243例计伤口护理量7290人次,不良事件3人次均为Ⅳ级,发生率0.041%;患者平均满意率(99.88±0.30)%,高于尝试期.2组不良事件发生率和等级比较差异无统计学意义(P=0.214和0.356).结论 IRM对提高患者满意率、降低不良事件发生率及等级有积极作用.%Objective Wound care invites high risks due to its special characteristics , and safe management is the key to its healthy development as well as to the harmonious construction of the wound care center . This study aims to evaluate integrated risk management (IRM) in the safe management of wound care in order to improve the safety of wound care and satisfaction of the patients . Methods Based on the idea of IRM , we designed the method of ARRDAPIIE , which stands for assess , recognize, report, determine, analyze, plan, inform

  16. Features of risk-management in innovative activity: regional aspect

    Directory of Open Access Journals (Sweden)

    Darmilova Zhenni, D.

    2015-03-01

    Full Text Available The main problems of risk management in modern conditions, especially in risk management innovation, tools, exposure to risks, directions of state support in the management of risk in a public- private partnership are considered in the paper.

  17. Data Management in Metagenomics: A Risk Management Approach

    Directory of Open Access Journals (Sweden)

    Filipe Ferreira

    2014-07-01

    Full Text Available In eScience, where vast data collections are processed in scientific workflows, new risks and challenges are emerging. Those challenges are changing the eScience paradigm, mainly regarding digital preservation and scientific workflows. To address specific concerns with data management in these scenarios, the concept of the Data Management Plan was established, serving as a tool for enabling digital preservation in eScience research projects. We claim risk management can be jointly used with a Data Management Plan, so new risks and challenges can be easily tackled. Therefore, we propose an analysis process for eScience projects using a Data Management Plan and ISO 31000 in order to create a Risk Management Plan that can complement the Data Management Plan. The motivation, requirements and validation of this proposal are explored in the MetaGen-FRAME project, focused in Metagenomics.

  18. The Professionalization of Risk Management: What Role can the ISO 31000 Risk Management Principles Play?

    DEFF Research Database (Denmark)

    Olechowski, Alison; Oehmen, Josef; Seering, W.

    2016-01-01

    Risk management is increasingly seen as a means of improving the likelihood of success in complex engineering projects. Yet the presence of a legitimacy gap, driven by the lack of empirical validation of published best practices, might explain low adoption of risk management on projects. We present...... practice, and to catalyze the professionalization of project risk management....

  19. Medicaid Managed Care Model of Primary Care and Health Care Management for Individuals with Developmental Disabilities

    Science.gov (United States)

    Kastner, Theodore A.; Walsh, Kevin K.

    2006-01-01

    Lack of sufficient accessible community-based health care services for individuals with developmental disabilities has led to disparities in health outcomes and an overreliance on expensive models of care delivered in hospitals and other safety net or state-subsidized providers. A functioning community-based primary health care model, with an…

  20. De kredietcrisis : het failliet van risk management?

    NARCIS (Netherlands)

    Koning, de W. Fred

    2009-01-01

    Ondanks alle ontwikkelingen op het gebied van kwantitatief risk management, die de laatste jaren hebben plaatsgevonden (mede gestimuleerd door Basel II), heeft de fi nanciële wereld de kredietcrisis1 niet kunnen vermijden. In dit artikel wordt onderzocht waarom risk management niet heeft kunnen bete

  1. A need for managed care in Saudi Arabia.

    Science.gov (United States)

    Mufti, M H

    2000-04-01

    Is the Kingdom of Saudi Arabia getting value for money invested in health? Quality care is being provided throughout health facilities in the Kingdom, however there is minimal control of utilization in all health sectors, consequently leading to abuse and over utilization, particularly in the public sector. Managed care programs have proven effective in reducing unnecessary inpatient and ancillary service utilization by reducing use of expensive procedures and unnecessary, highly specialized services, and shifting to less expensive care options. Health maintenance organizations are the best example of a managed health care model; tracking good performance and cost savings averaging between 20-40% compared to more traditional health plans. Key features of health maintenance organizations include serving a defined population voluntarily enrolled in the health plan; assumption of contractual responsibility and financial risk by plan to provide a range of services, and payment of a fixed periodic payment by the enrollee, independent of the actual use of services. The key characteristic that distinguishes health maintenance organizations from other delivery systems is prepayment for the care that is provided. Preferred Provider Organizations offer discounts for services received from a selected set of physicians and hospitals. Services received by enrollees are not fully reimbursed from this selected list of providers. Preferred Provider Organizations use health maintenance organizations administrative processes for controlling costs but do not include some of the intrinsic cost and quality controls of health maintenance organizations. Review of several studies indicate that patients enrolled in prepaid group practices (managed care organizations) were hospitalized 15-40% less often than those enrolled in fee-for-service health plans.

  2. RISK MANAGEMENT PROCESSES IN SUPPLY CHAINS

    Directory of Open Access Journals (Sweden)

    Aleksandar Aleksić

    2009-06-01

    Full Text Available One of the keys of successful business last few years is effective dealing with risks in every meaning of that word. At the time when the world economic crisis largely limits business, successful Risk management is the only way of survival for a large number of business systems. This paper will present the processes of risk management in supply chains that are in accordance with the standards ISO 28000 and ISO 31000. By implementing a holistic, enterprise-wide supply chain risk management program, companies also can uphold their commitment to providing strong corporate governance on behalf of stakeholders and increase their market value.

  3. Risk management - What about software?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    Risks in software systems arise from many directions. There are risks that the software is faulty, that the system may be attacked, that safety hazards exist, that the system may be inoperable or untimely, that an abnormal event may cause unexpected actions, etc. Risk analysis tools should support and document risk-mitigation decisions and facilitate understanding of residual risks. These tools must be based on a sound theory of risk, which does not exist today. Probabilistic risk assessment techniques apply to physically-based systems where failure modes and event dependence are fairly well understood. But they cannot be blindly applied to software systems, which do not share these characteristics. Moreover, we need to meld many diverse aspects of risk for software systems. This presentation will explore some thought-provoking ideas about modeling, problem spaces, solution approaches, math, decision friendly output, and the role of risk analysis in the software lifecycle.

  4. [Management of the esophageal candidiasis by the primary care physician].

    Science.gov (United States)

    Behrens, Garance; Bocherens, Astrid; Senn, Nicolas

    2014-05-14

    Esophageal candidiasis is one of the most common opportunistic infections in patients infected by human immunodeficiency virus (HIV). This pathology is also found in patients without overt immunodeficiency. Other risk factors are known to be associated with this disease like inhaled or systemic corticosteroid treatment or proton-pump inhibitors and H2 receptor antagonists. In the absence of identified risk factors, a primary immune deficiency should be sought. Prevention of esophageal candidiasis is based primarily on the identification of risk factors, and a better control of them. This article presents a review of the physiopathology, clinical presentation and management of esophageal candidiasis by primary care physicians. We will also discuss ways of preventing esophageal candidiasis when necessary.

  5. Risk assessment and management logistics chains

    Directory of Open Access Journals (Sweden)

    Vladimir Vikulov

    2014-03-01

    Full Text Available Background: In the context of economic globalization and increasing complexity of economic relations enterprises need methods and techniques to improve and sustain their position on the global market. Integration processes offer business new opportunities, but at the same time present new challenges for the management, including the key objectives of the risk management. Method: On the basis of analysis tools known from the pertinent literature (Supply Chain Management and Supply Chain Risk Management methods, methods of probability theory, methods of risk management, methods of statistics the authors of this paper proposed their own risk assessment method and the method of management of logistics chains. The proposed tool is a specific hybrid of solutions known from the literature. Results: The presented method has been successfully used within the frames of economic-mathematical model of industrial enterprises. Indicators of supply chain risks, including risks caused by supplier are considered in this paper. Authors formed a method of optimizing the level of supply chain risk in the integration with suppliers and customers. Conclusion: Every organization, which starting the process of integration with supplier and customers, needs to use tools, methodologies and techniques for identification of "weak links" in the supply chain. The proposed method allows to fix risk origin places in various links of the supply chain and to identify "weak links" of a logistic chain that may occur in the future. The method is a useful tool for managing not only risks and risk situations, but also to improve the efficiency of current assets management by providing the ability to optimize the level of risk in the current assets management of the industrial enterprise.

  6. Pulmonary Hypertension in Pregnancy: Critical Care Management

    Directory of Open Access Journals (Sweden)

    Adel M. Bassily-Marcus

    2012-01-01

    Full Text Available Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Imaging workup may have undesirable radiation exposure. Pulmonary artery catheter remains the gold standard for diagnosing pulmonary hypertension, although its use in the intensive care unit for other conditions has slowly fallen out of favor. Goal-directed bedside echocardiogram and lung ultrasonography provide attractive alternatives. Basic principles of managing pulmonary hypertension with right ventricular failure are maintaining right ventricular function and reducing pulmonary vascular resistance. Fluid resuscitation and various vasopressors are used with caution. Pulmonary-hypertension-targeted therapies have been utilized in pregnant women with understanding of their safety profile. Mainstay therapy for pulmonary embolism is anticoagulation, and the treatment for amniotic fluid embolism remains supportive care. Multidisciplinary team approach is crucial to achieving successful outcomes in these difficult cases.

  7. Project risk management in complex petrochemical system

    Directory of Open Access Journals (Sweden)

    Kirin Snežana

    2012-01-01

    Full Text Available Investigation of risk in complex industrial systems, as well as evaluation of main factors influencing decision making and implementation process using large petrochemical company as an example, has proved the importance of successful project risk management. This is even more emphasized when analyzing systems with complex structure, i.e. with several organizational units. It has been shown that successful risk management requires modern methods, based on adequate application of statistical analysis methods.

  8. Systems approach to project risk management

    Energy Technology Data Exchange (ETDEWEB)

    Kindinger, J. P. (John P.)

    2002-01-01

    This paper describes the need for better performance in the planning and execution of projects and examines the capabilities of two different project risk analysis methods for improving project performance. A quantitative approach based on concepts and tools adopted from the disciplines of systems analysis, probabilistic risk analysis, and other fields is advocated for managing risk in large and complex research & development projects. This paper also provides an overview of how this system analysis approach for project risk management is being used at Los Alamos National Laboratory along with examples of quantitative risk analysis results and their application to improve project performance.

  9. Portfolio Optimization under Entropic Risk Management

    Institute of Scientific and Technical Information of China (English)

    Wei ZHONG

    2009-01-01

    In this paper,properties of the entropic risk measure are examined rigorously in a general framework.This risk measure is then applied in a dynamic portfolio optimization problem,appearing in the risk management constraint.By considering the dual problem,we prove the existence and uniqueness of the solution and obtain an analytic expression for the solution.

  10. RISKS MANAGEMENT. A PROPENSITY SCORE APPLICATION

    Directory of Open Access Journals (Sweden)

    Constangioara Alexandru

    2008-05-01

    Full Text Available Risk management is relatively unexplored in Romania. Although Romanian specialists dwell on theoretical aspects such as the risks classification and the important distinction between risks and uncertainty the practical relevance of the matter is outside existing studies. Present paper uses a dataset of consumer data to build a propensity scorecard based on relevant quantitative modeling.

  11. Quality Risk Management of Compliant Excipients

    Directory of Open Access Journals (Sweden)

    Brian Carlin

    2012-12-01

    Full Text Available Raw material compliance and GMP do not eliminate variability. Quality by Design should minimize the riskthat raw material variability will adversely affect the finished product Critical Quality Attributes. The sourcesof technological risk from excipients are reviewed and approaches to excipient risk management arediscussed. Supplier involvement throughout the product life-cycle is recommended to minimizeexcipient-related risk.

  12. Crafting the group: Care in research management.

    Science.gov (United States)

    Davies, Sarah R; Horst, Maja

    2015-06-01

    This article reports findings from an interview study with group leaders and principal investigators in Denmark, the United Kingdom and the United States. Taking as our starting point current interest in the need to enhance 'responsible research and innovation', we suggest that these debates can be developed through attention to the talk and practices of scientists. Specifically, we chart the ways in which interview talk represented research management and leadership as processes of caring craftwork. Interviewees framed the group as the primary focus of their attention (and responsibilities), and as something to be tended and crafted; further, this process required a set of affective skills deployed flexibly in response to the needs of individuals. Through exploring the presence of notions of care in the talk of principal investigators and group leaders, we discuss the relation between care and craft, reflect on the potential implications of the promotion of a culture of care and suggest how mundane scientific understandings of responsibility might relate to a wider discussion of responsible research and innovation.

  13. Quality control and risk management: specific characteristics of the French health care system;Fonction qualite et gestion du risque: reflexions sur les specificites du systeme francais

    Energy Technology Data Exchange (ETDEWEB)

    Franck, D. [Syndicat National des Radiotherapeutes Oncologues (SNRO), 75 - Paris (France); Bureau de la Societe Francaise de Radiotherapie Oncologique (SFRO), 75 - Paris (France); Couderc, B. [Union Nationale Hospitaliere Privee de Cancerologie (UNHPC), 75 - Paris (France); Institut National du Cancer (INCa), 75 - Paris (France); Ligue Contre le Cancer, 75 - Paris (France); Parmentier, G. [UNHPC, 75 - Paris (France); College de l' Accreditation, Haut Conseil de Sante Publique, 75 - Paris (France)

    2009-12-15

    The techniques used in the field of radiotherapy are the same everywhere, but the organisation and scope of activities vary depending on the country, and sometimes depending on the specific region. The International Radiotherapy Conference held in Paris and devoted to the radiation protection of radiotherapy patients provides us with an opportunity to discuss some of the specific characteristics of the French health care system. These past years, the context of workforce shortage associated with strong government initiatives, the implementation of several successive National Cancer Plans, the transposition of European Directives into French law (EURATOM 96/29 and 97/43) and the accident in Epinal have had a rapidly restructuring effect on the French radiotherapy sector. (authors)

  14. Crew Management Processes Revitalize Patient Care

    Science.gov (United States)

    2009-01-01

    In 2005, two physicians, former NASA astronauts, created LifeWings Partners LLC in Memphis, Tennessee and began using Crew Resource Management (CRM) techniques developed at Ames Research Center in the 1970s to help improve safety and efficiency at hospitals. According to the company, when hospitals follow LifeWings? training, they can see major improvements in a number of areas, including efficiency, employee satisfaction, operating room turnaround, patient advocacy, and overall patient outcomes. LifeWings has brought its CRM training to over 90 health care organizations and annual sales have remained close to $3 million since 2007.

  15. Improving risk management: from lame excuses to principled practice.

    Science.gov (United States)

    Paté-Cornell, Elisabeth; Cox, Louis Anthony

    2014-07-01

    The three classic pillars of risk analysis are risk assessment (how big is the risk and how sure can we be?), risk management (what shall we do about it?), and risk communication (what shall we say about it, to whom, when, and how?). We propose two complements as important parts of these three bases: risk attribution (who or what addressable conditions actually caused an accident or loss?) and learning from experience about risk reduction (what works, and how well?). Failures in complex systems usually evoke blame, often with insufficient attention to root causes of failure, including some aspects of the situation, design decisions, or social norms and culture. Focusing on blame, however, can inhibit effective learning, instead eliciting excuses to deflect attention and perceived culpability. Productive understanding of what went wrong, and how to do better, thus requires moving past recrimination and excuses. This article identifies common blame-shifting "lame excuses" for poor risk management. These generally contribute little to effective improvements and may leave real risks and preventable causes unaddressed. We propose principles from risk and decision sciences and organizational design to improve results. These start with organizational leadership. More specifically, they include: deliberate testing and learning-especially from near-misses and accident precursors; careful causal analysis of accidents; risk quantification; candid expression of uncertainties about costs and benefits of risk-reduction options; optimization of tradeoffs between gathering additional information and immediate action; promotion of safety culture; and mindful allocation of people, responsibilities, and resources to reduce risks. We propose that these principles provide sound foundations for improving successful risk management.

  16. Analysis and estimation of risk management methods

    Directory of Open Access Journals (Sweden)

    Kankhva Vadim Sergeevich

    2016-05-01

    Full Text Available At the present time risk management is an integral part of state policy in all the countries with developed market economy. Companies dealing with consulting services and implementation of the risk management systems carve out a niche. Unfortunately, conscious preventive risk management in Russia is still far from the level of standardized process of a construction company activity, which often leads to scandals and disapproval in case of unprofessional implementation of projects. The authors present the results of the investigation of the modern understanding of the existing methodology classification and offer the authorial concept of classification matrix of risk management methods. Creation of the developed matrix is based on the analysis of the method in the context of incoming and outgoing transformed information, which may include different elements of risk control stages. So the offered approach allows analyzing the possibilities of each method.

  17. FINANCIAL RISK MANAGEMENT IN TRADE BANKS

    Directory of Open Access Journals (Sweden)

    Ms. Tamara Ye. Kononenko

    2016-09-01

    Full Text Available The paper clarifies the concepts of «risk», «financial risk» in banking business, and considers the main problems of financial risk management in trade banks while financing borrowers. The authors single out the most relevant problems, and conduct the analysis of overdue payment in case of OJSC “Sberbank of Russia”. The authors also offer a number of measures to minimize financial risks in trade bank activities in modern conditions.

  18. Risk quantification and risk management in renewable energy projects

    Energy Technology Data Exchange (ETDEWEB)

    Michelez, Jean; Rossi, Nicola; Blazquez, Rosario; Martin, Juan Manuel; Mera, Emilio; Christensen, Dana; Peineke, Christian; Graf, Konstantin; Lyon, David; Stevens, Geoff

    2011-07-01

    A key challenge in obtaining financing at a reasonable cost is the ability to quantify and manage the different elements of risk (i.e. organizational, political, technical, commercial) associated with Renewable Energy (RE) projects. IEA Renewable Energy Technology Deployment (IEA-RETD) commissioned a study to Altran which provides RE-specific guidelines in classification, assessment and management of different risk elements associated to support project valuation.

  19. Sustainable Risk Management in the Banking Sector

    Directory of Open Access Journals (Sweden)

    Županović Ivo

    2014-01-01

    Full Text Available The globalization of financial markets and negative consequences of the financial crisis resulted in negative connotations in the operation of many financial institutions, businesses and citizens and imposed the need to implement appropriate risk management measures in the banking sector. Evolution of the financial sector makes a lot of news in the field of risk management and particularly the modelling of market, credit and operational risk. The main methodology for risk management is the value-at-risk, which is used in practice with other techniques such as the capital- at-risk method in order to minimize business risks and achieve optimal results in the banking and, generally, financial operations. Accordingly, at all levels of governance in the banking sector, there are prudential policies in place governing the management of all types of financial and operational risks. Based on the abovementioned, the focus of the examination was on the above postulate, and prompt recognition, control and proper management of banking risks.

  20. The management of lipohypertrophy in diabetes care.

    Science.gov (United States)

    Hambridge, Kevin

    Lipohypertrophy has been a recognized complication of insulin therapy for many years, yet research shows that its prevalence in insulin-injecting patients with diabetes remains high. The problem for the patient is that the injection of insulin into a site of lipohypertrophy, although painless, may lead to erratic absorption of the insulin, with the potential for poor glycaemic control and unpredictable hypoglycaemia. Despite the important implications of this for diabetes control in insulin-injecting patients, there is a dearth of information and completed research into the condition. This article raises awareness of lipohypertrophy by reviewing the available literature on the prevention, identification and management of the condition from a nursing perspective. Recommendations for medical and nursing practice in diabetes care to improve prevention and management of lipohypertrophy are made.

  1. Intentional risk management through complex networks analysis

    CERN Document Server

    Chapela, Victor; Moral, Santiago; Romance, Miguel

    2015-01-01

    This book combines game theory and complex networks to examine intentional technological risk through modeling. As information security risks are in constant evolution,  the methodologies and tools to manage them must evolve to an ever-changing environment. A formal global methodology is explained  in this book, which is able to analyze risks in cyber security based on complex network models and ideas extracted from the Nash equilibrium. A risk management methodology for IT critical infrastructures is introduced which provides guidance and analysis on decision making models and real situations. This model manages the risk of succumbing to a digital attack and assesses an attack from the following three variables: income obtained, expense needed to carry out an attack, and the potential consequences for an attack. Graduate students and researchers interested in cyber security, complex network applications and intentional risk will find this book useful as it is filled with a number of models, methodologies a...

