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The effectiveness of risk management program on pediatric nurses' medication error.

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Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat

2013-09-01

Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses' medication error rate. This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P error-reporting rate was higher (P medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses' cooperation.
Medical device risk management and its economic impact

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Katerina Krsteva Jakimovska

2013-10-01

Full Text Available The importance of medical devices in everyday users/patients lives is imensse. This is the reason why emphasis must be put on safety during their use. Satisfactory safety level can be achived by implementation of quality and risk management standards. Medical device manufacturers must learn to deal with the potential risks by using theoretical and practical examples and measures in order to protect their users/patients and themselves from suffering huge losses arising from adverse events or recall of their products. The best moment for implementation of risk management methods and analysis begins from the device design and development through manufacturing, sales and distribution. These way medical device manufacturers will succseed in protecting their users/patients from serious adverse events and at the same time protect their brand and society status, while minimizing economic losses.
[Medical safety management in the setting of a clinical reference laboratory--risk management efforts in clinical testing].

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Seki, Akira; Miya, Tetsumasa

2011-03-01

As a result of recurring medical accidents, risk management in the medical setting has been given much attention. The announcement in August, 2000 by the Ministry of Health committee for formulating a standard manual for risk management, of a "Risk management manual formulation guideline" has since been accompanied by the efforts of numerous medical testing facilities to develop such documents. In 2008, ISO/TS 22367:2008 on "Medical laboratories-Reduction of error through risk management and continual improvement" was published. However, at present, risk management within a medical testing facility stresses the implementation of provisional actions in response to a problem after it has occurred. Risk management is basically a planned process and includes "corrective actions" as well as "preventive actions." A corrective action is defined as identifying the root cause of the problem and removing it, and is conducted to prevent the problem from recurring. A preventive action is defined as identifying of the any potential problem and removing it, and is conducted to prevent a problem before it occurs. Presently, I shall report on the experiences of our laboratory regarding corrective and preventive actions taken in response to accidents and incidents, respectively.
Automated Risk Control in Medical Imaging Equipment Management Using Cloud Application

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Sally M. Ghanem

2018-01-01

Full Text Available Medical imaging equipment (MIE is the baseline of providing patient diagnosis in healthcare facilities. However, that type of equipment poses high risk for patients, operators, and environment in terms of technology and application. Considering risk management in MIE management is rarely covered in literature. The study proposes a methodology that controls risks associated with MIE management. The methodology is based on proposing a set of key performance indicators (KPIs that lead to identify a set of undesired events (UDEs, and through a risk matrix, a risk level is evaluated. By using cloud computing software, risks could be controlled to be manageable. The methodology was verified by using a data set of 204 pieces of MIE along 104 hospitals, which belong to Egyptian Ministry of Health. Results point to appropriateness of proposed KPIs and UDEs in risk evaluation and control. Thus, the study reveals that optimizing risks taking into account the costs has an impact on risk control of MIE management.
Information Risk Management: Qualitative or Quantitative? Cross industry lessons from medical and financial fields

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Upasna Saluja

2012-06-01

Full Text Available Enterprises across the world are taking a hard look at their risk management practices. A number of qualitative and quantitative models and approaches are employed by risk practitioners to keep risk under check. As a norm most organizations end up choosing the more flexible, easier to deploy and customize qualitative models of risk assessment. In practice one sees that such models often call upon the practitioners to make qualitative judgments on a relative rating scale which brings in considerable room for errors, biases and subjectivity. On the other hand under the quantitative risk analysis approach, estimation of risk is connected with application of numerical measures of some kind. Medical risk management models lend themselves as ideal candidates for deriving lessons for Information Security Risk Management. We can use this considerably developed understanding of risk management from the medical field especially Survival Analysis towards handling risks that information infrastructures face. Similarly, financial risk management discipline prides itself on perhaps the most quantifiable of models in risk management. Market Risk and Credit Risk Information Security Risk Management can make risk measurement more objective and quantitative by referring to the approach of Credit Risk. During the recent financial crisis many investors and financial institutions lost money or went bankrupt respectively, because they did not apply the basic principles of risk management. Learning from the financial crisis provides some valuable lessons for information risk management.
Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

International Nuclear Information System (INIS)

Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo

2000-01-01

This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)
Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

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Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

2000-12-01

This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)
75 FR 391 - Medical Device Quality System Regulation Educational Forum on Risk Management Through the Product...

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2010-01-05

...] Medical Device Quality System Regulation Educational Forum on Risk Management Through the Product Life... on Risk Management through the Product Life Cycle.'' This public workshop is intended to provide... discussed at the workshop: (1) Standards and guidance, (2) risk management in design, (3) risk management in...
In-hospital delirium risk assessment, diagnosis and management; medications to avoid

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Andrew Clegg

2013-03-01

Full Text Available Background: Delirium is a common, but potentially preventable complication of acute illness that is associated with important adverse outcomes including increased length of hospital admission, risk of dementia and admission to long-term care. In-hospital risk assessment and diagnosis: Age over 65, severe illness, current hip fracture and presence of cognitive impairment or dementia are important risk factors for delirium. Assess people with any of these risk factors for recent changes or fluctuations in behaviour that might indicate delirium. If any indicators are present, complete a full cognitive assessment to confirm the diagnosis of delirium. In-hospital risk management: Multicomponent delirium prevention interventions can reduce the incidence of delirium in hospital by around one third and should be provided to people with any of the important risk factors that do not have delirium at admission. A medication review that considers both the number and type of prescribed medications is an important part of the multicomponent