  2. Risk perception and clinical decision making in primary care

    DEFF Research Database (Denmark)

    Barfoed, Benedicte Marie Lind

    2015-01-01

    Objectives We aim to present new knowledge about different perspectives of health care professionals’ risk perceptions and clinical decision making. Furthermore, we intend to discuss differences between professional and personal risk perceptions and the impact on decisions in terms of both short...... and long-term outcomes. Background Insight into healthcare professionals’ perception of risk is a cornerstone for understanding their strategies for practising preventive care. The way people perceive risk can be seen as part of a general personality trait influenced by a mixture of individual...... considerations and the specific context. Most research has been focused on understanding of the concepts of risk. However healthcare professionals’ risk perception and personal attitudes also affect their clinical decision-making and risk communication. The differences between health care professionals’ personal...

  3. Risk perception as a driver for risk management policies

    Science.gov (United States)

    Carmona, María; Mañez, María

    2016-04-01

    Risk is generally defined as the "combination of the probability of the occurrence of an event and its negative consequences" ( UNISDR, 2009). However, the perception of a risk differs among cultures regarding different features such as the context,causes, benefits or damage. Risk perception is the subjective valuation of the probability of an event happening and how concerned individuals or groups are with the consequences (Sjöberg, 2004). Our study is based on an existing framework for risk perception (Rehn and Rohrmann, 2000). We analyse the characteristics of the risk perception regarding extreme events (e.g.droughts) and how the perception of the group drives the action to manage the risk. We do this to achieve an overview of the conditions that let stakeholders join each other to improve risk management especially when governments are not reacting properly. For our research, attention is paid on risk perception of Multi-Sector Partnerships not taking into account the individual level of risk perception. We focus on those factors that make risk management effective and increase resilience. Multi-Sector Partnerships, considered as significant governance structures for risk management, might contribute to reduce vulnerability in prone areas to natural hazards and disasters. The Multi-Sector Partnerships used for our research are existing partnerships identified in the cases studies of the European project ENHANCE. We implement a survey to analyse the perception of risk in the case studies. That survey is based on the Cultural Theory (Douglas and Wildavsky, 1982)and the Protection Motivation Theory (Rogers, 1975). We analyse the results using the Qualitative-Comparative Analysis proposed by Ragin in 1987. The results show the main characteristics of a risk culture that are beneficial to manage a risk. Those characteristics are shaped by the perception of risk of the people involved in the partnership, which in turn shapes their risk management. Nevertheless, we

  4. [First aid and management of multiple trauma: in-hospital trauma care].

    Science.gov (United States)

    Boschin, Matthias; Vordemvenne, Thomas

    2012-11-01

    Injuries remain the leading cause of death in children and young adults. Management of multiple trauma patients has improved in recent years by quality initiatives (trauma network, S3 guideline "Polytrauma"). On this basis, strong links with preclinical management, structured treatment algorithms, training standards (ATLS®), clear diagnostic rules and an established risk- and quality management are the important factors of a modern emergency room trauma care. We describe the organizational components that lead to successful management of trauma in hospital.

  5. Practical Risk Management for the CIO

    CERN Document Server

    Scherling, Mark

    2007-01-01

    The growing complexity of today's interconnected systems has not only increased the need for improved information security, but also helped to move information from the IT backroom to the executive boardroom as a strategic asset. And, just like the tip of an iceberg is all you see until you run into it, the risks to your information are mostly invisible until disaster strikes. Detailing procedures that will help your team perform better risk assessments and aggregate results into more meaningful metrics, Practical Risk Management for the CIO approaches information risk management through impro

  6. Practical Methods for Information Security Risk Management

    Directory of Open Access Journals (Sweden)

    Cristian AMANCEI

    2011-01-01

    Full Text Available The purpose of this paper is to present some directions to perform the risk man-agement for information security. The article follows to practical methods through question-naire that asses the internal control, and through evaluation based on existing controls as part of vulnerability assessment. The methods presented contains all the key elements that concurs in risk management, through the elements proposed for evaluation questionnaire, list of threats, resource classification and evaluation, correlation between risks and controls and residual risk computation.

  7. Implementation of an oral care protocol to promote early detection and management of stomatitis.

    Science.gov (United States)

    Caplinger, Jane; Royse, Mary; Martens, Jennifer

    2010-12-01

    This project aimed to promote early identification and treatment of stomatitis in patients with cancer receiving head and neck radiation and chemotherapy. A literature review revealed criteria for identifying high-risk patients, interventions to minimize risk, oral assessment tools, treatment protocols, and instructions for a comprehensive oral examination. Thorough and accurate oral care assessments by RNs, promotion of oral care protocols, and early patient education will improve symptom management and quality of life in this population.

  8. Managing Climate Risk. Interim Report

    Energy Technology Data Exchange (ETDEWEB)

    Obersteiner, M.; Mechler, R.; Nilsson, S. [International Institute for Applied Systems Analysis IIASA, Laxenburg (Austria); Azar, C. [Department of Physical Resource Theory, Chalmers University of Technology, Goeteborg University, Goeteborg (Sweden); Kossmeier, S. [Department of Economics and Finance, Institute for Advanced Studies, Vienna (Austria); Moellersten, K.; Yan, J. [Department of Chemical Engineering and Technology, Royal Institute of Technology KTH, Stockholm (Sweden); Read, P. [Economics Department, Massey University, Palmerston North (New Zealand); Yamagata, Y. [Climate Change Research Project, National Institute for Environmental Studies NIES, Ibaraki (Japan)

    2001-12-01

    At the heart of the traditional approach to strategy in the climate change dilemma lies the assumption that the global community, by applying a set of powerful analytical tools, can predict the future of climate change accurately enough to choose a clear strategic direction for it. We claim that this approach might involve underestimating uncertainty in order to lay out a vision of future events sufficiently precise to be captured in a discounted cost flow analysis in integrated assessment models. However, since the future of climate change is truly uncertain, this approach might at best be marginally helpful and at worst downright dangerous: underestimating uncertainty can lead to strategies that do not defend the world against unexpected and sometimes even catastrophic threats. Another danger lies on the other extreme: if the global community can not find a strategy that works under traditional analysis or if uncertainties are too large that clear messages are absent, they may abandon the analytical rigor of their planning process altogether and base their decisions on good instinct and consensus of some future process that is easy to agree upon. In this paper, we try to outline a system to derive strategic decisions under uncertainty for the climate change dilemma. What follows is a framework for determining the level of uncertainty surrounding strategic decisions and for tailoring strategy to that uncertainty. Our core argument is that a robust strategy towards climate change involves the building of a technological portfolio of mitigation and adaptation measures that includes sufficient opposite technological positions to the underlying baseline emission scenarios given the uncertainties of the entire physical and socioeconomic system in place. In the case of mitigation, opposite technological positions with the highest leverage are particular types of sinks. A robust climate risk management portfolio can only work when the opposite technological positions are

  9. Financial incentives for disease management programmes and integrated care in German social health insurance.

    Science.gov (United States)

    Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen

    2006-10-01

    As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.

  10. Severe ovarian hyperstimulation syndrome: Intensive care management of two cases

    Directory of Open Access Journals (Sweden)

    Praveen Talawar

    2011-01-01

    Full Text Available Severe ovarian hyperstimulation syndrome (OHSS is characterized by increased capillary permeability and fluid retention in the third space. It is generally a complication of assisted reproduction therapy (ART with exogenous gonadotropins, but cases with natural onset of OHSS have been reported. The massive extravascular exudation can cause tense ascites, pleural and pericardial effusion, hypovolemic shock, oliguria, electrolyte imbalance (hyponatremia and hyperkalemia, and hemoconcentration, with a tendency for hypercoagulability and risk of life-threatening thromboembolic complications. The patient can rarely develop multi-organ failure (adult respiratory distress syndrome, renal failure and death. With increasing use of ART, this syndrome may be seen more frequently in the intensive care unit (ICU, requiring multidisciplinary care. We report the management of two cases of severe OHSS, which required admission to the ICU in our hospital.

  11. Characteristics of Managing Operational Banking Risk

    Directory of Open Access Journals (Sweden)

    Adela Socol

    2008-12-01

    Full Text Available The objective of this paper is to provide a global perspective of the operational risk from a banking societies’ viewpoint. We describe the main regulations and settlements in the field and examine the various approaches of the operational banking risk. The paper presents the need of banks to managing operational risk. We study comparatively for a banking society the capital charge for covering the operational risk under the basic indicator approach and under the standardized approach. We present a case study of implementing current capital requirements at the level of a Romanian banking society. From the theoretical approach and from the description of quantifying of operational banking risk, the results of this study insist on the importance of measuring of operational banking risk and identifies major issues that need to be considered to improve the managing operational banking risk.

  12. Fundamentals of risk management understanding, evaluating and implementing effective risk management

    CERN Document Server

    Hopkin, Paul

    2012-01-01

    Now more than ever, organizations must plan, response and recognize all forms of risks that they face. "Fundamentals of Risk Management", now in its second edition, provides a comprehensive introduction to the subject of commercial and business risk for anyone studying for a career in risk as well as a broad range of risk professionals. It examines the key components of risk management and its application with examples to demonstrate its benefit to organisations in the public and private sector. The second edition has been completely updated to take into account the greater influence of ISO 3100, the emergence of Governance Risk and Compliance (GRC) and the wide use of the bowtie method to illustrate risk management. In addition, there is now a chapter on the skills and competencies required by an effective risk manager.

  13. RISK MANAGEMENT IN THE ELECTRONIC BUSINESS

    Directory of Open Access Journals (Sweden)

    Georgeta Soava

    2016-12-01

    Full Text Available Risk should not be understood as a destructive phenomenon, but bear in mind that managers who know how to use it can lead to real opportunities. Manager must first recognize the existence of risk, namely to identify and then use specific methods to avoid or reduce the risk. The purpose of this paper is to enter the world, at all simple, of risk management, relatively easy concept to understand but not so easy to put into practice. Of course, the approach relates primarily at the risks inherent of the business in digital environments, but they not represent only a particular case of the risks they are exposed, in general, the companies. In the paper we put in evidence the significance in general business, risks in e-business, then we added a description of the types of security risks, an exemplification of these and a series of test scenarios, and finally to make a analysis of operational solutions of risk management

  14. 76 FR 57723 - Electricity Sector Cybersecurity Risk Management Process Guideline

    Science.gov (United States)

    2011-09-16

    ... Electricity Sector Cybersecurity Risk Management Process Guideline AGENCY: Department of Energy. ACTION... to publish the Electricity Sector Cybersecurity Risk Management Process Guideline. The guideline describes a risk management process that is targeted to the specific needs of electricity...

  15. The role of managed care organizations in obesity management.

    Science.gov (United States)

    Schaecher, Kenneth L

    2016-06-01

    In the United States, obesity is characterized as this century's greatest healthcare threat. The American Medical Association and several other large organizations now classify obesity as a disease. Several federal initiatives are in the planning stages, have been approved, or are being implemented to address the disease. Obesity poses challenges for all healthcare stakeholders. Diet and exercise often are insufficient to create the magnitude of change patients and their attending healthcare providers need. Managed care organizations (MCOs) have 3 tools that can help their members: health and wellness programs focusing on lifestyle changes, prescription weight-loss drugs, and bariatric surgical interventions. MCOs are addressing changes with national requirements and are responding to the availability of new weight-loss drugs to help their members achieve better health. A number of factors either deter or stimulate the progress of weight loss therapy. Understanding how MCOs are key to managing obesity at the local level is important for healthcare providers. It can help MCOs and individual healthcare providers develop and coordinate strategies to educate stakeholders and better manage overall care.

  16. From CSR to Social Risk Management

    DEFF Research Database (Denmark)

    Taarup Esbensen, Jacob

    2014-01-01

    When it comes to social risks multinational companies (MNC) within Mining are one of the most exposed businesses one can imagine. This paper examines how social risk management is practiced through the case of Teghout copper-molybdenum mine in North- Eastern Armenia, supplemented with evidence from...... other mining MNCs in the country, onsite fieldwork, interviews with key stakeholders, and public available information. This evidence suggest that a standards based social risk management strategy is adopted and that this strategy is based on international Corporate Social Responsibility (CSR) standards...... engagement management systems that is promoted through the standard. The implemented social risk management systems are ineffective because they makes the MNC unable to recognise the value of weak ties and fail to build legitimacy and trust with some of the key stakeholders resulting in the creation of more...

  17. COMPUTERIZED MODEL OF RISK MANAGEMENT IN BUSINESS

    Directory of Open Access Journals (Sweden)

    Petrişor MANDU

    2011-01-01

    Full Text Available The occurrence of risk situation and the manager’s awareness of it are serious threats for the organization and its objectives. Consequently, the manager has to have available, analyze, select and interpret many pieces of information, under stress, before making a decision for avoiding a disaster. Under these circumstances, a computerized model of risk management is the most adequate solution to make the intervention possibilities effective through a quicker and more accurate intervention. The model offers enough confidence and a favorable psychological state for managing risk. In accordance with this model, the risk manager processes the information by means of some operational (mathematical methods and that favors reaching optimum solutions in the shortest delay, based on some estimated anticipations through a rational model.

  18. Patient care management as a global nursing concern.

    Science.gov (United States)

    Bower, Kathleen A

    2004-01-01

    Effective and efficient patient management is important in all health care environments because it influences clinical and financial outcomes as well as capacity. Design of care management processes is guided by specific principles. Roles (e.g., case management) and tools (e.g., clinical paths) provide essential foundations while attention to outcomes anchors the process.

  19. Survival strategies in the era of managed care.

    Science.gov (United States)

    Rudomin, M L; Spirakes, A S

    1996-02-01

    The era of managed care has forced an unprecedented restructuring of the health care environment. As hospitals downsize in response, materiel managers should consider adopting strategies that may help ensure their survival, including innovative approaches to supply management and the development of individual responses that will best position them to succeed in this new reality.

  20. Wildfire Risk Management: Challenges and Opportunities

    Science.gov (United States)

    Thompson, M.; Calkin, D. E.; Hand, M. S.; Kreitler, J.

    2014-12-01

    In this presentation we address federal wildfire risk management largely through the lens of economics, targeting questions related to costs, effectiveness, efficiency, and tradeoffs. Beyond risks to resources and assets such as wildlife habitat, watersheds, and homes, wildfires present financial risk and budgetary instability for federal wildfire management agencies due to highly variable annual suppression costs. Despite its variability, the costs of wildfire management have continued to escalate and account for an ever-growing share of overall agency budgets, compromising abilities to attain other objectives related to forest health, recreation, timber management, etc. Trends associated with a changing climate and human expansion into fire-prone areas could lead to additional suppression costs in the future, only further highlighting the need for an ability to evaluate economic tradeoffs in investments across the wildfire management spectrum. Critically, these economic analyses need to accurately capture the complex spatial and stochastic aspects of wildfire, the inherent uncertainty associated with monetizing environmental impacts of wildfire, the costs and effectiveness of alternative management policies, and linkages between pre-fire investments and active incident management. Investing in hazardous fuels reduction and forest restoration in particular is a major policy lever for pre-fire risk mitigation, and will be a primary focus of our presentation. Evaluating alternative fuel management and suppression policies could provide opportunities for significant efficiency improvements in the development of risk-informed management fire management strategies. Better understanding tradeoffs of fire impacts and costs can help inform policy questions such as how much of the landscape to treat and how to balance investments in treating new areas versus maintaining previous investments. We will summarize current data needs, knowledge gaps, and other factors

  1. Multinational Performance and Risk Management Effects

    OpenAIRE

    Juul Andersen, Torben

    2008-01-01

    Multinational enterprise provides access to a diverse resource base that may support options related business initiatives and operational flexibilities with a potential to improve performance and risk management capabilities. Hence, multinationality should be associated with strategic responsiveness as real option structures allow the corporation to exploit new initiatives and pursue alternative actions. This, in turn should improve economic performance and risk management capabilities as cor...

  2. Risk management practices in the airline industry

    OpenAIRE

    Fernando, Sharon Perpetua Anasta

    2006-01-01

    This paper reviews the use of financial derivative instruments by non-financial entities to manage risk exposure. It provides the main objectives of a non-financial corporation to enter into derivative contracts with a counterparty and the scope of usage of these instruments. It is evident that most companies use derivative instruments to preserve cash flows and firm value as opposed to taking positions in contracts for speculative purposes. The paper focuses on the risk management practices ...

  3. Managed care contracting issues in integrated delivery systems.

    Science.gov (United States)

    Stewart, E E

    1996-01-01

    This article is a checklist for use by health care providers in reviewing proposed managed care contracting agreements. This checklist is not an exhaustive list, but is intended to be used as a framework for review.

  4. From risk management to uncertainty management: a significant change in project management

    Institute of Scientific and Technical Information of China (English)

    LI Gui-jun; ZHANG Yue-song

    2006-01-01

    Starting with the meanings of the terms "risk" and "uncertainty,"" he paper compares uncertainty management with risk management in project management. We bring some doubt to the use of "risk" and "uncertainty" interchangeably in project management and deem their scope, methods, responses, monitoring and controlling should be different too. Illustrations are given covering terminology, description, and treatment from different perspectives of uncertainty management and risk management. Furthermore, the paper retains that project risk management (PRM) processes might be modified to facilitate an uncertainty management perspective,and we support that project uncertainty management (PUM) can enlarge its contribution to improving project management performance, which will result in a significant change in emphasis compared with most risk management.

  5. Osteoporosis screening and risk management

    OpenAIRE

    Wilkins, Consuelo H.

    2007-01-01

    Consuelo H WilkinsDepartment of Medicine, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, USAAbstract: Osteoporosis is common among older adults and results in costly osteoporotic fractures. Screening for this metabolic bone disorder is warranted in most older adults and clinicians must be diligent in identifying persons at risk. The evaluation should include an assessment of risk factors for falls, a bone density test, and consideratio...

  6. Regulation and Risk: Early Childhood Education and Care Services as Sites where the "Laugh of Foucault" Resounds

    Science.gov (United States)

    Fenech, Marianne; Sumsion, Jennifer; Goodfellow, Joy

    2008-01-01

    This article problematises the construction of regulation as an effective manager of risks to children in early childhood education and care (ECEC) services. Adopting a Foucaldian, governmentalist approach to regulation and risk, the authors suggest that governments in Australia have "risk colonised" regulation to meet their own…

  7. The NASA Continuous Risk Management Process

    Science.gov (United States)

    Pokorny, Frank M.

    2004-01-01

    As an intern this summer in the GRC Risk Management Office, I have become familiar with the NASA Continuous Risk Management Process. In this process, risk is considered in terms of the probability that an undesired event will occur and the impact of the event, should it occur (ref., NASA-NPG: 7120.5). Risk management belongs in every part of every project and should be ongoing from start to finish. Another key point is that a risk is not a problem until it has happened. With that in mind, there is a six step cycle for continuous risk management that prevents risks from becoming problems. The steps are: identify, analyze, plan, track, control, and communicate & document. Incorporated in the first step are several methods to identify risks such as brainstorming and using lessons learned. Once a risk is identified, a risk statement is made on a risk information sheet consisting of a single condition and one or more consequences. There can also be a context section where the risk is explained in more detail. Additionally there are three main goals of analyzing a risk, which are evaluate, classify, and prioritize. Here is where a value is given to the attributes of a risk &e., probability, impact, and timeframe) based on a multi-level classification system (e.g., low, medium, high). It is important to keep in mind that the definitions of these levels are probably different for each project. Furthermore the risks can be combined into groups. Then, the risks are prioritized to see what risk is necessary to mitigate first. After the risks are analyzed, a plan is made to mitigate as many risks as feasible. Each risk should be assigned to someone in the project with knowledge in the area of the risk. Then the possible approaches to choose from are: research, accept, watch, or mitigate. Next, all risks, mitigated or not, are tracked either individually or in groups. As the plan is executed, risks are re-evaluated, and the attribute values are adjusted as necessary. Metrics

  8. Patient care and management: reduced skin integrity of the foot.

    Science.gov (United States)

    Bateman, Sharon

    The development and deterioration of pressure ulcers are a frequent occurrence across all healthcare settings and specialties, posing daily challenges to the healthcare worker and unnecessary suffering to the patient. Reduced skin integrity occurs within those patients deemed high risk, particularly to the vulnerable areas such as the heel and ankle (American Physical Therapy Association (APTA), 1996). The incidence of pressure ulcers, alongside diabetes, vascular insufficiency and obesity, is on the increase, posing additional demands on current clinical resources; specialist clinics, debridement therapies and appropriate dressing management regimes. This article will focus on the heel and ankle in regards to reduced skin integrity and the positive introduction of an innovative dressing product as an adjunct to the overall care and management of this patient group.

  9. Methodology of environmental risk assessment management

    Directory of Open Access Journals (Sweden)

    Saša T. Bakrač

    2012-04-01

    Full Text Available Successful protection of environment is mostly based on high-quality assessment of potential and present risks. Environmental risk management is a complex process which includes: identification, assessment and control of risk, namely taking measures in order to minimize the risk to an acceptable level. Environmental risk management methodology: In addition to these phases in the management of environmental risk, appropriate measures that affect the reduction of risk occurrence should be implemented: - normative and legal regulations (laws and regulations, - appropriate organizational structures in society, and - establishing quality monitoring of environment. The emphasis is placed on the application of assessment methodologies (three-model concept, as the most important aspect of successful management of environmental risk. Risk assessment methodology - European concept: The first concept of ecological risk assessment methodology is based on the so-called European model-concept. In order to better understand this ecological risk assessment methodology, two concepts - hazard and risk - are introduced. The European concept of environmental risk assessment has the following phases in its implementation: identification of hazard (danger, identification of consequences (if there is hazard, estimate of the scale of consequences, estimate of consequence probability and risk assessment (also called risk characterization. The European concept is often used to assess risk in the environment as a model for addressing the distribution of stressors along the source - path - receptor line. Risk assessment methodology - Canadian concept: The second concept of the methodology of environmental risk assessment is based on the so-called Canadian model-concept. The assessment of ecological risk includes risk arising from natural events (floods, extreme weather conditions, etc., technological processes and products, agents (chemical, biological, radiological, etc

  10. Management of drought risk under global warming

    Science.gov (United States)

    Zhang, Qiang; Han, Lanying; Jia, Jianying; Song, Lingling; Wang, Jinsong

    2016-07-01

    Drought is a serious ecological problem around the world, and its impact on crops and water availability for humans can jeopardize human life. Although drought has always been common, the drought risk has become increasingly prominent because of the climatic warming that has occurred during the past century. However, it still does not comprehensively understand the mechanisms that determine the occurrence of the drought risk it poses to humans, particularly in the context of global climate change. In this paper, we summarize the progress of research on drought and the associated risk, introduce the principle of a drought "transition" from one stage to another, synthesize the characteristics of key factors and their interactions, discuss the potential effect of climatic warming on drought risk, and use this discussion to define the basic requirements for a drought risk management system. We also discuss the main measures that can be used to prevent or mitigate droughts in the context of a risk management strategy.

  11. Risk Management of Large Component in Decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Ku; Kim, Tae Ryong [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2014-10-15

    The need for energy, especially electric energy, has been dramatically increasing in Korea. Therefore, a rapid growth in nuclear power development has been achieved to have about 30% of electric power production. However, such a large nuclear power generation has been producing a significant amount of radioactive waste and other matters such as safety issue. In addition, owing to the severe accidents at the Fukushima in Japan, public concerns regarding NPP and radiation hazard have greatly increased. In Korea, the operation of KORI 1 has been scheduled to be faced with end of lifetime in several years and Wolsong 1 has been being under review for extending its life. This is the reason why the preparation of nuclear power plant decommissioning is significant in this time. Decommissioning is the final phase in the life-cycle of a nuclear facility and during decommissioning operation, one of the most important management in decommissioning is how to deal with the disused large component. Therefore, in this study, the risk in large component in decommissioning is to be identified and the key risk factor is to be analyzed from where can be prepared to handle decommissioning process safely and efficiently. Developing dedicated acceptance criteria for large components at disposal site was analyzed as a key factor. Acceptance criteria applied to deal with large components like what size of those should be and how to be taken care of during disposal process strongly affect other major works. For example, if the size of large component was not set up at disposal site, any dismantle work in decommissioning is not able to be conducted. Therefore, considering insufficient time left for decommissioning of some NPP, it is absolutely imperative that those criteria should be laid down.

  12. Comparisons on International Approaches of Business and Project Risk Management

    OpenAIRE

    Nadia Carmen ENE

    2005-01-01

    In this article we intend to present a comparative approach between three recognized international methodologies for risk management: RISKMAN, Project Management Institute Methodology-PMBoK and Project Risk Analysis and Management Guide (produced by Association for Project Management).

  13. Lessons Learned in Risk Management on NCSX

    Energy Technology Data Exchange (ETDEWEB)

    Neilson, G. H.; Gruber, C. O.; Harris, J. H.; Rej, D. J.; Simmons, R. T.; Strykowsky, R. L.

    2009-07-21

    The National Compact Stellarator Experiment (NCSX) was designed to test physics principles of an innovative stellarator design developed by the Princeton Plasma Physics Laboratory and Oak Ridge National Laboratory. Construction of some of the major components and sub-assemblies was completed, but the estimated cost and schedule for completing the project grew as the technical requirements and risks became better understood, leading to its cancellation in 2008. The project's risks stemmed from its technical challenges, primarily the complex component geometries and tight tolerances that were required. The initial baseline, established in 2004, was supported by a risk management plan and risk-based contingencies, both of which proved to be inadequate. Technical successes were achieved in the construction of challenging components and subassemblies, but cost and schedule growth was experienced. As part of an effort to improve project performance, a new risk management program was devised and implemented in 2007-08. It led to a better understanding of project risks, a sounder basis for contingency estimates, and improved management tools. Although the risks ultimately were unacceptable to the sponsor, valuable lessons in risk management were learned through the experiences with the NCSX project.

  14. Lessons Learned in Risk Management on NCSX

    Energy Technology Data Exchange (ETDEWEB)

    G.H. Neilson, C.O. Gruber, J.H. Harris, D.J. Rej, R.T. Simmons, and R.L. Strykowsky

    2009-02-11

    The National Compact Stellarator Experiment (NCSX) was designed to test physics principles of an innovative stellarator design developed by the Princeton Plasma Physics Laboratory and Oak Ridge National Laboratory. Construction of some of the major components and sub-assemblies was completed, but the estimated cost and schedule for completing the project grew as the technical requirements and risks became better understood, leading to its cancellation in 2008. The project's risks stemmed from its technical challenges, primarily the complex component geometries and tight tolerances that were required. The initial baseline, established in 2004, was supported by a risk management plan and risk-based contingencies, both of which proved to be inadequate. Technical successes were achieved in the construction of challenging components and subassemblies, but cost and schedule growth was experienced. As part of an effort to improve project performance, a new risk management program was devised and implemented in 2007-08. It led to a better understanding of project risks, a sounder basis for contingency estimates, and improved management tools. Although the risks ultimately were unacceptable to the sponsor, valuable lessons in risk management were learned through the experiences with the NCSX project.

  15. Lessons Learned in Risk Management on NCSX

    Energy Technology Data Exchange (ETDEWEB)

    Neilson, G. H. [Princeton Plasma Physics Laboratory, Princeton, NJ; Gruber, C. O. [Princeton Plasma Physics Laboratory, Princeton, NJ; Harris, Jeffrey H [ORNL; Rej, D. J. [Princeton Plasma Physics Laboratory (PPPL); Simmons, R. T. [Princeton Plasma Physics Laboratory, Princeton, NJ; Strykowsky, R. L. [Princeton Plasma Physics Laboratory, Princeton, NJ

    2010-01-01

    The National Compact Stellarator Experiment (NCSX) was designed to test physics principles of an innovative stellarator design developed by Princeton Plasma Physics Laboratory and Oak Ridge National Laboratory. Construction of some of the major components and subassemblies was completed, but the estimated cost and schedule for completing the project grew as the technical requirements and risks became better understood, leading to its cancellation in 2008. The project's risks stemmed from its technical challenges, primarily the complex component geometries and tight tolerances that were required. The initial baseline, which was established in 2004, was supported by a risk management plan and risk-based contingencies, both of which proved to be inadequate. Technical successes were achieved in the construction of challenging components and subassemblies, but cost and schedule growth was experienced. As part of an effort to improve project performance, a new risk management program was devised and implemented in 2007-2008. It led to a better understanding of project risks, a sounder basis for contingency estimates, and improved management tools. Although the risks were ultimately unacceptable to the sponsor, valuable lessons in risk management were learned through the experiences with the NCSX project.

  16. Influences on Case-Managed Community Aged Care Practice.

    Science.gov (United States)

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-10-01

    Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts.

  17. A Stochastic Processes Toolkit for Risk Management

    OpenAIRE

    Damiano Brigo; Antonio Dalessandro; Matthias Neugebauer; Fares Triki

    2008-01-01

    In risk management it is desirable to grasp the essential statistical features of a time series representing a risk factor. This tutorial aims to introduce a number of different stochastic processes that can help in grasping the essential features of risk factors describing different asset classes or behaviors. This paper does not aim at being exhaustive, but gives examples and a feeling for practically implementable models allowing for stylised features in the data. The reader may also use t...

  18. CORPORATE STRATEGIES FOR CURRENCY RISK MANAGEMENT

    OpenAIRE

    Sarkis, Sumbat; Shu, Chang

    2008-01-01

    Title: Corporate Strategies for Currency Risk Management ackground:Currency fluctuations are a global phenomenon, and can affect multinational companies directly through their cash flow, financial result and company valuation. The exposure to currency risks might however be covered against or ‘hedged’, as it is called, by different external and internal corporate strategies. However, some of these strategies might include a risk themselves as they can be expensive and uncertain. It is therefo...

  19. Information needs for risk management/communication

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, D.A. [Environmental Protection Agency, Washington, DC (United States)

    1990-12-31

    The hazardous waste cleanup program under the Comprehensive Environmental Response, Compensation, and Liability Act (Superfund) is delegated to the ten Regions of the US Environmental Protection Agency (EPA) and has, to date, identified more than 33,000 sites for consideration. The size and complexity of the program places great demands on those who would provide information to achieve national consistency in application of risk assessment while meeting site-specific needs for risk management and risk communication.

  20. Self-management of vascular risk factors

    NARCIS (Netherlands)

    Sol-de Rijk, B.G.M.

    2009-01-01

    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing v

  1. A View Inside Corporate Risk Management

    NARCIS (Netherlands)

    Bodnar, G.M.; Giambona, E.; Graham, J.R.; Harvey, C.R.

    2014-01-01

    A number of theories have been proposed to explain why firms hedge. Unfortunately, these theories are hard to test: While we might observe the hedges, it is hard to answer the question of "why" hedging occurs. Our paper attacks the "why" by directly questioning the managers that make the risk manage

  2. Health information technology: transforming chronic disease management and care transitions.

    Science.gov (United States)

    Rao, Shaline; Brammer, Craig; McKethan, Aaron; Buntin, Melinda B

    2012-06-01

    Adoption of health information technology (HIT) is a key effort in improving care delivery, reducing costs of health care, and improving the quality of health care. Evidence from electronic health record (EHR) use suggests that HIT will play a significant role in transforming primary care practices and chronic disease management. This article shows that EHRs and HIT can be used effectively to manage chronic diseases, that HIT can facilitate communication and reduce efforts related to transitions in care, and that HIT can improve patient safety by increasing the information available to providers and patients, improving disease management and safety.

  3. Process-based project proposal risk management

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2016-12-01

    Full Text Available We all are aware of the organizational omnipresence. Projects within the organizations are ubiquitous too. Projects achieve their goals successfully if they are planned, scheduled, controlled and implemented well. The project lifecycle of initiating, planning, scheduling, controlling and implementing are very well-planned by project managers and the organizations. Successful projects have well-developed risk management plans to deal with situations impacting projects. Like any other organisation, a university does try to access funds for different purposes too. For such organisations, running a project is not the issue, rather getting a project proposal approved to fund a project is the key. Project proposal processing is done by the nodal office in every organisation. Usually, these nodal offices help in administration and submission of a project proposal for accessing funds. Seldom are these nodal project offices within the organizations facilitate a project proposal approval by proactively reaching out to the project managers. And as project managers prepare project proposals, little or no attention is made to prepare a project proposal risk plan so as to maximise project acquisition. Risk plans are submitted while preparing proposals but these risk plans cater to a requirement to address actual projects upon approval. Hence, a risk management plan for project proposal is either missing or very little effort is made to treat the risks inherent in project acquisition. This paper is an integral attempt to highlight the importance of risk treatment for project proposal stage as an extremely important step to preparing the risk management plan made for projects corresponding to their lifecycle phases. Several tools and techniques have been proposed in the paper to help and guide either the project owner (proposer or the main organisational unit responsible for project management. Development of tools and techniques to further enhance project

  4. Risk ManagementManaging Risks, not Calculating Them

    OpenAIRE

    Kostov, Phillip; Lingard, John

    2004-01-01

    The expected utility approach to decision making advocates a probability vision of the world and labels any deviation from it ‘irrational’. This paper reconsiders the rationality argument and argues that calculating risks is not a viable strategy in an uncertain world. Alternative strategies not only can save considerable cognitive and computational resources, but are more ‘rational’ with view to the restricted definition of rationality applied by expected utility theorists. The alternative d...

  5. Primary care management of opioid use disorders

    Science.gov (United States)

    Srivastava, Anita; Kahan, Meldon; Nader, Maya

    2017-01-01

    Abstract Objective To advise physicians on which treatment options to recommend for specific patient populations: abstinence-based treatment, buprenorphine-naloxone maintenance, or methadone maintenance. Sources of information PubMed was searched and literature was reviewed on the effectiveness, safety, and side effect profiles of abstinence-based treatment, buprenorphine-naloxone treatment, and methadone treatment. Both observational and interventional studies were included. Main message Both methadone and buprenorphine-naloxone are substantially more effective than abstinence-based treatment. Methadone has higher treatment retention rates than buprenorphine-naloxone does, while buprenorphine-naloxone has a lower risk of overdose. For all patient groups, physicians should recommend methadone or buprenorphine-naloxone treatment over abstinence-based treatment (level I evidence). Methadone is preferred over buprenorphine-naloxone for patients at higher risk of treatment dropout, such as injection opioid users (level I evidence). Youth and pregnant women who inject opioids should also receive methadone first (level III evidence). If buprenorphine-naloxone is prescribed first, the patient should be promptly switched to methadone if withdrawal symptoms, cravings, or opioid use persist despite an optimal buprenorphine-naloxone dose (level II evidence). Buprenorphine-naloxone is recommended for socially stable prescription oral opioid users, particularly if their work or family commitments make it difficult for them to attend the pharmacy daily, if they have a medical or psychiatric condition requiring regular primary care (level IV evidence), or if their jobs require higher levels of cognitive functioning or psychomotor performance (level III evidence). Buprenorphine-naloxone is also recommended for patients at high risk of methadone toxicity, such as the elderly, those taking high doses of benzodiazepines or other sedating drugs, heavy drinkers, those with a lower

  6. COORDINATES OF A RISK MANAGEMENT PROJECT

    Directory of Open Access Journals (Sweden)

    ALEXANDRU OLTEANU

    2013-05-01

    Full Text Available High risk – high benefit: a well-known correlation both in the economic field and in the day-to-day life. Another correlation, on which this article is based: large project – numerous participants – increased risks and other malfunctions. The risk management concept is challenged by those projects and is forced to find the most adequate “customized” ways for each project at its turn. In this respect, the assessment of management has followed the trend of the last three decades, marked by moving of management profit analysis by risk intermediation, respectively the transition from managing profit to risk-return relationship management. Such trend assumes the obligation of participants to identify objectives and expected benefits of the project on the basis of the strategies laid-down, the elements of risk management policies, in conjunction with the indication of the most negative scenarios which they may provide. This activity must take into consideration the process of obtaining and combining human, financial, physical and information resources in order to accomplish the primary goal of the proposed and wanted project by a certain segment of population. Project participants are directed to evaluate their own activities in terms of revenues and risks from the business access, opportunity, operating mode, as well as the limitations and boundaries on certain sides of activity. The paper focuses on the analysis and evaluation of incomes and risks, on simulations to streamline the activities and the determination of the optimal model of project choice. Also, the paper treats the risks that can be taken over by the sponsors, especially those related to implied guaranties, even implied guaranties.

  7. Managing care in an integrated delivery system via an Intranet.

    Science.gov (United States)

    Halamka, J D; Hughes, M; Mack, J; Hurwitz, M; Davis, F; Wood, D; Borten, K; Saal, A K

    1998-01-01

    The CareGroup Provider Service Network is a managed care contracting organization which provides central administrative services for over 1800 physicians and 200,000 managed care lives. Services include utilization management, disease management and credentialing for the entire network. The management model of the Provider Service Network empowers local physician groups with information and education. To meet the managed care information needs of the network, we implemented an intranet-based executive information system, PSNWeb, which retrieves data from a managed care data warehouse. The project required the integration of diverse technologies and development of a complex security/confidentiality infrastructure to deliver information to 8 major clinician groups, each with different information needs.

  8. Assessment, authorization and access to medicaid managed mental health care.

    Science.gov (United States)

    Masland, Mary C; Snowden, Lonnie R; Wallace, Neal T

    2007-11-01

    Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

  9. How managed care growth affects where physicians locate their practices.

    Science.gov (United States)

    Polsky, D; Escarce, J J

    2000-11-01

    Managed care has had a profound effect on physician practice. It has altered patterns in the use of physician services, and consequently, the practice and employment options available to physicians. But managed care growth has not been uniform across the United States, and has spawned wide geographic disparities in earning opportunities for generalists and specialists. This Issue Brief summarizes new information on how managed care has affected physicians' labor market decisions and the impact of managed care on the number and distribution of physicians across the country.

  10. Palliative care case management in primary care settings: A nationwide survey

    NARCIS (Netherlands)

    Plas, A.G. van der; Deliens, L.; Watering, M. van de; Jansen, W.J.; Vissers, K.C.P.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    BACKGROUND: In case management an individual or small team is responsible for navigating the patient through complex care. Characteristics of case management within and throughout different target groups and settings vary widely. Case management is relatively new in palliative care. Insight into the

  11. Risk factors for intensive care delirium: A systematic review.

    NARCIS (Netherlands)

    Rompaey, B. van; Schuurmans, M.J.; Shortridge-Baggett, L.M.; Truijen, S.; Bossaert, L.

    2007-01-01

    Delirium has been a recognised syndrome in the intensive care unit for some years. This systematic review reports risk factors for delirium studied in the intensive care unit. Four predisposing and 21 precipitating factors, including nine laboratory blood values and seven items relating to the use o

  12. Analysis and evaluation of enterprise risk management capability elements

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Research on enterprise risk management capability is conducted with a view of discerning and processing risks, in which an evaluation index system and an evaluation model of enterprise risk management capabilities are constructed. The risk management capability consists of four aspects, i.e. risk identification capability, risk assessment capability, risk planning capability and risk control capability. Risk identification and assessment capabilities reflect the level of enterprises on finding and analyzing...

  13. Security Risk Management - Approaches and Methodology

    Directory of Open Access Journals (Sweden)

    Elena Ramona STROIE

    2011-01-01

    Full Text Available In today’s economic context, organizations are looking for ways to improve their business, to keep head of the competition and grow revenue. To stay competitive and consolidate their position on the market, the companies must use all the information they have and process their information for better support of their missions. For this reason managers have to take into consideration risks that can affect the organization and they have to minimize their impact on the organization. Risk management helps managers to better control the business practices and improve the business process.

  14. Probability distributions in risk management operations

    CERN Document Server

    Artikis, Constantinos

    2015-01-01

    This book is about the formulations, theoretical investigations, and practical applications of new stochastic models for fundamental concepts and operations of the discipline of risk management. It also examines how these models can be useful in the descriptions, measurements, evaluations, and treatments of risks threatening various modern organizations. Moreover, the book makes clear that such stochastic models constitute very strong analytical tools which substantially facilitate strategic thinking and strategic decision making in many significant areas of risk management. In particular the incorporation of fundamental probabilistic concepts such as the sum, minimum, and maximum of a random number of continuous, positive, independent, and identically distributed random variables in the mathematical structure of stochastic models significantly supports the suitability of these models in the developments, investigations, selections, and implementations of proactive and reactive risk management operations. The...

  15. Operational risk management for a NPP

    Energy Technology Data Exchange (ETDEWEB)

    Scott, C.K., E-mail: KScott@AtlanticNuclear.ca [Atlantic Nuclear Services Inc., Fredericton, New Brunswick (Canada)

    2013-07-01

    Organizational failures are a hazard to the successful operation of a nuclear power plant. Risk reduction strategies have been developed around two themes: using an understanding of the nature and mechanism of human failures to eliminate them by modifying work processes; or, modifying human behaviour by creating a strong safety culture that overrides the tendency to fail. This paper examines the problem from the perspective of operational risk management. It includes the internal management of operations and the influence of the external environment on the organization. A model is proposed that encompasses all the operational risk factors in the organization's decision making process. To prevent failure the organization must have the capability to adapt and the capacity to evolve. The hazards that would lead to an organizational failure are developed from this evolutionary model. The operational risk management program would include these hazards as well as the conventional nuclear safety hazards. (author)

  16. Risk Management in the Clinical Laboratory

    Science.gov (United States)

    Njoroge, Sarah W

    2014-01-01

    Clinical laboratory tests play an integral role in medical decision-making and as such must be reliable and accurate. Unfortunately, no laboratory tests or devices are foolproof and errors can occur at pre-analytical, analytical and post-analytical phases of testing. Evaluating possible conditions that could lead to errors and outlining the necessary steps to detect and prevent errors before they cause patient harm is therefore an important part of laboratory testing. This can be achieved through the practice of risk management. EP23-A is a new guideline from the CLSI that introduces risk management principles to the clinical laboratory. This guideline borrows concepts from the manufacturing industry and encourages laboratories to develop risk management plans that address the specific risks inherent to each lab. Once the risks have been identified, the laboratory must implement control processes and continuously monitor and modify them to make certain that risk is maintained at a clinically acceptable level. This review summarizes the principles of risk management in the clinical laboratory and describes various quality control activities employed by the laboratory to achieve the goal of reporting valid, accurate and reliable test results. PMID:24982831

  17. NETWORKS OF HEALTH CARE: A CHALLENGE TO SUS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Camila Dubow

    2013-09-01

    Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

  18. Does managed care make a difference? Physicians' length of stay decisions under managed and non-managed care

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2004-02-01

    Full Text Available Abstract Background In this study we examined the influence of type of insurance and the influence of managed care in particular, on the length of stay decisions physicians make and on variation in medical practice. Methods We studied lengths of stay for comparable patients who are insured under managed or non-managed care plans. Seven Diagnosis Related Groups were chosen, two medical (COPD and CHF, one surgical (hip replacement and four obstetrical (hysterectomy with and without complications and Cesarean section with and without complications. The 1999, 2000 and 2001 – data from hospitals in New York State were used and analyzed with multilevel analysis. Results Average length of stay does not differ between managed and non-managed care patients. Less variation was found for managed care patients. In both groups, the variation was smaller for DRGs that are easy to standardize than for other DRGs. Conclusion Type of insurance does not affect length of stay. An explanation might be that hospitals have a general policy concerning length of stay, independent of the type of insurance of the patient.

  19. Care management actions in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Marcelo Costa Fernandes

    2015-11-01

    Full Text Available Objective: to identify, from nurses’ speeches, the actions that enable care management in the Family Health Strategy.Methods: descriptive study with a qualitative approach conducted with 32 nurses of primary care. It was used a semistructuredinterview as the data collection technique. The methodological process of the collective subject discourse wasused to organize the data Results: from the nurses’ speeches one identified the categories: complementary relationshipbetween care and management; meeting with community health agents, a care management strategy in nurses’ work;health education activities such as a care management action and a health information system as an essential tool forcare Conclusion: it was possible to observe that nurses understood the importance of coordination and complementaritybetween the activities of the working process of care and management.

  20. Pharmacist credentialing in pain management and palliative care.

    Science.gov (United States)

    Juba, Katherine M

    2012-10-01

    A credential is documented evidence of a pharmacist's qualifications; while credentialing is the method used to acquire, confirm, determine, and document a pharmacist's qualifications to practice. Voluntary credentials are important in clinical pharmacy specialties to ensure proficiency in caring for patients with complex pharmacotherapy needs. This article discusses current and future pharmacy pain management and palliative care credentialing opportunities. Pharmacists wishing to pursue voluntary pain management and palliative care credentialing may elect to take a multidisciplinary pain credentialing exam offered by the American Society of Pain Educators (ASPE) or American Academy of Pain Management (AAPM) and/or complete an American Society of Health System Pharmacists (ASHP) Postgraduate Year 2 (PGY2) pain management and palliative care pharmacy residency. A palliative care credentialing exam is not currently available to pharmacists. Efforts are underway within the pharmacy profession to standardize the board certification process, design a pain and palliative certificate program, and create a specialty pain management and palliative care board certification examination.

  1. The management of liquidity risk

    OpenAIRE

    Claudia MITITELU; Stefan MITITELU

    2009-01-01

    The importance of ensuring liquidity exceeds the level of a single banking institution, since recording of the deficit of liquidity only at the level of a single bank may have nevagtive repercurssions on the whole banking system, and entire national economy. Liquidity represents one the permanent concerns in banking management.

  2. The Architecture of Financial Risk Management Systems

    Directory of Open Access Journals (Sweden)

    Iosif ZIMAN

    2013-01-01

    Full Text Available The architecture of systems dedicated to risk management is probably one of the more complex tasks to tackle in the world of finance. Financial risk has been at the center of attention since the explosive growth of financial markets and even more so after the 2008 financial crisis. At multiple levels, financial companies, financial regulatory bodies, governments and cross-national regulatory bodies, all have put the subject of financial risk in particular and the way it is calculated, managed, reported and monitored under intense scrutiny. As a result the technology underpinnings which support the implementation of financial risk systems has evolved considerably and has become one of the most complex areas involving systems and technology in the context of the financial industry. We present the main paradigms, require-ments and design considerations when undertaking the implementation of risk system and give examples of user requirements, sample product coverage and performance parameters.

  3. Managing IT-related operational risks

    Directory of Open Access Journals (Sweden)

    Savić Ana

    2008-01-01

    Full Text Available Not so long ago, information technology (IT risk occupied a small corner of operational risk - the opportunity loss from a missed IT development deadline. Today, the success of an entire financial institution may lay on managing a broad landscape of IT risks. IT risk is a potential damage to an organization's value, resulting from inadequate managing of processes and technologies. IT risk includes the failure to respond to security and privacy requirements, as well as many other issues such as: human error, internal fraud through software manipulation, external fraud by intruders, obsolesce in applications and machines, reliability issues or mismanagement. The World Economic Forum provides best information about this problem. They rank a breakdown of critical information infrastructure among the most likely core global risks, with 10-20 % likelihood over the next 10 years and potential worldwide impact of $250 billion. Sustained investment in IT - almost $1.2 trillion or 29% of 2006 private-sector capital investment in the U.S. alone fuels growing exposure to IT risk. Greg Hughes, chief strategy officer in Symantec Corp. recently claimed "IT risk management is more than using technology to solve security problems. With proper planning and broad support, it can give an organization the confidence to innovate, using IT to outdistance competitors".

  4. Banking Risk Management in the Light of Basel II

    Directory of Open Access Journals (Sweden)

    Vasile DEDU

    2010-02-01

    Full Text Available This study presents a summary of what is the meaning of risk management in light of the Basel II Agreement. The study is structured in three parts, namely: credit risk management, significant credit risk management and credit risk management under Basel II Agreement. Thus, in the first part it refers to how developed the credit risk management over time and which are current phenomena that generate these risks, continuing in the second part with a summary of the reasons for which one wishes management of such credit risks, following the third party to talk about the shippings of Basel II in terms of credit risk management.

  5. Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.

    Science.gov (United States)

    Taylor, Erin Fries; Machta, Rachel M; Meyers, David S; Genevro, Janice; Peikes, Deborah N

    2013-01-01

    Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care.

  6. Risk management - unappreciated instrument of supply chain management strategy

    Directory of Open Access Journals (Sweden)

    Wojciech Machowiak

    2012-12-01

    Full Text Available Background: Unlike Enterprise Risk Management, which is certainly quite well rooted in business practice, Supply Chain Risk Management (SCRM still continues to be dynamically developing subject of academic research, whereas its practical applications are rather scarce. Material and methods: On the basis of broad review of the current state of the art in world literature, significant  relevancies to the core processes and enterprise strategy are discussed.   Results: The paper shows some interesting from the enterprise's performance and competitiveness point of view additional benefits, potentially resulting from the proactive, consistent and effective implementation of the SCRM system. Conclusions: Some additional advantages from proactive supply chain risk management account for perceiving SCRM as multifunctional instrument of strategic SC management, exceeding established understanding RM as security and threat-prevention  tool only. Positive influence from SCRM onto SC performance and competitiveness can make reasonable to enhance its position within SCM strategy.

  7. Federal Nursing Service Award. Impact of TriCare/managed care on total force readiness.

    Science.gov (United States)

    Ray, M A; Turkel, M C

    2001-04-01

    Mission readiness is dependent on a healthy total force and the response of military medical and nursing services. Managed care has become the norm in U.S. health care, including the Department of Defense Military Health System. Cost management, health maintenance organizations, and other health plans are defined as "managed care," an aggressive cost-control effort by health care purchasers and insurers to limit health care spending and services and advance a market-oriented, profit-driven system. The impact of managed care on mission readiness and retention of active and reserve personnel is and will continue to be profound. The purpose of this research was to conduct a qualitative, phenomenological study (life experiences) of TriCare/managed care to explore the impact and the meaning of the experience on total force mission readiness of the U.S. Air Force and how managed care has changed nursing practice. The results reveal the significance of the impact of TriCare/managed care on total force readiness by identifying, through themes, meta-themes, and a representative model, the negative effect that economics is having on active duty and reserve force health and well-being.

  8. Managing risks in business model innovation processes

    DEFF Research Database (Denmark)

    Taran, Yariv; Boer, Harry; Lindgren, Peter

    2010-01-01

    ) innovation is a risky enterprise, many companies are still choosing not to apply any risk management in the BM innovation process. The objective of this paper is to develop a better understanding of how risks are handled in the practice of BM innovation. An analysis of the BM innovation experiences of two...... industrial companies shows that both companies are experiencing high levels of uncertainty and complexity during their innovation processes and are, consequently, struggling to find new processes for handling the risks involved. Based on the two companies’ experiences, various testable propositions are put...... forward, which link success and failure to the way companies appreciate and handle the risks involved in BM innovation....

  9. Critical pathways for the management of preeclampsia and severe preeclampsia in institutionalised health care settings

    Directory of Open Access Journals (Sweden)

    Daftari Ashi

    2003-10-01

    Full Text Available Abstract Background Preeclampsia is a complex disease in which several providers should interact continuously and in a coordinated manner to provide proper health care. However, standardizing criteria to treat patients with preeclampsia is problematical and severe flaws have been observed in the management of the disease. This paper describes a set of critical pathways (CPs designed to provide uniform criteria for clinical decision-making at different levels of care of pregnant patients with preeclampsia or severe preeclampsia. Methods Clinicians and researchers from different countries participated in the construction of the CPs. The CPs were developed using the following steps: a Definition of the conceptual framework; b Identification of potential users: primary care physicians and maternal and child health nurses in ambulatory settings; ob/gyn and intensive care physicians in secondary and tertiary care levels. c Structural development. Results The CPs address the following care processes: 1. Screening for preeclampsia, risk assessment and classification according to the level of risk. 2. Management of preeclampsia at primary care clinics. 3. Evaluation and management of preeclampsia at secondary and tertiary care hospitals: 4. Criteria for clinical decision-making between conservative management and expedited delivery of patients with severe preeclampsia. Conclusion Since preeclampsia continues to be one of the primary causes of maternal deaths and morbidity worldwide, the expected impact of these CPs is the contribution to improving health care quality in both developed and developing countries. The CPs are designed to be applied in a complex health care system, where different physicians and health providers at different levels of care should interact continuously and in a coordinated manner to provide care to all preeclamptic women. Although the CPs were developed using evidence-based criteria, they could require careful evaluation and

  10. Pain management improves care and revenue: an interview with ProCare Systems.

    Science.gov (United States)

    Davis, F N; Walsh, C

    2000-01-01

    As provider and managed care organizations continue to look for better ways to control costs and improve patient outcomes, disease management programs are getting an increasing share of their attention. One often-over-looked area with significant potential to improve outcomes, reduce costs, and enhance revenues is pain management. It has been estimated that at least 40 percent of senior citizens suffer from chronic pain, and as the population ages, the number of chronic pain sufferers will only increase. Pain management companies have been forming to meet the current and future demand for comprehensive pain management programs. One such company is ProCare Systems, a single-specialty physician practice management company based in Grand Rapids, Michigan. HFM spoke with Fred N. Davis, MD, president and cofounder of ProCare Systems, and Cyndy Walsh, ProCare System's CEO, about pain management programs and the patient care and financial impact they can effect.

  11. Iatrogenic disease management: moderating medication errors and risks in a pharmacy benefit management environment.

    Science.gov (United States)

    Nair, Vinit; Salmon, J Warren; Kaul, Alan F

    2007-12-01

    Disease Management (DM) programs have advanced to address costly chronic disease patterns in populations. This is in part due to the programs' significant clinical and economical value, coupled with interest by pharmaceutical manufacturers, managed care organizations, and pharmacy benefit management firms. While cost containment realizations for many such interventions have been less than anticipated, this article explores potentials in marrying Medication Error Risk Reduction into DM programs within managed care environments. Medication errors are an emergent serious problem now gaining attention in US health policy. They represent a failure within population-based health programs because they remain significant cost drivers. Therefore, medication errors should be addressed in an organized fashion, with DM being a worthy candidate for piggybacking such programs to achieve the best synergistic effects.

  12. Front office staff as medical educators, risk creators, and risk managers.

    Science.gov (United States)

    Kapp, Marshall B

    2016-03-16

    The author describes his own negative series of encounters with the front office staff of a large specialty medical practice during a recent lengthy episode of significant medical distress. The author suggests several reasons, including legal risk management, that medical students should be exposed as part of their education to the interactions of patients with front office staffs (not just physicians) to get a fuller picture of patients' actual experiences with the health care system.

  13. International and Russian practice of banking risk-management. Mortgage risks

    Directory of Open Access Journals (Sweden)

    A. V. Nikolaeva

    2016-01-01

    . The article considers the statistics of the mortgage market of recent years and analyzes the new requirements to the banks, involved in mortgage landing. The work offers some new advanced approaches for risk management of mortgage lending in the Russian banking sector, that improve the reliability of banking operations and increase trust between contractors.Conclusion: In 2016 the Basel Committee concluded that risk management in Russia meets international standards, and some standards imposed in our country are even stricter than required in the last international agreement.  However, the accelerated implementation of the new standard in Russia is rather risky. By implementing "Basel 3" in the context of high capital requirements, the Central Bank believes that standards will be acceptable only to the large banks, and for others these requirements will lead to losses. This advanced approaches to risk management also require more careful monitoring. So on the one hand, these banks will be better protected from stock market risks and it will lead to formation of highreliable banking system. But the question is: how this system will develop in the conditions of lack of competition?

  14. Primary care practice-based care management for chronically ill patients (PraCMan: study protocol for a cluster randomized controlled trial [ISRCTN56104508

    Directory of Open Access Journals (Sweden)

    Baldauf Annika

    2011-06-01

    Full Text Available Abstract Background Care management programmes are an effective approach to care for high risk patients with complex care needs resulting from multiple co-occurring medical and non-medical conditions. These patients are likely to be hospitalized for a potentially "avoidable" cause. Nurse-led care management programmes for high risk elderly patients showed promising results. Care management programmes based on health care assistants (HCAs targeting adult patients with a high risk of hospitalisation may be an innovative approach to deliver cost-efficient intensified care to patients most in need. Methods/Design PraCMan is a cluster randomized controlled trial with primary care practices as unit of randomisation. The study evaluates a complex primary care practice-based care management of patients at high risk for future hospitalizations. Eligible patients either suffer from type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure or any combination. Patients with a high likelihood of hospitalization within the following 12 months (based on insurance data will be included in the trial. During 12 months of intervention patients of the care management group receive comprehensive assessment of medical and non-medical needs and resources as well as regular structured monitoring of symptoms. Assessment and monitoring will be performed by trained HCAs from the participating practices. Additionally, patients will receive written information, symptom diaries, action plans and a medication plan to improve self-management capabilities. This intervention is addition to usual care. Patients from the control group receive usual care. Primary outcome is the number of all-cause hospitalizations at 12 months follow-up, assessed by insurance claims data. Secondary outcomes are health-related quality of life (SF12, EQ5D, quality of chronic illness care (PACIC, health care utilisation and costs, medication adherence (MARS, depression

  15. Risk management methodology for RBMN project

    Energy Technology Data Exchange (ETDEWEB)

    Borssatto, Maria F.B.; Tello, Cledola C.O.; Uemura, George, E-mail: fborssatto@gmail.com, E-mail: tellocc@cdtn.br, E-mail: george@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    RBMN Project has been developed to design, construct and commission a national repository to dispose the low- and intermediate-level radioactive wastes from the operation of nuclear power plants and other industries that use radioactive sources and materials. Risk is a characteristic of all projects. The risks arise from uncertainties due to assumptions associated with the project and the environment in which it is executed. Risk management is the method by which these uncertainties are systematically monitored to ensure that the objectives of the project will be achieved. Considering the peculiarities of the Project, that is, comprehensive scope, multidisciplinary team, apparently polemic due to the unknowing of the subject by the stake holders, especially the community, it is being developed a specific methodology for risk management of this Project. This methodology will be critical for future generations who will be responsible for the final stages of the repository. It will provide greater guarantee to the processes already implemented and will maintain a specific list of risks and solutions for this Project, ensuring safety and security of the repository throughout its life cycle that is the planned to last at least three hundred years. This paper presents the tools and processes already defined, management actions aimed at developing a culture of proactive risk in order to minimize threats to this Project and promote actions that bring opportunities to its success. The methodology is based on solid research on the subject, considering methodologies already established and globally recognized as best practices for project management. (author)

  16. Issues and challenges in flood risk management: Editorial for the special issue on flood risk management

    NARCIS (Netherlands)

    Jonkman, S.N.; Dawson, R.J.

    2012-01-01

    Recent flood-related disasters (Japan, Thailand, US, Australia) emphasize the need for an effective management of flood risks. As an introduction to this special issue, this editorial summarizes some of the key challenges in the field. Flood risk management needs to recognize the interconnections be

  17. Basic HR Risk Management Principles in Digital Libraries

    OpenAIRE

    Mirembe, Florence

    2009-01-01

    Human beings are responsible for causing risk as well as mitigating risk. This paper focuses on the human resources management risk remedies for digital libraries. Risk management aims at identifying, assessing and resolving risk items before they become disasters to an organization or digital library. Effective risk management plans should include short-term and long-term risks to project schedules, costs, and the functionality, adequacy and quality of project deliverables. Risks can bec...

  18. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  19. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  20. 205_WS: Improving the Delivery of Primary Care Through Risk Stratification

    DEFF Research Database (Denmark)

    Kinder, Karen; Kristensen, Troels; Abrams, Chad

    Objectives The aim of this workshop is to provide an insight into how information gained through applications of risk stratification in the primary health care sector, from integrated care networks to primary care clinics and finally at the individual clinician level can improve the delivery....... – Pharmaceutical Management. Method Each session will be comprised of presentations illustrating real world case-mix applications. The workshop would conclude with a plenary session which would summarize the take home messages of the three sessions. Other considerations The participants will experience first...

  1. Perceptions of food risk management among key stakeholders

    DEFF Research Database (Denmark)

    van Kleef, Ellen; Frewer, Lynn J.; Chryssochoidis, George M.;

    2006-01-01

    In designing and implementing appropriate food risk management strategies, it is important to examine how key stakeholders perceive both the practice and effectiveness of food risk management.......In designing and implementing appropriate food risk management strategies, it is important to examine how key stakeholders perceive both the practice and effectiveness of food risk management....

  2. A REVIEW OF ENTERPRISE SUPPLY CHAIN RISK MANAGEMENT

    Institute of Scientific and Technical Information of China (English)

    Dailun SHI

    2004-01-01

    This paper reviews enterprise risk management practices in the context of supply chains. Starting with the importance of managing supply chain risks, the paper established the benefits of managing risks using an enterprise-wise integrated approach. The rest of the paper then presents a practical framework for enterprises to manage risks in their extended supply chains.

  3. Radon risk management. Construction solutions

    Directory of Open Access Journals (Sweden)

    Borja Frutos Vázquez

    2011-12-01

    Full Text Available Radon gas is a radioactive element that appears in nature by the decay of radium found in terrestrial soils. This gas is able to travel between the pores of the ground and enter into the buildings where the concentration can increase and becoming a health risk to occupants from inhaling. The World Health Organization rate the radon gas as a level 1 carcinogen agent. According to this organization, radon is the second leading cause of lung cancer contraction after tobacco. Based on the perception of risk derived from epidemiological medical studies, some countries have established radon concentration values as safety limits, above which is recommended or required an architectural intervention to reduce levels. From an architectural perspective, there have been studies of several radon protection techniques to reduce radon immission in buildings or to evacuate it, in order to reduce the radon levels below the safety limits. This article develops some protection strategies that have been being used for these purposes, some of which have been tested in Spain thanks to a research project funded by the Nuclear Safety Council, and developed by the Eduardo Torroja Institute and the University of Cantabria.

  4. Measuring the savings from managed care: experience at Citibank.

    Science.gov (United States)

    Reiff, M G; Sperling, K L

    1995-01-01

    In a leap of faith, Citibank in 1989 designed a point-of-service plan aimed at containing health care costs in the long term without sacrificing quality of care. In 1994 a study was undertaken to empirically evaluate whether these goals had been achieved. The study supported Citibank's overall managed care strategy, providing objective, quantifiable data that can lead to greater efficiencies.

  5. Ethical Issues in Managed Care: Perspectives in Evolution.

    Science.gov (United States)

    Belar, Cynthia D.

    2000-01-01

    Presents a reaction to Cooper and Gottlieb's (this issue) article titled, "Ethical Issues with Managed Care: Challenges Facing Counseling Psychology." Challenges that many issues addressed by Cooper and Gottlieb have been longstanding in the profession. Argues against the belief that the managed care environment is fraught with more ethical…

  6. Primary care referral management: a marketing strategy for hospitals.

    Science.gov (United States)

    Bender, A D; Geoghegan, S S; Lundquist, S H; Cantone, J M; Krasnick, C J

    1990-06-01

    With increasing competition among hospitals, primary care referral development and management programs offer an opportunity for hospitals to increase their admissions. Such programs require careful development, the commitment of the hospital staff to the strategy, an integration of hospital activities, and an understanding of medical practice management.

  7. Psychotropic Medication Management in a Residential Group Care Program

    Science.gov (United States)

    Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

    2010-01-01

    This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

  8. COPD self-management supportive care: chaos and complexity theory.

    Science.gov (United States)

    Cornforth, Amber

    This paper uses the emergent theories of chaos and complexity to explore the self-management supportive care of chronic obstructive pulmonary disease (COPD) patients within the evolving primary care setting. It discusses the concept of self-management support, the complexity of the primary care context and consultations, smoking cessation, and the impact of acute exacerbations and action planning. The author hopes that this paper will enable the acquisition of new insight and better understanding in this clinical area, as well as support meaningful learning and facilitate more thoughtful, effective and high quality patient-centred care within the context of primary care.

  9. Enterprise risk management in international construction operations

    CERN Document Server

    Zhao, Xianbo; Low, Sui Pheng

    2015-01-01

    This book provides readers an understanding of the implementation of Enterprise Risk Management (ERM) for international construction operations. In an extended case study, it primarily focuses on Chinese construction firms (CCFs) based in Singapore. In this regard, the book explains the differences and similarities between Risk Management (RM), Project Risk Management (PRM) and ERM in the construction industry, and examines their linkages for international construction operations in a broader context. The explanation elaborates on how companies may adopt and implement RM, PRM and ERM as appropriate in their various operations, both in their home market as well as in overseas host markets. The book also reviews the whole spectrum of work relating to organizational behavior (OB) as one of the key underpinnings for companies to evaluate and implement ERM. It will benefit practitioners from the industry as well as academics interested in the implementation of ERM practices in international construction operat...

  10. Injury risk management plan for volleyball athletes.

    Science.gov (United States)

    James, Lachlan P; Kelly, Vincent G; Beckman, Emma M

    2014-09-01

    Volleyball is an increasingly popular team sport. As with any competitive sport, there is an inherent risk of injury that must be recognized and collaboratively managed. This article provides a practical approach to the management of volleyball injuries within a team or organization. A brief review of the epidemiological data is presented which establishes (i) ankle sprain, (ii) shoulder overuse injury, (iii) patella tendinopathy, and (iv) anterior cruciate ligament injury as the primary injuries to address amongst these athletes. The interaction of modifiable and non-modifiable risk factors for these injuries are used to classify athletes into high-, medium- and low-risk groups. Targeted training interventions are suggested, based upon the risk level of the athlete, to minimize the occurrence of these injuries. Practical methods for integrating these activities into a training plan are also discussed.

  11. Challenges for Managed Care from 340B Contract Pharmacies.

    Science.gov (United States)

    Fein, Adam J

    2016-03-01

    The federal 340B Drug Pricing Program has expanded rapidly, with important yet still unmeasured impact on both managed care practice and policies. Notably, providers increasingly rely on external, contract pharmacies to extend 340B pricing to a broad set of patients. In 2014, 1 in 4 U.S. retail, mail, and specialty pharmacy locations acted as contract pharmacies for 340B-covered entities. This commentary discusses crucial ways in which 340B growth is affecting managed care pharmacy through formulary rebates, profits from managed care paid prescriptions, disruption of retail pharmacy networks, and reduced generic dispensing rates. Managed care should become more engaged in the discussion on how the 340B program should evolve and offer policy proposals to mitigate the challenges being encountered. There is also an urgent need for objective, transparent research on the 340B program's costs, benefits, and implications for managed care pharmacy and practice.

  12. Price elasticity and pharmaceutical selection: the influence of managed care.

    Science.gov (United States)

    Domino, Marisa Elena; Salkever, David S

    2003-07-01

    State Medicaid programs are turning increasingly to managed care to control expenditures, although the types of managed care programs in use have changed dramatically. Little is known about the influence of the shifting Medicaid managed care arena on treatment decisions. This paper investigates factors affecting the selection of treatments for depression by providers participating in either of two Medicaid managed care programs. Of particular interest is the influence of medication price on the choice of treatment, since one vehicle through which managed care organizations can reduce total expenditures is by increasing the price sensitivity of participating providers. We take a new approach by phrasing the problem as a discrete choice, using a nested multinomial logit model for the analyses. Contrary to earlier literature, we find some evidence that physicians in both programs do take price into consideration when selecting among treatment options. HMO providers in particular demonstrate increased price sensitivity in the two most commonly prescribed categories of antidepressants.

  13. Managing conscientious objection in health care institutions.

    Science.gov (United States)

    Wicclair, Mark R

    2014-09-01

    It is argued that the primary aim of institutional management is to protect the moral integrity of health professionals without significantly compromising other important values and interests. Institutional policies are recommended as a means to promote fair, consistent, and transparent management of conscience-based refusals. It is further recommended that those policies include the following four requirements: (1) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient's/surrogate's timely access to information, counseling, and referral. (2) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient's timely access to health care services offered within the institution. (3) Conscience-based refusals will be accommodated only if the accommodation will not impose excessive burdens on colleagues, supervisors, department heads, other administrators, or the institution. (4) Whenever feasible, health professionals should provide advance notification to department heads or supervisors. Formal review may not be required in all cases, but when it is appropriate, several recommendations are offered about standards and the review process. A key recommendation is that when reviewing an objector's reasons, contrary to what some have proposed, it is not appropriate to adopt an adversarial approach modelled on military review boards' assessments of requests for conscientious objector status. According to the approach recommended, the primary function of reviews of objectors' reasons is to engage them in a process of reflecting on the nature and depth of their objections, with the objective of facilitating moral clarity on the part of objectors rather than enabling department heads, supervisors, or ethics committees to determine whether conscientious objections are sufficiently genuine.

  14. Efficient Management of the Entrepreneurial Risk by Implementing Risk Management ISO 31000:2009

    Directory of Open Access Journals (Sweden)

    Irina Todos

    2015-08-01

    Full Text Available The contemporary economy is characterized by a high level of entrepreneurial risk. The risk is that the entrepreneur's tool offers various opportunities for development and the lack of a risk management system leads to business failure. Therefore, this can be avoided by implementing a standard-ISO 31000: 2009.

  15. 75 FR 30106 - Terrorism Risk Insurance Program; Litigation Management Submissions

    Science.gov (United States)

    2010-05-28

    ... Terrorism Risk Insurance Program; Litigation Management Submissions AGENCY: Departmental Offices. ACTION..., the Terrorism Risk Insurance Program Office is seeking comments regarding Litigation Management..., preferably an original and two copies) to: Terrorism Risk Insurance Program, Public Comment Record,...

  16. Stakeholder Risk Management in Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    evidence from hybrid organizations as Publicly Owned Enterprises (POEs) mixed of private corporations and political administration. The model offers a new way of combining risk management with ethical decisionmaking processes by the inclusion of multiple stakeholders. Not only does the model apply...... to these kinds of hybrid organizations, but it is easily adopted and tested for other private business models too. The findings and the conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk......Stakeholder management has for the last three decades been concerned either with strategic business management or business ethics, values and quality. Many models have been developed, but recently the literature asks for more dynamic models instead of the staticism that characterizes some models...

  17. Management of Financial and Banking Risk

    OpenAIRE

    Ion Gr. Ionescu

    2013-01-01

    It is certainly clear that a powerful banking strategy should include both software and bank risk management procedures that aim, in fact, minimize the likelihood of these risks and potential exposure of the bank. The main objective of these policies is to minimize losses or additional expenses incurred by the bank and central banking goal is to achieve a higher profit for shareholders. But not always these two objectives - the general and sector - are consistent. It may, in some cases, the c...

  18. Managing information risk a director's guide

    CERN Document Server

    Mitchell, Stewart

    2009-01-01

    This pocket guide addresses the scope of risks involved in a modern IT system, and outlines strategies for working through the process of putting risk management at the heart of your corporate culture. Given that no two companies are the same, this pocket guide should not be taken as a step-by-step guide, but should provide decision makers with a solid overview of the factors they need to consider and a framework for implementing a regime that suits their needs.

  19. Managing industrial price risk: a balancing act

    Energy Technology Data Exchange (ETDEWEB)

    Muse, J-F. [Cargill Energy (United States)

    2000-07-01

    The challenge of managing industrial price risk is assessed by a senior executive of Cargill, a diversified industrial conglomerate, involved in steel manufacturing and recycling, oilseeds, cocoa, beef, pork, and poultry processing, fertilizer and fruit juice production, in addition to trading and financial risk management. Energy is a key component in many of Cargill's businesses, hence the company has good reason to be concerned about price volatility. The effects of energy risk management on the company's shareholders are demonstrated by an analysis of month-to-month price fluctuations over the Nov 1999 to Oct 2000 period, showing the monthly value of risk at the 95 per cent confidence level as $4,832,195. The effects of alternatives for an end-user such as passing on cost to customers, improving energy efficiency. fuel switching and production curtailment, are explored and limitations and problems with each of the approaches are discussed. The best options for industrial end-users of natural gas are suggested to be a proactive risk management program in the short-term and asset diversification, fuel switching, and geographic relocation of production facilities in the long-term.

  20. Stop IT Project Failures Through Risk Management

    CERN Document Server

    Remenyi, D

    1999-01-01

    This book is about information systems development failures and how to avoid them. .It considers what goes wrong with information systems development projects and what actions may be taken to avoid potential difficulties.The reduction of the impact,or even the elimination of the problems,is discussed in terms of an information systems risk management programme. Stop I.T.Project failure helps to ensure that IS project managers are successful in helping to deliver application systems. However, IS development risk can never be entirely eliminated and consequently the practitioner needs to bear in

  1. LIQUIDITY MANAGEMENT AND CORPORATE RISK

    Directory of Open Access Journals (Sweden)

    Fenyves Veronika

    2011-07-01

    Full Text Available The consequence of the economic crisis, the access of the external financing resources was narrowed significantly and lenders had became more cautious. This meant that the external source providers analyze more thoroughly the source claimants, and they also need to be more aware of their situation, to submit well founded loan applications to financial institutions. The other aspect is why the indicators presented in the study, the firms should be addressed much more thoroughly than ever before to have a much better understanding their situation, to recognize the sources of internal funding opportunities, and to use more efficiently the available internal resources. However, analysts should be aware of which are the ratios which should be paid a special attention and which ones are essential to assess a given situation, knowing them they can properly inform the leaders as well as to give an appropriate help to the decision makers. To ensure the appropriate level of internal resources the company's activity is continuous financing closely related to the working capital management. The other reason is why the working capital management coming into view - which is linked to the previous one - that longer and longer payment periods have emerged in the corporate sales, in point of fact there is a significant increase in commercial lending period, the companies must be able to finance this period. The working capital is essential for companies to determine their short-term financial positions. A significant change in working capital provides an important information to the company's various stakeholders, and this is especially true for the net working capital. The working capital analysis is one way the company's creditability evaluation, and helps also to better understand the company's normal business cycle.

  2. Risk Management in IT Governance Framework

    Directory of Open Access Journals (Sweden)

    Mirela GHEORGHE

    2011-12-01

    Full Text Available The concept of governance has an already old contour: the system by which business corporations are directed and controlled. The most praised principles regarding shareholder rights, transparency and board accountability now constitute the foundation for new tendencies evolved from such ground. Executive compensation, transparency and shareholder reporting are new issues attached to board responsibilities. Besides such almost negative approaches the board faces a more and more prominent role from risk management and IT governance perspective. Nowadays is generally acknowledged that the board is in charge for managing and controlling the risks to assets of the enterprises and business future. IT Governance has emerged as a support for corporate governance, as an important part of board’s striving efforts to perform better in a competition environment. These responsibilities, risk management and IT Governance, remain within the framework of old concept of corporate governance and are fed from its substance. The interaction between these concepts is the core interest of this research.IT Governance is defined as procedures and policies established in order to assure that the IT system of an organization sustains its goals and strategies. The management of the organisations face a new challenge: structural redefinition of the IT component in order to create plus value and to minimize IT risks through an efficient management of all IT resources of the organisation. The evolution of the present IT environment is a natural process according to which business environment should adapt.

  3. Understanding cardiovascular risk in hemophilia: A step towards prevention and management.

    Science.gov (United States)

    Sousos, Nikolaos; Gavriilaki, Eleni; Vakalopoulou, Sofia; Garipidou, Vasileia

    2016-04-01

    Advances in hemophilia care have led to increased life expectancy and new challenges in the management of the aging hemophilia population, including cardiovascular risk. Despite the deep knowledge into cardiovascular disease in terms of pathophysiology, risk prediction, prevention, early detection and management gained over the last decades, studies in hemophiliacs are scarce and mainly descriptive. As a growing amount of evidence points towards a similar or increased prevalence of traditional cardiovascular risk factors in hemophilia compared to the general population, the role of non-traditional, disease-related and treatment-related cardiovascular risk factors remains under investigation. Better understanding of cardiovascular risk in hemophilia is mandatory for proper cardiovascular risk prevention and management. Therefore, this review aims to summarize current knowledge on cardiovascular risk in hemophilia patients focusing on a) cardiovascular risk factors (traditional, non-traditional, disease-related and treatment-related), b) cardiovascular morbidity and mortality and c) cardiovascular prevention and management.

  4. Coastal Risk Management in a Changing Climate

    DEFF Research Database (Denmark)

    Existing coastal management and defense approaches are not well suited to meet the challenges of climate change and related uncertanities. Professionals in this field need a more dynamic, systematic and multidisciplinary approach. Written by an international group of experts, "Coastal Risk...... Management in a Changing Climate" provides innovative, multidisciplinary best practices for mitigating the effects of climate change on coastal structures. Based on the Theseus program, the book includes eight study sites across Europe, with specific attention to the most vulnerable coastal environments...

  5. Does Corporate Governance Impact Risk Management System?

    Directory of Open Access Journals (Sweden)

    Petre BREZEANU

    2011-04-01

    Full Text Available This paper brings forth the contribution of corporate governance to risk management system at the enterprise level. The research is a complex one, integrating both quantitative and qualitative information. The quantitative information consists of balance sheet and profit and loss account data while the qualitative one includes dummy variables reflecting the agency and monitoring costs which govern the relationship between managers and shareholders.

  6. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...... highly effective and orbit proven hardware is used, HERMES is designed to be reliable, precise and of low cost. The project can be extended for use on other space bodies (planets) for rapid observation of the planetary surface....

  7. Pain management: lessons from palliative care.

    Science.gov (United States)

    Langlois, John P

    2013-01-01

    Reducing suffering and helping patients to control their symptoms are key components of palliative care. This commentary will offer a comprehensive definition of palliative care and will present a case history to illustrate how palliative care can benefit patients with chronic pain.

  8. Audit of psychosocial risk management systems

    DEFF Research Database (Denmark)

    2014-01-01

    organizations on how to manage risks. Internal and external audits of compliance with the standard are key elements. Auditors should be competent to carry out the task and be familiar with risks of the areas they are auditing. The competences and practice of internal auditors have been studied...... in two Danish municipalities. The results show that auditors have a varied background and a limited knowledge about psychosocial risks. They have difficulties in carrying out audits and the results are mainly influenced by personal preferences....

  9. NGNP Risk Management through Assessing Technology Readiness

    Energy Technology Data Exchange (ETDEWEB)

    John W. Collins

    2010-08-01

    Throughout the Next Generation Nuclear Plant (NGNP) project life cycle, technical risks are identified, analyzed, and mitigated and decisions are made regarding the design and selection of plant and sub-system configurations, components and their fabrication materials, and operating conditions. Risk resolution and decision making are key elements that help achieve project completion within budget and schedule constraints and desired plant availability. To achieve this objective, a formal decision-making and risk management process was developed for NGNP, based on proven systems engineering principles that have guided aerospace and military applications.

  10. Proposal for a security management in cloud computing for health care.

    Science.gov (United States)

    Haufe, Knut; Dzombeta, Srdan; Brandis, Knud

    2014-01-01

    Cloud computing is actually one of the most popular themes of information systems research. Considering the nature of the processed information especially health care organizations need to assess and treat specific risks according to cloud computing in their information security management system. Therefore, in this paper we propose a framework that includes the most important security processes regarding cloud computing in the health care sector. Starting with a framework of general information security management processes derived from standards of the ISO 27000 family the most important information security processes for health care organizations using cloud computing will be identified considering the main risks regarding cloud computing and the type of information processed. The identified processes will help a health care organization using cloud computing to focus on the most important ISMS processes and establish and operate them at an appropriate level of maturity considering limited resources.

  11. Proposal for a Security Management in Cloud Computing for Health Care

    Directory of Open Access Journals (Sweden)

    Knut Haufe

    2014-01-01

    Full Text Available Cloud computing is actually one of the most popular themes of information systems research. Considering the nature of the processed information especially health care organizations need to assess and treat specific risks according to cloud computing in their information security management system. Therefore, in this paper we propose a framework that includes the most important security processes regarding cloud computing in the health care sector. Starting with a framework of general information security management processes derived from standards of the ISO 27000 family the most important information security processes for health care organizations using cloud computing will be identified considering the main risks regarding cloud computing and the type of information processed. The identified processes will help a health care organization using cloud computing to focus on the most important ISMS processes and establish and operate them at an appropriate level of maturity considering limited resources.

  12. Integrated Performance Management strategy, risk and sustainability Management

    OpenAIRE

    Lux, Wilfried

    2014-01-01

    This article gives an overview about an integrated approach to Performance Management, meaning strategy formulation and implementation. A step-wise approach is illustrated to arrive at strategic goals and to implement them by defi key performance indicators, actions and responsibilities. Modern approachesto trend analysis are introduced in order to make more predictable statements. Risk management as the other side of strategy implementation is suggested to get integrated into the process of ...

  13. Managed care and its impact on American urology.

    Science.gov (United States)

    Holtgrewe, H L

    1998-05-01

    America's health care is undergoing a revolution. A previous private, fee-for-service, delivery system chiefly centered around hospital specialty care is rapidly being replaced by a commercialized system of managed care, controlled by businessmen whose prime motive is profit. Increasing emphasis of these managed care organizations is upon primary physicians who function as gatekeepers. While this new commercialized method of health care has been attended with reductions in the previous omnipresent health care inflation our country has experienced for the past several decades, its impact on quality of care and patient choice of physician remain a great concern. Especially vulnerable in this new system are our nation's academic centers, which, burdened with responsibility for education and research, are at a disadvantage in the competitive cost-based bidding for managed care contracts. Urology work force issues and the number of urologists in our nation remain another concern for urologists as they compete for access to patients in this new highly competitive environment. In a 1995 survey of a cohort of urologists in seven states, the respondents reported 35.8% of gross income came from managed care contracts, 86% reported the need for preservice approval for many diagnostic and therapeutic undertakings, 87% reported an inability to refer complex cases outside the Managed Care Organization (MCO) network, and 23% reported they were required to retain patients for treatment who they would have otherwise referred to a more qualified urologist. The majority of American urologists are reporting dropping gross revenues and increasing overhead in their dealings with managed care contracts. The advent of managed care is being attended with dropping gross revenues, increasing overhead costs and interference with the practice patterns of American urologists.

  14. Is managed care restraining the adoption of technology by hospitals?

    Science.gov (United States)

    Mas, Núria; Seinfeld, Janice

    2008-07-01

    As health care costs increase, cost-control mechanisms become more widespread and it is crucial to understand their implications for the health care market. This paper examines the effect that managed care activity (based on the aim to control health care expenditure) has on the adoption of technologies by hospitals. We use a hazard rate model to investigate whether higher levels of managed care market share are associated with a decrease on medical technology adoption during the period 1982-1995. We analyze annual data on 5390 US hospitals regarding the adoption of 13 different technologies. Our results are threefold: first, we find that managed care has a negative effect on hospitals' technology acquisition for each of the 13 medical technologies in our study, and its effect is stronger for those technologies diffusing in the 1990s, when the managed care sector is at its largest. If managed care enrollment had remained at its 1984 level, there would be 5.3%, 7.3% and 4.1% more hospitals with diagnostic radiology, radiation therapy and cardiac technologies, respectively. Second, we find that the rise in managed care leads to long-term reductions in medical cost growth. Finally, we take into account that profitability analysis is one of the main dimensions considered by hospitals when deciding about the adoption of new technologies. In order to determine whether managed care affects technologies differently if they have a different cost-reimbursement ratio (CRR), we have created a unique data set with information on the cost-reimbursement for each of the 13 technologies and we find that managed care enrollment has a considerably larger negative effect on the adoption of less profitable technologies.

  15. Towards integrative risk management and more resilient societies

    Science.gov (United States)

    Al-Khudhairy, D.; Axhausen, K.; Bishop, S.; Herrmann, H.; Hu, B.; Kröger, W.; Lewis, T.; MacIntosh, J.; Nowak, A.; Pickl, S.; Stauffacher, D.; Tan, E.

    2012-11-01

    Society depends decisively on the availability of infrastructure systems such as energy, telecommunication, transportation, banking and finance, health care and governmental and public administration. Even selective damages of one of these infrastructures may result in disruptions of governmental, industrial or public functions. Vulnerability of infrastructures therefore provides spectacular leverage for natural disasters as well as criminal and terrorist actions. Threats and risks are part of the technological, economical, and societal development. This article focuses on the development and characterization of an integrative risk-management which, from the perspective of "resilient systems", can be seen as an innovative and pro-active crisis management approach dealing with the increasing amount of complexity in societies in a comprehensive, agile and adaptive way.

  16. Perception of nurses regarding risk classification in emergency care units

    Directory of Open Access Journals (Sweden)

    Carmen Lúcia Mottin Duro

    2014-09-01

    Full Text Available This study aimed to assess nurses’ perception regarding the risk classification in emergency care units. It is a descriptive study that used a qualitative approach and that was conducted with 55 nurses from emergency care units in the south of Brazil. Data were collected between July and October, 2011, through open questions, answered in writing. The data collected were submitted to the thematic analysis technique. Results indicate that the risk classification contributes to the organization of the service flow provided to patients, intervening in severe cases and preventing sequelae. Difficulties were described, such as: inadequate physical installations, overcrowding, disagreement in the definition of priorities among doctors and nurses and lack of articulation between the emergency care network and basic health care. It is highlighted the need to improve the physical structure, the quantity of human resources and the implementation of public policies to overcome these challenges.

  17. Diagnosing and managing psychosis in primary care.

    Science.gov (United States)

    Saunders, Kate; Brain, Susannah; Ebmeier, Klaus P

    2011-05-01

    Psychosis is broadly defined as the presence of delusions and hallucinations. It can be organic or functional. The former is secondary to an underlying medical condition, such as delirium or dementia, the latter to a psychiatric disorder, such as schizophrenia or bipolar disorder. The identification and treatment of psychosis is vital as it is associated with a 10% lifetime risk of suicide and significant social exclusion. Psychosis can be recognised by taking a thorough history, examining the patient's mental state and obtaining a collateral history. The history usually enables a distinction to be made between bipolar disorder, schizophrenia and other causes. Early symptoms often include low mood, declining educational or occupational functioning, poor motivation, changes in sleep, perceptual changes, suspiciousness and mistrust. The patient's appearance, e.g. unkempt or inappropriately attired, may reflect their predominant mental state. There may be signs of agitation, hostility or distractibility. Speech may be disorganised and difficult to follow or there may be evidence of decreased speech. Mood may be depressed or elated or change rapidly. Patients may describe abnormal thoughts and enquiry into thoughts of suicide should be routine. Disturbances of thought such as insertion or withdrawal may be present along with perceptual abnormalities i.e. illusions, hallucinations. Insight varies during the course of a psychotic illness but should be explored as it has implications for management. All patients presenting with first episode psychosis for which no organic cause can be found should be referred to the local early intervention service. In patients with a known diagnosis consider referral if there is: poor response or nonadherence to treatment; intolerable side effects; comorbid substance misuse; risk to self or others.

  18. Risk-Adjusted Control Charts for Health Care Monitoring

    Directory of Open Access Journals (Sweden)

    Willem Albers

    2011-01-01

    the distribution involved is negative binomial. However, in health care monitoring, (groups of patients will often belong to different risk categories. In the present paper, we will show how information about category membership can be used to adjust the basic negative binomial charts to the actual risk incurred. Attention is also devoted to comparing such conditional charts to their unconditional counterparts. The latter do take possible heterogeneity into account but refrain from risk-adjustment. Note that in the risk adjusted case several parameters are involved, which will all be typically unknown. Hence, the potentially considerable estimation effects of the new charts will be investigated as well.

  19. Learned predation risk management by spider mites

    Directory of Open Access Journals (Sweden)

    Thomas eHackl

    2014-09-01

    Full Text Available Predation is a prime selective force shaping prey behavior. Investment in anti-predator behavior is traded-off against time and energy for other fitness-enhancing activities such as foraging or reproduction. To optimize this benefit/cost trade-off, prey should be able to innately and/or by experience modulate their behavior to the level of predation risk. Here, we assessed learned predation risk management in the herbivorous two-spotted spider mite Tetranychus urticae. We exposed spider mites coming from benign (naïve or high immediate predation risk (experienced environments to latent and/or no risk and assessed their site choice, activity and oviposition. Benign environments were characterized by the absence of any predator cues, high immediate risk environments by killed spider mites, physical presence of the predatory mite Phytoseiulus persimilis and associated chemosensory traces left on the surface, and latent risk environments by only predator traces. In the no-choice experiment both naïve and experienced spider mites laid their first egg later on leaves with than without predator traces. Irrespective of predator traces presence/absence, experienced mites laid their first egg earlier than naïve ones did. Naïve spider mites were more active, indicating higher restlessness, and laid fewer eggs on leaves with predator traces, whereas experienced mites were less active and laid similar numbers of eggs on leaves with and without predator traces. In the choice experiment both naïve and experienced spider mites preferentially resided and oviposited on leaves without predator traces but experienced mites were less active than naïve ones. Overall, our study suggests that spider mites experienced with high predation risk behave bolder under latent risk than naïve spider mites. Since predator traces alone do not indicate immediate risk, we argue that the attenuated anti-predator response of experienced spider mites represents adaptive learned

  20. An investigation of risk management strategies in projects

    Directory of Open Access Journals (Sweden)

    Zahra Asadi

    2015-06-01

    Full Text Available Risk is considered as an inseparable part of any project and since all the effective factors in projects are not predictable, risk management is inevitable. One of the biggest administrative problems with internal projects is the managers’ neglect of the importance of risk management which leads to delay in projects delivery and increase of the cost of the projects. Since not all risks are regarded as threats but also as opportunities, risk management is considered as a balance factor between the loss of threats and the profit earned through opportunities. It has focused on some strategies for successful implementation of risk management in projects as well. In the risk management, the most logical way of planning is managing risk before taking risk. This study investigated risk and risk management, its aims, components, and different stages of risk to reach the expected aims and outcomes of the study.

  1. Proposal for a Security Management in Cloud Computing for Health Care

    OpenAIRE

    Knut Haufe; Srdan Dzombeta; Knud Brandis

    2014-01-01

    Cloud computing is actually one of the most popular themes of information systems research. Considering the nature of the processed information especially health care organizations need to assess and treat specific risks according to cloud computing in their information security management system. Therefore, in this paper we propose a framework that includes the most important security processes regarding cloud computing in the health care sector. Starting with a framework of general info...

  2. Patient safety and managing risk in nursing

    CERN Document Server

    Fisher, Melanie

    2013-01-01

    This book aims to provide nursing students and new nurses with a greater understanding of how to manage patient safety and risk in their own practice. The book focuses on the essentials that students and nurses need to know, and therefore provides a clear pathway through what can sometimes seem an overwhelmingly complex mass of rules, procedures and possible options.

  3. Risk modelling and management: An overview

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); D.E. Allen (David); M.J. McAleer (Michael); T. Pérez-Amaral (Teodosio)

    2013-01-01

    textabstractThe papers in this special issue of Mathematics and Computers in Simulation are substantially revised versions of the papers that were presented at the 2011 Madrid International Conference on "Risk Modelling and Management" (RMM2011). The papers cover the following topics: currency hedgi

  4. Economic optimisation of flood risk management projects

    NARCIS (Netherlands)

    Tsimopoulou, V.

    2015-01-01

    The Netherlands has developed a flood risk management policy based on an economic rationale. After the flood disaster of 1953, when a large area of the south-western part of the country was flooded and more than 1800 people lost their lives, the so-called Delta Committee was installed, whose main pu

  5. Coastal Risk Management in a Changing Climate

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Zanuttigh, Barbara; Andersen, Thomas Lykke

    2014-01-01

    Existing coastal management and defense approaches are not well suited to meet the challenges of climate change and related uncertanities. Professionals in this field need a more dynamic, systematic and multidisciplinary approach. Written by an international group of experts, Coastal Risk Managem...

  6. Natech disasters risk management in France

    OpenAIRE

    Vallée, Agnès

    2004-01-01

    International audience; France is subjected to several types of natural phenomena (floods, earthquake, landslides, storms, forest fires...) and to attacks potentially generated by human activities (industrial facilities, nuclear power plants, transportation of dangerous goods...). The natural and technological risks are managed in France, as regards prevention, protection, intervention, in order to limit their human and economic consequences. Furthermore, an industrial accident could be trigg...

  7. Risk Management for New Product Development Projects in Food Industry

    Directory of Open Access Journals (Sweden)

    Porananond, D.

    2014-07-01

    Full Text Available Project risk management provides a guideline for decision making in new product development (NPD projects, reducing uncertainty and increasing success rate. However, the acceptance of formal risk management applications in industry, especially for NPD projects is still in question. A study of a food conglomerate in Thailand found that only 9% of NPD projects used a systematic approach for managing risk. 61% of the projects realised the importance of risk management, while the remaining 30% did not involve risk management at all. This study aims to develop a risk management model for NPD projects in the food industry. The first section of this paper reviews the literature on risk management theory, including international standards for risk and project management (ISO31000 and ISO21500, publications for the Project Management Body of Knowledge (PMBOK, by a professional organisation the Project Management Institute (PMI, and also academic research. 182 academic papers, published between January 2002 and August 2012 were selected. The second part interviews conducted with eight NPD experts from five of the major food manufacturers in Thailand to examine their risk management practices and problems. Conclusions are made on five topics : classification of research method, project type and industrial segment, distribution of articles by region, tools & techniques for risk management and risk factors in projects. Specific requirements of risk management for NPD projects in the food industry are identified. A risk management model and the concept of risk management applications for the food industry are proposed.

  8. Are telehealth technologies for hypertension care and self-management effective or simply risky and costly?

    Science.gov (United States)

    McKoy, June; Fitzner, Karen; Margetts, Miranda; Heckinger, Elizabeth; Specker, James; Roth, Laura; Izenberg, Maxwell; Siegel, Molly; McKinney, Shannon; Moss, Gail

    2015-06-01

    Hypertension is a prevalent chronic disease that requires ongoing management and self-care. The disease affects 31% of American adults and contributed to or caused the deaths of 348,000 Americans in 2008, fewer than 50% of whom effectively self-managed the disease. However, self-management is complex, with patients requiring ongoing support and easy access to care. Telehealth may help foster the knowledge and skills necessary for those with hypertension to engage in successful self-management. This paper considers the applicability, efficacy, associated risks, and cost-effectiveness of telehealth for individuals and populations with hypertension. Telehealth is a broad term, encompassing telemedicine and mobile health that is used for physician-patient interactions, diagnostics, care delivery, education, information sharing, monitoring, and reminders. Telemedicine may have considerable utility for people diagnosed with hypertension who have poor access or social barriers that constrain access, but potential risks exist. Telehealth technology is evolving rapidly, even in the absence of fully proven cost-effectiveness and efficacy. Considering the cost of inpatient and emergency department care for patients with hypertension, telehealth is a highly attractive alternative, but there are risks to consider. Incorporating telehealth, which is increasingly characterized by mobile health, can increase both the capacity of health care providers and the reach of patient support, clinical management, and self-care. Telehealth studies need improvement; long-term outcome data on cardiovascular events must be obtained, and robust risk analyses and economic studies are needed to prospectively evaluate the safety and cost savings for hypertension self-management.

  9. Mainstreaming disaster risk management in higher education

    Directory of Open Access Journals (Sweden)

    MARCIA VILLASANA

    Full Text Available Universities should actively participate in disseminating and fostering a culture for disaster risk management (DRM among students and the community. Particularly in countries with high levels of risk, education plays a key role in raising awareness on the importance of preventing and implementing conscious risk management. Though the incorporation of DRM into the curricula, education programs become a mechanism to prepare students from a perspective of strengthening of values, citizenship, and social sensibility towards how disaster represents a disruption of the functioning of a community and impairs business activity. This paper presents the proposal for the integration of DRM of a private university in Mexico, one of the countries particularly susceptible to extreme hydrometereological and geological events. The proposal includes a concentration area for undergraduate business students, a mandatory introductory course for all business majors, and for the business community an executive education program for SMEs

  10. The "Battle" of Managing Language Barriers in Health Care.

    Science.gov (United States)

    Steinberg, Emma M; Valenzuela-Araujo, Doris; Zickafoose, Joseph S; Kieffer, Edith; DeCamp, Lisa Ross

    2016-02-18

    Providing safe and high-quality health care for children whose parents have limited English proficiency (LEP) remains challenging. Reports of parent perspectives on navigating language discordance in health care are limited. We analyzed portions of 48 interviews focused on language barriers from 2 qualitative interview studies of the pediatric health care experiences of LEP Latina mothers in 2 urban US cities. We found mothers experienced frustration with health care and reported suboptimal accommodation for language barriers. Six themes emerged relevant to health care across settings: the "battle" of managing language barriers, preference for bilingual providers, negative bias toward interpreted encounters, "getting by" with limited language skills, fear of being a burden, and stigma and discrimination experienced by LEP families. Parents' insights highlight reasons why effective language accommodation in health care remains challenging. Partnering with families to address the management of language barriers is needed to improve health care quality and safety for LEP patients and families.

  11. Preliminary risk analysis applied to the handling of health-care waste

    Directory of Open Access Journals (Sweden)

    Carvalho S.M.L.

    2002-01-01

    Full Text Available Between 75% and 90% of the waste produced by health-care providers no risk or is "general" health-care waste, comparable to domestic waste. The remaining 10-25% of health-care waste is regarded as hazardous due to one or more of the following characteristics: it may contain infectious agents, sharps, toxic or hazardous chemicals or it may be radioactive. Infectious health-care waste, particularly sharps, has been responsible for most of the accidents reported in the literature. In this work the preliminary risks analysis (PRA technique was used to evaluate practices in the handling of infectious health-care waste. Currently the PRA technique is being used to identify and to evaluate the potential for hazard of the activities, products, and services from facilities and industries. The system studied was a health-care establishment which has handling practices for infectious waste. Thirty-six procedures related to segregation, containment, internal collection, and storage operation were analyzed. The severity of the consequences of the failure (risk that can occur from careless management of infectious health-care waste was classified into four categories: negligible, marginal, critical, and catastrophic. The results obtained in this study showed that events with critics consequences, about 80%, may occur during the implementation of the containment operation, suggesting the need to prioritize this operation. As a result of the methodology applied in this work, a flowchart the risk series was also obtained. In the flowchart the events that can occur as a consequence of a improper handling of infectious health-care waste, which can cause critical risks such as injuries from sharps and contamination (infection from pathogenic microorganisms, are shown.

  12. Toward population management in an integrated care model.

    Science.gov (United States)

    Maddux, Franklin W; McMurray, Stephen; Nissenson, Allen R

    2013-01-01

    Under the Patient Protection and Affordable Care Act of 2010, accountable care organizations (ACOs) will be the primary mechanism for achieving the dual goals of high-quality patient care at managed per capita costs. To achieve these goals in the newly emerging health care environment, the nephrology community must plan for and direct integrated delivery and coordination of renal care, focusing on population management. Even though the ESRD patient population is a complex group with comorbid conditions that may confound integration of care, the nephrology community has unique experience providing integrated care through ACO-like programs. Specifically, the recent ESRD Management Demonstration Project sponsored by the Centers for Medicare & Medicaid Services and the current ESRD Prospective Payment System with it Quality Incentive Program have demonstrated that integrated delivery of renal care can be accomplished in a manner that provides improved clinical outcomes with some financial margin of savings. Moving forward, integrated renal care will probably be linked to provider performance and quality outcomes measures, and clinical integration initiatives will share several common elements, namely performance-based payment models, coordination of communication via health care information technology, and development of best practices for care coordination and resource utilization. Integration initiatives must be designed to be measured and evaluated, and, consistent with principles of continuous quality improvement, each initiative will provide for iterative improvements of the initiative.

  13. Predictors of health-related quality of life in patients at risk for cardiovascular disease in European primary care.

    NARCIS (Netherlands)

    Ludt, S.; Wensing, M.J.P.; Szecsenyi, J.; Lieshout, J. van; Rochon, J.; Freund, T.; Campbell, S.M.; Ose, D.

    2011-01-01

    BACKGROUND: Cardiovascular risk management plays an important role in primary care. In patients at high risk for cardiovascular diseases (CVD) lifestyle and, where appropriate, medical interventions are recommended in guidelines. Health-related quality of life (HRQoL) is an important outcome in clin

  14. Diabetes quality management in care groups and outpatient clinics

    NARCIS (Netherlands)

    Campmans-Kuijpers, M.J.E.

    2015-01-01

    This research project relates to diabetes quality management in Dutch care groups (40-200 GP practices) and outpatient clinics. Improvement of quality management at an organisational level on top of the existing quality management in separate general practices is expected to be associated with bette

  15. Quality risk management in pharmaceutical development.

    Science.gov (United States)

    Charoo, Naseem Ahmad; Ali, Areeg Anwer

    2013-07-01

    The objective of ICH Q8, Q9 and Q10 documents is application of systemic and science based approach to formulation development for building quality into product. There is always some uncertainty in new product development. Good risk management practice is essential for success of new product development in decreasing this uncertainty. In quality by design paradigm, the product performance properties relevant to the patient are predefined in target product profile (TPP). Together with prior knowledge and experience, TPP helps in identification of critical quality attributes (CQA's). Initial risk assessment which identifies risks to these CQA's provides impetus for product development. Product and process are designed to gain knowledge about these risks, devise strategies to eliminate or mitigate these risks and meet objectives set in TPP. By laying more emphasis on high risk events the protection level of patient is increased. The process being scientifically driven improves the transparency and reliability of the manufacturer. The focus on risk to the patient together with flexible development approach saves invaluable resources, increases confidence on quality and reduces compliance risk. The knowledge acquired in analysing risks to CQA's permits construction of meaningful design space. Within the boundaries of the design space, variation in critical material characteristics and process parameters must be managed in order to yield a product having the desired characteristics. Specifications based on product and process understanding are established such that product will meet the specifications if tested. In this way, the product is amenable to real time release, since specifications only confirm quality but they do not serve as a means of effective process control.

  16. Corporate social responsibility and the future health care manager.

    Science.gov (United States)

    Collins, Sandra K

    2010-01-01

    The decisions and actions of health care managers are oftentimes heavily scrutinized by the public. Given the current economic climate, managers may feel intense pressure to produce higher results with fewer resources. This could inadvertently test their moral fortitude and their social consciousness. A study was conducted to determine what corporate social responsibility orientation and viewpoint future health care managers may hold. The results of the study indicate that future health care managers may hold patient care in high regard as opposed to profit maximization. However, the results of the study also show that future managers within the industry may continue to need rules, laws, regulations, and legal sanctions to guide their actions and behavior.

  17. Managed care, consumerism, preventive medicine: does a causal connection exist?

    Science.gov (United States)

    Rizzo, John A; Xie, Yang

    2006-07-01

    Managed care plans, and HMOs in particular, have long touted that their emphasis is on preventive care, to avoid expensive illness later in life. However, few articles in the contemporary literature adequately address this claim. The available evidence seems to support that HMOs do, in fact, provide greater access to preventive services, but the limitations of this research are substantial. This article discusses the scientific evidence on the relationships between managed care arrangements and the implications for preventive care in the current era, emphasizing consumer choices and less-restrictive plan structures.

  18. Developing a broader approach to management of infection control breaches in health care settings.

    Science.gov (United States)

    Patel, Priti R; Srinivasan, Arjun; Perz, Joseph F

    2008-12-01

    Our experiences with health departments and health care facilities suggest that questions surrounding instrument reprocessing errors and other infection control breaches are becoming increasingly common. We describe an approach to management of these incidents that focuses on risk of bloodborne pathogen transmission and the role of public health and other stakeholders to inform patient notification and testing decisions.

  19. Case Management as a Significant Component of Usual Care Psychotherapy for Youth with Disruptive Behavior Problems

    Science.gov (United States)

    Zoffness, Rachel; Garland, Ann; Brookman-Frazee, Lauren; Roesch, Scott

    2009-01-01

    Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in…

  20. Cardiovascular risk factor assessment after pre-eclampsia in primary care

    Directory of Open Access Journals (Sweden)

    Numans Mattijs E

    2009-12-01

    Full Text Available Abstract Background Pre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management. Methods Review of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined. Results 35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p Conclusion Despite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands.

  1. [Managing health risks of workers in business trip].

    Science.gov (United States)

    Gevorkian, E V

    2014-01-01

    The article presents data of prospective observation over the risk management system concerning health of international oil and gas company workers in business trips. The management system included training and screening of workers under risk, specific prophylaxis and other measures. The authors described problems of the risk management system implementation, suggested recommendations to control risks connected with business trips.

  2. 12 CFR 704.6 - Credit risk management.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Credit risk management. 704.6 Section 704.6... CREDIT UNIONS § 704.6 Credit risk management. (a) Policies. A corporate credit union must operate according to a credit risk management policy that is commensurate with the investment risks and...

  3. Adverse pregnancy outcomes and cardiovascular risk factor management.

    Science.gov (United States)

    Mehta, Puja K; Minissian, Margo; Bairey Merz, C Noel

    2015-06-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman's risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia can be evaluated for hypertension and other CVD risk factors within 6 months to 1-year post-partum. Given the burden and impact of CVD on women in our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors.

  4. Risk factors of tuberculosis among health care workers in Sabah, Malaysia.

    Science.gov (United States)

    Jelip, Jenarun; Mathew, George G; Yusin, Tanrang; Dony, Jiloris F; Singh, Nirmal; Ashaari, Musa; Lajanin, Noitie; Shanmuga Ratnam, C; Yusof Ibrahim, Mohd; Gopinath, Deyer

    2004-01-01

    Tuberculosis (TB) is one of the main public health problems in Sabah; 30% of the total number of TB cases reported in Malaysia every year occur in Sabah. The average incidence of TB among health care workers over the past 5 years is 280.4 per 100,000 population (1, Annual Report of Sabah State TB Control Programme, 1998). At present, there are no specific measures for the prevention of TB transmission in health care facilities. A case-control study was conducted among health care workers in Sabah in 2000-2001. Cases were health care workers with TB diagnosed between January 1990 and June 2000. Controls were health care workers without TB and working in the same facility as cases during the disease episode. The study attempted to identify risk factors for TB among the study population. Data were collected through structured interviews and review of patients' records. The notification rate of TB among health care workers was significantly higher than that to the general population (Z=4.893, p<0.01). The average notification rate of TB among health care workers over the last 5 years was two times higher than in the general population (280.4/100,000 compared to 153.9/100,000). Regression results showed that ethnicity, designation, family contact and TB related knowledge did not significantly contribute to the risk of contracting TB in this study. However, after controlling for the above factors, age, gender, history of TB contact outside the workplace (other than family contact), duration of service and failure to use respiratory protection when performing high-risk procedures, were the main risk factors of TB among health care workers. This study succeeded in identifying some of the risk factors of TB among health care workers. We managed to include the large ratio of controls to case (3:1) and those cases spanned over a period of 10 years. However, the findings from the study have to be applied with caution due to the limitations of this study, which include recall

  5. CRISIS: A System for Risk Management

    Directory of Open Access Journals (Sweden)

    Erica Y. Sanchez

    2012-12-01

    Full Text Available In a situation of an unexpected catastrophe, uncertainty and demand for information are constant. In such a disaster scenario, the CRISIS system arises as a tool to contribute to previous coordination, procedure validation, exercise execution, a good and frequent communication among organizations, and weakness and threat assessment for an appropriate risk management. It offers a wide variety of tools for online communication, consultation and collaboration that, up to this day, includes cartography, tasks, resources, news, forums, instant messaging and chat. As a complement, mathematical models for training and emergency management are being researched and developed. For Argentinean society, it is a necessity to switch from the current handcrafted, bureaucratic emergency management method to a decision-making management model. Previous coordination, exercise execution, a fluid communication among institutions, and threats and weaknesses assessment are required for a proper risk management. With that goal in mind, it is important to reduce confusion, avoid the duplication of efforts to fulfill the same tasks, and have access to a complete vision of the situation, generated from the data of all the organizations taking part. The CRISIS system is a secure web application, accessible to every node in a network formed by the organizations which have complementary responsibilities during prevention and response. It offers a wide variety of tools for online communication, consultation and collaboration that, up to this day, includes cartography, tasks, media (organization and resources, news, forums, instant messaging and chat. As a complement, mathematical models for training and emergency management are being researched and developed. Currently, there are toxicological and epidemiological emergency models available. The present paper analyses, from the perspectives related to risk management for emergencies and disasters, the strengths and weaknesses

  6. Radon programme in the Netherlands: risk assessment and risk management

    Energy Technology Data Exchange (ETDEWEB)

    Jung, D.W.G. [Ministry of Housing, Physical Planning and Environment, The Hague (Netherlands). Directorate for Chemicals, External Safety and Radiation Protection

    1994-12-31

    The Dutch policy on the control of the risk of radon is predominantly based on the results of the Radon Research Programme. Important topics of the Radon Research Programme are described. Furthermore, the Dutch policy on indoor radiation is reviewed in view of the national environmental policy and radiation risk management. The policy on the control of radon in domestic and other buildings is related to other policies, both national and international, e.g. economic, environmental and housing policy. A short review of these relations in the Netherlands is given. In brief a description will be given of the attention paid by the government to the communication strategies used in order to enforce, for instance, remedial actions and the implementation of risk reduction technology. (author).

  7. Risk management activities at the DOE Class A reactor facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, D.A. [Westinghouse Savannah River Co., Aiken, SC (United States); Hill, D.J. [Argonne National Lab., IL (United States); Linn, M.A. [Oak Ridge National Lab., TN (United States); Atkinson, S.A. [EG and G Idaho, Inc., Idaho Falls, ID (United States); Hu, J.P. [Brookhaven National Lab., Upton, NY (United States)

    1993-12-31

    The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented.

  8. Risk management activities at the DOE Class A reactor facilities

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, D.A. (Westinghouse Savannah River Co., Aiken, SC (United States)); Hill, D.J. (Argonne National Lab., IL (United States)); Linn, M.A. (Oak Ridge National Lab., TN (United States)); Atkinson, S.A. (EG and G Idaho, Inc., Idaho Falls, ID (United States)); Hu, J.P. (Brookhaven National Lab., Upton, NY (United States))

    1993-01-01

    The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented.

  9. VaR BASED RISK MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Mária Bohdalová

    2013-06-01

    Full Text Available In this paper we discuss the Value–at–Risk concept and we analyse the market risk by using EWMA approach. EWMA (exponentially weighted moving average forecasting technique is a popular measure of various risks in financial risk management. We will compare standard EWMA, robust EWMA and skewed EWMA forecast of VaR. JP Morgan standard EWMA is derived from Gaussian distribution. Robust EWMA is based on Laplace distribution and skewed EWMA is a new approach derived from an asymmetric Laplace distribution. Asymmetric Laplace distribution takes into account both skewness and heavy tails in return distribution and the time varying nature of them in practice. Skewed EWMA VaR is a generalization of the standard EWMA method. Using these approaches we will analyse selected financial series (three European market indexes and one exchange rate. We have found andconfirmed that skewed EWMA forecasting of VaR outperforms the standard EWMA method.

  10. Disabling health care? Medicaid managed care and people with disabilities in America

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder

    2011-01-01

    Medicaid, America's largest government-funded health insurance program, plays a pivotal role in providing health services to eight million adults with disabilities. Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using...... business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical disabilities present their own constellation of health care issues that is not readily appreciated in health and social services....... The purpose of the study was to understand their experiences in accessing physical health care services and to ascertain the effects of managed care on their health and well-being. This study found beneficiaries encounter numerous barriers in accessing preventative, treatment, and acute care services. Overall...

  11. Risk management :A probe and study on forest fires

    Institute of Scientific and Technical Information of China (English)

    YUE Jinzhu; FENG Zhongke; JIANG Wei; YANG Xiaoqin

    2007-01-01

    The subject of risk management is attracting more and more attention around the world.The risk of forest fire disasters should be faced and dealt with for forest fires cannot be avoided.Treating forest fire disasters as a risk management issue promotes important measures and methods for fire fighters to prevent,reduce and control the risks of forest fires.In this paper,the risk concept andrisk connotation as well as the management risks for forest fire suppression are discussed clearly.Issues such as risk judgments,risk analysis,risk control and the assessment of risk,including their contents and corresponding methods are clarified.

  12. The Professionalization of Risk Management: What Role can the ISO 31000 Risk Management Principles Play?

    DEFF Research Database (Denmark)

    Olechowski, Alison; Oehmen, Josef; Seering, W.;

    2016-01-01

    an empirical investigation and discussion of the eleven principles of the ISO 31000:2009 Risk Management Standard via a large-scale survey of engineering and product development practitioners. Adhering to the risk management principles at a high level was found to be a significant factor in better reaching......Risk management is increasingly seen as a means of improving the likelihood of success in complex engineering projects. Yet the presence of a legitimacy gap, driven by the lack of empirical validation of published best practices, might explain low adoption of risk management on projects. We present...... cost, schedule, technical and customer targets, in addition to achieving a more stable project execution. This finding suggests that, rather than a single rigid standard or an ever-changing set of detailed methods, the ISO principles have potential to be the basis for our shared understanding of best...

  13. People deliver eye care: managing human resources

    Directory of Open Access Journals (Sweden)

    Kayode Odusote

    2005-12-01

    Full Text Available People deliver health. Effective health care needs an efficient and motivated health workforce, which is the totality of individuals who directly or indirectly contribute to the promotion, protection and improvement of the health of the population.Community eye health is about providing eye health care to the people as close as possible to where they live and as much as possible at a price they can afford. It promotes people-centred care rather than the traditional disease-centred eye care services. In order to provide effective and efficient eye care services, we need an adequate number of well-qualified, well-motivated and equitably distributed eye health workers (EHWs.

  14. Approving the ISDWIR method of risk measurement in making risk management decision

    OpenAIRE

    Strelnik, Mikhail

    2014-01-01

    This paper is devoted to risk management and risk measurement methods. The author considers methods of risk measurement and proposes the Inte- gral Sum of Differential Weighted Indexes of Risks (or ISDWIR) method of risk measurement. The method is based on dynamic enterprise risk matri- ces. The matrix describes the changes of corporate risk values over the time. The method assists to choose risk management decision having good effects on corporate risk values. The ISDWIR method is also compa...

  15. Risk Management in Supply Chain using Consistent Fuzzy Preference Relations

    OpenAIRE

    Ahmad Jafarnejad; Mehran Ebrahimi; Mohammad Ali Abbaszadeh; Seyed Mehdi Abtahi

    2014-01-01

    Nowadays, supply chains are exposed to numerous risks. Thus, to success in risky business environment, it is imperative for firms to systematically manage supply chain risks. Risk management is the identification, assessment, and prioritization of supply chain risks. The purpose of this paper is to propose a comprehensive approach to risk management in supply chains. Thus, by an appropriate review of the literature, supply chain risk sources are identified in six areas. Then, a CFPR method is...

  16. How to manage project opportunity and risk why uncertainty management can be a much better approach than risk management

    CERN Document Server

    Ward, Stephen

    2011-01-01

    Since I wrote the Foreword for the second edition of this book, risk management processes have become much more widely used, but controversy about what should be done and how best to do it has grown. Managing risk is a risky business. Chapman and Ward provide an in-depth explanation of why it is important to understand and manage underlying uncertainty in all its forms, in order to realise opportunities more fully and enhance corporate performance. They show what best practice should look like. The implications go well beyond the conventional wisdom of project risk management, providing an enl

  17. The European initiative for quality management in lung cancer care

    DEFF Research Database (Denmark)

    Blum, Torsten G; Rich, Anna; Baldwin, David

    2014-01-01

    . The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility...... study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide...... countries. The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe....

  18. Tools for primary care management of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Bennett, Alice L; Munkholm, Pia; Andrews, Jane M

    2015-01-01

    are helpful but they are not designed for the primary care setting. Few non-expert IBD management tools or guidelines exist compared with those used for other chronic diseases such as asthma and scant data have been published regarding the usefulness of such tools including IBD action plans and associated......Healthcare systems throughout the world continue to face emerging challenges associated with chronic disease management. Due to the likely increase in chronic conditions in the future it is now vital that cooperation and support between specialists, generalists and primary health care physicians...... affected by IBD in their caseload, the proportion of patients with IBD-related healthcare issues cared for in the primary care setting appears to be widespread. Data suggests however, that primary care physician's IBD knowledge and comfort in management is suboptimal. Current treatment guidelines for IBD...

  19. Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

    Science.gov (United States)

    Haas, Sheila A; Vlasses, Frances; Havey, Julia

    2016-01-01

    There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

  20. Understanding and managing risk in software systems

    Energy Technology Data Exchange (ETDEWEB)

    Fletcher, S.K.; Jansma, R.; Lim, J.; Murphy, M.; Wyss, G.

    1995-07-01

    When software is used in safety-critical, security-critical, or mission-critical situations, it is imperative to understand and manage the risks involved. A risk assessment methodology and toolset have been developed which are specific to software systems. This paper describes the concepts of the methodology, with emphasis on the experience of designing a toolset to support the methodology. Also presented are results of applying the methodology to two real software-based products: the software toolset itself, and a network firewall.

  1. Advanced Risk Management and Monitoring System, ARMMS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kil Yoo; Han, Sang Hoon; Lim, Ho Gon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-10-15

    Many risk informed regulation and applications (RIR and A) are approved and used for the nuclear power plants(NPPs), and more RIR and A will be actively applied in Korea. Also, since Korean NPPs are recently exported to other country such as UAE, RIR and A would be applied to the exported NPPs. Thus, a tool which will help the user apply RIR and A is required. KAERI is being developing a tool, called ARMMS (Advanced Risk Management and Monitoring System), for this purpose. The design plan of ARMMS was introduced in the Ref, and in this paper, the actual implementation of ARMMS is introduced, and the performance monitoring module is introduced

  2. Managing palliative care for adults with advanced heart failure.

    Science.gov (United States)

    Kaasalainen, Sharon; Strachan, Patricia H; Brazil, Kevin; Marshall, Denise; Willison, Kathleen; Dolovich, Lisa; Taniguchi, Alan; Demers, Catherine

    2011-09-01

    The purpose of this study was to explore the care processes experienced by community-dwelling adults dying from advanced heart failure, their family caregivers, and their health-care providers. A descriptive qualitative design was used to guide data collection, analysis, and interpretation. The sample comprised 8 patients, 10 informal caregivers, 11 nurses, 3 physicians, and 3 pharmacists. Data analysis revealed that palliative care was influenced by unique contextual factors (i.e., cancer model of palliative care, limited access to resources, prognostication challenges). Patients described choosing interventions and living with fatigue, pain, shortness of breath, and functional decline. Family caregivers described surviving caregiver burden and drawing on their faith. Health professionals described their role as trying to coordinate care, building expertise, managing medications, and optimizing interprofessional collaboration. Participants strove towards 3 outcomes: effective symptom management, satisfaction with care, and a peaceful death.

  3. Management of power economical risks in the district heating at Vienna. Risk management as chance management; Management energiewirtschaftlicher Risiken bei Fernwaerme Wien. Risikomanagement als Chancenmanagement

    Energy Technology Data Exchange (ETDEWEB)

    Pschick, Andreas [Fernwaerme Wien GmbH, Vienna (Austria). Abt. Energiewirtschaft

    2009-05-15

    District heat supply companies are exposed to different risks. Some examples are the legal guidelines of the European Union, increased combustible prices, more warm winters and the required use of CO{sub 2} certificates. A risk management in the field of energy economy is therefore indispensable. The author explains the risk management in the district heating at Vienna. The risk management is also perceived as chance management. (orig.)

  4. Staged diabetes management. Toward an integrated model of diabetes care.

    Science.gov (United States)

    Mazze, R S; Etzwiler, D D; Strock, E; Peterson, K; McClave, C R; Meszaros, J F; Leigh, C; Owens, L W; Deeb, L C; Peterson, A

    1994-06-01

    This paper introduces a new and innovative approach to diabetes management in the primary-care setting. Staged diabetes management (SDM) represents a four-year effort to develop and test a data-based approach to diabetes management that could be easily adapted to a variety of health-care settings in which diabetes management is principally under the direction of primary-care physicians was limited access to specialists. After testing under controlled circumstances at the International Diabetes Center (Minneapolis, MN), SDM was subjected to substantial field trials under conditions that represent the scope and variety of primary-care practices in diabetes. The following represents the work of several investigators who independently undertook a review of SDM.

  5. Identifying and managing patients with delirium in acute care settings.

    Science.gov (United States)

    Bond, Penny; Goudie, Karen

    2015-11-01

    Delirium is an acute medical emergency affecting about one in eight acute hospital inpatients. It is associated with poor outcomes, is more prevalent in older people and it is estimated that half of all patients receiving intensive care or surgery for a hip fracture will be affected. Despite its prevalence and impact, delirium is not reliably identified or well managed. Improving the identification and management of patients with delirium has been a focus for the national improving older people's acute care work programme in NHS Scotland. A delirium toolkit has been developed, which includes the 4AT rapid assessment test, information for patients and carers and a care bundle for managing delirium based on existing guidance. This toolkit has been tested and implemented by teams from a range of acute care settings to support improvements in the identification and immediate management of delirium.

  6. Medicaid Managed Care Penetration Rates and Expansion Enr...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid managed care penetration rates and expansion enrollment by state charts are composed annually by the Data and System Group (DSG) of the Centers for...

  7. Effects of managed care contracting on physician labor supply.

    Science.gov (United States)

    Libby, A M; Thurston, N K

    2001-06-01

    We examine the effect of managed care contracting on physician labor supply for office-based medical practices. We extend the standard labor supply model to incorporate choices regarding the patient base. Empirical tests use data from the 1985 and 1988 national HCFA Physician Practice Costs and Income Surveys and InterStudy Managed Care Surveys. We use physician-level information on participation in managed care contracting to estimate changes in work hours. Managed care contracting is generally associated with lower physician work hours. However, accounting for motivations to participate in contracts and the extent of contracting, the effect on hours is reduced in magnitude and significance. We conclude that relying on broad aggregate measures for policy analysis will likely be misleading as underlying motivations and contracting incentives change over time.

  8. Multidisciplinary care planning in the primary care management of completed stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Erikssen Lars

    2008-08-01

    Full Text Available Abstract Background Chronic disease management requires input from multiple health professionals, both specialist and primary care providers. This study sought to assess the impact of co-ordinated multidisciplinary care in primary care, represented by the delivery of formal care planning by primary care teams or shared across primary-secondary teams, on outcomes in stroke, relative to usual care. Methods A Systematic review of Medline, EMBASE, CINAHL (all 1990–2006, Cochrane Library (Issue 1 2006, and grey literature from web based searching of web sites listed in the CCOHA Health Technology Assessment List Analysis used narrative analysis of findings of randomised and non-randomised trials, and observational and qualitative studies of patients with completed stroke in the primary care setting where care planning was undertaken by 1 a multi-disciplinary primary care team or 2 through shared care by primary and secondary providers. Results One thousand and forty-five citations were retrieved. Eighteen papers were included for analysis. Most care planning took part in the context of multidisciplinary team care based in hospitals with outreach to community patients. Mortality rates are not impacted by multidisciplinary care planning. Functional outcomes of the studies were inconsistent. It is uncertain whether the active engagement of GPs and other primary care professionals in the multidisciplinary care planning contributed to the outcomes in the studies showing a positive effect. There may be process benefits from multidisciplinary care planning that includes primary care professionals and GPs. Few studies actually described the tasks and roles GPs fulfilled and whether this matched what was presumed to be provided. Conclusion While multidisciplinary care planning may not unequivocally improve the care of patients with completed stroke, there may be process benefits such as improved task allocation between providers. Further study on the impact

  9. Mission Risk Reduction Regulatory Change Management

    Science.gov (United States)

    Scroggins, Sharon

    2007-01-01

    NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated

  10. The assessment and management of skin tears in care homes.

    Science.gov (United States)

    Stephen-Haynes, Jackie; Callaghan, Rosie; Bethell, Elaine; Greenwood, Michelle

    This article discusses a project conducted in Worcestershire nursing homes to review current practices in the management of skin tears and the subsequent development and implementation of guidelines resulting in a standardised client care package. An initial audit in five care homes was followed by an in-depth audit in 52 homes over a 12-week period. This led to the development of resources and the 'STAR box' to assist with implementation of timely and appropriate care delivery.

  11. Headache in primary care: how important is diagnosis to management?

    OpenAIRE

    O'Flynn, Norma; Ridsdale, Leone

    2002-01-01

    Headache is a common presentation in primary care. The classification of headache was overhauled by the International Headache Society (IHS) in 1988, and the past decade has seen rapid growth in the understanding of headache disorders. The IHS places particular importance on precise headache diagnosis. This paper discusses the relevance of such an approach to primary care. A review of the literature revealed a dearth of evidence regarding headache management in primary care settings. The evid...

  12. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    Science.gov (United States)

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  13. Risk assessment and management to prevent preterm birth.

    Science.gov (United States)

    Koullali, B; Oudijk, M A; Nijman, T A J; Mol, B W J; Pajkrt, E

    2016-04-01

    Preterm birth is the most important cause of neonatal mortality and morbidity worldwide. In this review, we review potential risk factors associated with preterm birth and the subsequent management to prevent preterm birth in low and high risk women with a singleton or multiple pregnancy. A history of preterm birth is considered the most important risk factor for preterm birth in subsequent pregnancy. General risk factors with a much lower impact include ethnicity, low socio-economic status, maternal weight, smoking, and periodontal status. Pregnancy-related characteristics, including bacterial vaginosis and asymptomatic bacteriuria, appear to be of limited value in the prediction of preterm birth. By contrast, a mid-pregnancy cervical length measurement is independently associated with preterm birth and could be used to identify women at risk of a premature delivery. A fetal fibronectin test may be of additional value in the prediction of preterm birth. The most effective methods to prevent preterm birth depend on the obstetric history, which makes the identification of women at risk of preterm birth an important task for clinical care providers.

  14. The management of diabetes in indigenous Australians from primary care

    Directory of Open Access Journals (Sweden)

    Thomas Merlin C

    2007-10-01

    Full Text Available Abstract Background Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care. Methods Diabetes management and outcomes in Indigenous patients enrolled in the NEFRON study (n = 144 was systematically compared with that in non-Indigenous patients presenting consecutively to the same practitioner (n = 449, and the NEFRON cohort as a whole (n = 3893. Results Indigenous Australians with diabetes had high rates of micro- and macrovascular disease. 60% of Indigenous patients had an abnormal albumin to creatinine ratio compared to 33% of non-Indigenous patients (p 1c ≥ 8.0%, observed in 55% of all Indigenous patients, despite the similar frequency use of oral antidiabetic agents and insulin. Smoking was also more common in Indigenous patients (38%vs 10%, p Conclusion Although seeing the same doctors and receiving the same medications, glycaemic and smoking cessation targets remain unfulfilled in Indigenous patients. This cross-sectional study confirms Aboriginal ethnicity as a powerful risk factor for microvascular and macrovascular disease, which practitioners should use to identify candidates for intensive multifactorial intervention.

  15. Energy Risk Management with Carbon Assets

    OpenAIRE

    Chevallier, Julien

    2009-01-01

    This article proposes a mean-variance optimization and portfolio frontier analysis of energy risk management with carbon assets, introduced in January 2005 as part of the EU Emissions Trading Scheme. In a stylized exercise, we compute returns, standard deviations and correlations for various asset classes from April 2005 to January 2009. Our central result features an expected return of 3% with a standard deviation < 0.06 by introducing carbon assets – carbon futures and CERs- in a diversifie...

  16. Cultural resource management: The risk of compliance

    Energy Technology Data Exchange (ETDEWEB)

    Curtis, S.A.

    1994-02-01

    The statutory mandate for federal agencies to involve American Indians in the management of cultural resources may create a cultural risk for the people those statutes are intended to protect. A conceptual framework is given to help understand this dilemma. Factors that can exacerbate the severity of the adverse cultural impacts for tribal people are also examined. Policy recommendations are offered for reducing tensions among an the participants in the statutory process.

  17. Becoming nursing manager in the nested and complex border of caring and management dimensions

    Directory of Open Access Journals (Sweden)

    Gabriela Marcellino de Melo Lanzoni

    2015-06-01

    Full Text Available The study aimed to understand the experience of managing medical-surgical inpatient units in a general hospital, highlighting the meaning of being a nursing manager, with the intention to qualify and instrument nurses for caring management practice in this scenario. This is a Grounded Theory research, conducted from August 2010 to August 2012, through interviews with 19 participants from the nursing team, distributed in 3 sampling groups. From the analysis emerged the phenomenon “Becoming a nursing manager in the nested and complex border of caring and management dimension”. To exercise caring management, nurses use management instruments as essential tools, they become capable theoretically and enhances, based on his experience, professional skills and personal characteristics.  We conclude that competency mobilization beyond the clinical aspect is needed; allowing the use of management instruments to make caring viable and to improve relational and interactive processes.

  18. Disaster Risk Management of Urban Systems

    Directory of Open Access Journals (Sweden)

    Ana-Diana Ancaş

    2006-01-01

    Full Text Available Evaluating the risk of natural disasters is an intensely debated issue, both on national and international level. In the present paper, after a brief review of the international research in this field and an introduction in risk management, we insisted on risk analysis of an urban area, called urban system. More precisely, we investigated the evaluation of risk and the behavior of the pipelines infrastructure characteristic in an urban area during an earthquake.By taking into account a certain region in Jassy city area, we present a methodology of evaluating seismic risk of the utilities network of the region. The method consists in establishing the necessary steps to be taken in such an evaluation. These steps are also graphically displayed for the gas pipelines of the area, and emphasizing the critical points existent in that sector e.g. gas stations. Using the cellular automata technique, inspired from the artificial intelligence and complex system fields, based on the GIS map of the analysed region, we obtained a map with the risk areas in case of an earthquake, taking into account the gas pipelines network and the existing critical points.

  19. Global Aspects of Flood Risk Management

    Institute of Scientific and Technical Information of China (English)

    Wolfgang Kron

    2015-01-01

    Various flood disasters in the last decade have confirmed that the risk from flooding has been increasing significantly worldwide. The driving factors for the risk are the unabated increase in global population, the concentration of people in high-risk areas such as coasts and flood plains, the rise in vulnerability of assets, infrastructure and social systems, and the consequences of climate change. Risk reduction is based on comprehensive risk management from identification of the hazard and assessing the risk to building defenses. To achieve this, general awareness at all levels in a society is key. It is not sufficient merely to be aware of the situation-findings must be acted upon with no significant delay. Flood-related computations have progressed considerably in recent years, but model results can only be as good as their input data. Modeling floods and flood losses is very complex, as model parameters are subject to change during an event and conditions sometimes greatly depend on small-scale factors.

  20. How family members manage risk around functional decline: the autonomy management process in households facing dementia.

    Science.gov (United States)

    Berry, Brandon; Apesoa-Varano, Ester Carolina; Gomez, Yarin

    2015-04-01

    Most dementia research investigates the social context of declining ability through studies of decision-making around medical treatment and end-of-life care. This study seeks to fill an important gap in research about how family members manage the risks of functional decline at home. Drawing on three waves of in-depth interviewing in 2012-2014, it investigates how family members in US households manage decline in an affected individual's natural range of daily activities over time. The findings show that early on in the study period affected individuals were perceived to have awareness of their decline and routinely drew on family members for support. Support transformed when family members detected that the individual's deficit awareness had diminished, creating a corresponding increase in risk of self-harm around everyday activities. With a loss of confidence in the individual's ability to regulate his or her own activities to avoid these risks, family members employed unilateral practices to manage the individual's autonomy around his or her activity involvements. These practices typically involved various deceits and ruses to discourage elders from engaging in activities perceived as potentially dangerous. The study concludes by discussing the implications that the social context of interpretive work around awareness and risk plays an important role in how families perceive an elder's functional ability and manage his or her activity involvements.

  1. Application of a Proactive Risk Analysis to Emergency Department Sickle Cell Care

    Directory of Open Access Journals (Sweden)

    Victoria L. Thornton

    2014-07-01

    Full Text Available Introduction: Patients with sickle cell disease (SCD often seek care in emergency departments (EDs for severe pain. However, there is evidence that they experience inaccurate assessment, suboptimal care, and inadequate follow-up referrals. The aim of this project was to 1 explore the feasibility of applying a failure modes, effects and criticality analysis (FMECA in two EDs examining four processes of care (triage, analgesic management, high risk/high users, and referrals made for patients with SCD, and 2 report the failures of these care processes in each ED. Methods: A FMECA was conducted of ED SCD patient care at two hospitals. A multidisciplinary group examined each step of four processes. Providers identified failures in each step, and then characterized the frequency, impact, and safeguards, resulting in risk categorization. Results: Many “high risk” failures existed in both institutions, including a lack of recognition of high-risk or high-user patients and a lack of emphasis on psychosocial referrals. Specific to SCD analgesic management, one setting inconsistently used existing analgesic policies, while the other setting did not have such policies. Conclusion: FMECA facilitated the identification of failures of ED SCD care and has guided quality improvement activities. Interventions can focus on improvements in these specific areas targeting improvements in the delivery and organization of ED SCD care. Improvements should correspond with the forthcoming National Heart, Lung and Blood-sponsored guidelines for treatment of patients with sickle cell disease. [West J Emerg Med. 2014;15(4:446–458.

  2. 78 FR 76297 - Social Media: Consumer Compliance Risk Management Guidance

    Science.gov (United States)

    2013-12-17

    .../or sex or use data ] mining technology to obtain such information from social media sites, the... INSTITUTIONS EXAMINATION COUNCIL Social Media: Consumer Compliance Risk Management Guidance AGENCY: Federal... supervisory guidance entitled ``Social Media: Consumer Compliance Risk Management Guidance'' (Guidance)....

  3. Managing University IT Risks in Structured and Organized Environment

    Directory of Open Access Journals (Sweden)

    Sayef Sami Hassen

    2013-07-01

    Full Text Available In this digital era, most universities rely heavily on Information Technology (IT to process their information for better support of their visions and missions. However, with this reliance, IT is facing different types of risks under expansions and complexities as experienced by most universities these days. IT risk is not bounded to only information systems and security, but unbounded to encompass the risk to financial, strategic, technological, as well as reputational. All these types of risk are prevalent in universities and hence the need to implement an effective risk management process including but not limited to IT. The best opportunities for managing IT risks can be achieved through managing it within an integrated approach and not to be carried out separately from managing risks of the organization. Such approach ensures that IT is achieving the goals and objectives of the organization by providing a reasonable basis for strategic planning and improves decision making for top management based on risk management value. This study identifies the current implementation of risk management at one Malaysian university to face all risks. The main findings of this study are: (1 The majority of staff supports the fundamental objectives of risk management; (2 The necessity to improve and enhance some procedures of risk management at the university. This study provide recommendations and improvements in some procedures of risk management to increase the awareness of risk management among all the university staff.

  4. Bisphenol A and Risk Management Ethics

    Science.gov (United States)

    Resnik, David B.; Elliot, Kevin C.

    2013-01-01

    It is widely recognized that endocrine disrupting compounds, such as Bisphenol A, pose challenges for traditional paradigms in toxicology, insofar as these substances appear to have a wider range of low-dose effects than previously recognized. These compounds also pose challenges for ethics and policymaking. When a chemical does not have significant low-dose effects, regulators can allow it to be introduced into commerce or the environment, provided that procedures and rules are in place to keep exposures below an acceptable level. This option allows society to maximize the benefits from the use of the chemical while minimizing risks to human health or the environment, and it represents a compromise between competing values. When it is not possible to establish acceptable exposure levels for chemicals that pose significant health or environmental risks, the most reasonable options for risk management may be to enact either partial or complete bans on their use. These options create greater moral conflict than other risk management strategies, leaving policymakers difficult choices between competing values. PMID:24471646

  5. Natural-technological risk assessment and management

    Science.gov (United States)

    Burova, Valentina; Frolova, Nina

    2016-04-01

    EM-DAT statistical data on human impact and economic damages in the 1st semester 2015 are the highest since 2011: 41% of disasters were floods, responsible for 39% of economic damage and 7% of events were earthquakes responsible for 59% of total death toll. This suggests that disaster risk assessment and management still need to be improved and stay the principle issue in national and international related programs. The paper investigates the risk assessment and management practice in the Russian Federation at different levels. The method is proposed to identify the territories characterized by integrated natural-technological hazard. The maps of the Russian Federation zoning according to the integrated natural-technological hazard level are presented, as well as the procedure of updating the integrated hazard level taking into account the activity of separate processes. Special attention is paid to data bases on past natural and technological processes consequences, which are used for verification of current hazard estimation. The examples of natural-technological risk zoning for the country and some regions territory are presented. Different output risk indexes: both social and economic, are estimated taking into account requirements of end-users. In order to increase the safety of population of the Russian Federation the trans-boundaries hazards are also taken into account.

  6. Risk Management-An Industry Approach

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    An effective risk management system covering the whole process offood production from “farm to fork” is required by the food industry in order to assure that the food provided to consumers is safe. Food safety and quality assurance begins with the design and development of food products starting with product conceptualisation and continuing with the selection, purchasing, and evaluation of raw materials and with the specifications for processing, packaging and distribution. Within a larger quality management framework a number of tools have been developed by the food industry, which when used in an integrated fashion facilitate the management of food safety. These include good manufacturing practice (GMP), good hygiene practice (GHP) and HACCP (hazard analysis critical control point) as well as quality systems which allow the verification that all factors affecting the safety of a product are under control. Finally, regulations and systems can only function if they are applied. Everyone, from the farmer, the line operator in the manufacturing plant, to the person handling the food in distribution and sales, needs to be aware of his influence with regards safety. The effectiveness of safety awareness programs specific to each area is key to an industry approach to risk management.

  7. Proposals for enhanced health risk assessment and stratification in an integrated care scenario

    Science.gov (United States)

    Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

    2016-01-01

    Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. Settings The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Participants Responsible teams for regional data management in the five ACT regions. Primary and secondary outcome measures We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. Results There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. Conclusions The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches

  8. Emotion management in children′s palliative care nursing

    Directory of Open Access Journals (Sweden)

    Eryl Zac Maunder

    2008-01-01

    Full Text Available This article explores the emotional labor involved for nurses providing palliative care for children/young people living with life-limiting illnesses/conditions, and their families. It highlights the challenges nurses face in managing their emotion when caring for children/young people and their families, and explores strategies to enable nurses to cope with this aspect of their role without compromising their personal wellbeing. It suggests that emotional labor within nursing goes largely unrecorded, and remains undervalued by managers and health care services.

  9. The Functions of Sourcing Intermediaries in Global Supply Risk Management

    DEFF Research Database (Denmark)

    Vedel, Mette; Ellegaard, Chris

    The aim of this work-in-progress paper is to uncover the supply risk management functions performed by sourcing intermediaries. The purchasing and supply chain management literature, including the part of it concerned with supply risk, pays little attention to sourcing intermediaries....... But the fields of marketing and international business have investigated the intermediary including its high supply risk reducing potentials, suggesting that this supply chain entity may be highly relevant to supply risk management. In order to get a better understanding of the supply risk reducing properties...... in the supply risk management literature and as a managerial option that can effectively alleviate certain kinds of supply risk....

  10. Strategic Risk Management and it applications to Porsche AG

    OpenAIRE

    Oláh, Róbert

    2009-01-01

    The main objective of this thesis is not only to describe and categorize risk but also to look at Porsche AG and determine how they deal with strategic risks. Primary focus is on the description and categorization of risks, strategic risks, importance of Risk Management and strategic risks faced by Porsche AG and their mitigation.

  11. An Aspect Oriented Process Based Approach To Information Risk Management

    Directory of Open Access Journals (Sweden)

    Dhanya Pramod

    2013-06-01

    Full Text Available In this era of fast paced technological advancements, security issues and risks related to it have become a key concern for all organizations. Enterprise Governance, Risk management and Compliance(GRC is the popular approach to handle enterprise risks and reduce its impact. This paper focuses on the risk management, especially the risk assessment approaches and proposes an aspect oriented approach to risk management. In this approach, the risk management processes are designed separately from the core business processes and are weaved to the flow of business process steps wherever necessary.This brings the advantage of separation of concerns of risk management from the business process. The design of business processes then need not look into the design of risk assessment related to it. This will enable handling of risk and its assessment by expert risk advisories, those who are specialized in it.

  12. How to manage burns in primary care.

    OpenAIRE

    Waitzman, A. A.; Neligan, P. C.

    1993-01-01

    Burns are common injuries; more than 200,000 occur in Canada annually. Nearly all burn injuries can be managed on on outpatient basis. Appropriate treatment depends on burn depth, extent, and location. Special types of burns, such as chemical, tar, and electrical injuries, need specific management strategies. Prevention through education is important to reduce the incidence of burns.

  13. Improving Chronic Care: Developing and testing disease-management interventions applied in COPD care

    NARCIS (Netherlands)

    K.M.M. Lemmens (Karin)

    2009-01-01

    textabstractDisease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control health care costs. So far, however, the effects of this strategy remain unclear. The purpose of this thesis was to determine the core elements of dis

  14. Formative evaluation of practice changes for managing depression within a Shared Care model in primary care.

    Science.gov (United States)

    Beaulac, Julie; Edwards, Jeanette; Steele, Angus

    2017-01-01

    Aim To investigate the implementation and initial impact of the Physician Integrated Network (PIN) mental health indicators, which are specific to screening and managing follow-up for depression, in three primary care practices with Shared Mental Health Care in Manitoba.

  15. Anticoagulated patient management in primary care service

    Directory of Open Access Journals (Sweden)

    Marco Antonio Zapata Sampedro

    2008-05-01

    Full Text Available Out-patients undergoing anticoagulant treatment are attended by nursing staff, working with doctors.To be able to provide adequate medical care, nurses must have the minimum knowledge and skills needed to work with the programme described in this article. These include basic and specific knowledge of anticoagulation. The correct functioning of the service will help provide an optimum control of the INR (International Normalized Ratio and reduce the complications of bleeding, both of which are the main objectives of the nursing care of these patients.

  16. Managing Risks in Electrical Infrastructure Assets from a Strategic Perspective

    NARCIS (Netherlands)

    Zhuang, Q.

    2015-01-01

    Should risks always be quantified before being managed? The answer is “yes” in the opinion of most asset managers in today’s electricity transmission and distribution companies, but “no” in modern theories of risk management. When the risks refer to reliability hazards of high-voltage assets, the

  17. 48 CFR 39.102 - Management of risk.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Management of risk. 39.102... CONTRACTING ACQUISITION OF INFORMATION TECHNOLOGY General 39.102 Management of risk. (a) Prior to entering... monitored, funding availability, and program management risk. (c) Appropriate techniques should be...

  18. Audit Trail Management System in Community Health Care Information Network.

    Science.gov (United States)

    Nakamura, Naoki; Nakayama, Masaharu; Nakaya, Jun; Tominaga, Teiji; Suganuma, Takuo; Shiratori, Norio

    2015-01-01

    After the Great East Japan Earthquake we constructed a community health care information network system. Focusing on the authentication server and portal server capable of SAML&ID-WSF, we proposed an audit trail management system to look over audit events in a comprehensive manner. Through implementation and experimentation, we verified the effectiveness of our proposed audit trail management system.

  19. Hypertension management in primary care in Belarus and The Netherlands.

    NARCIS (Netherlands)

    Schellevis, F.G.; Rusovich, V.; Egorov, K.N.; Podpalov, V.P.; Boerma, W.G.W.

    2005-01-01

    Both in Belarus and in the Netherlands, guidelines on the management of hypertension in primary care have been developed, including recommendations about detection, treatment and follow-up. These guidelines are meant to harmonize actual practice management of hypertension of improve the quality of c

  20. What are purchasers looking for in managed care quality?

    Science.gov (United States)

    Lipson, E H

    1993-01-01

    Spurred by competition and the growth of managed care, providers are seeking new approaches for satisfying the needs of health care purchases. Increasingly, these purchasers are focusing on the value of managed care arrangements, especially the degree to which they manage quality. Underlying the emerging focus on quality are concerns about "undercare," potential legal liability, and the economics of quality. Purchasers are sensitive to the quality of service and the experience of their patients, as well as the clinical quality of the care they receive, and many employers are now engaged in a systematic effort to assess both of these dimensions of quality. The emergence of national data banks, practice standards, and accreditation programs offers additional tools for strengthening provider accountability for quality.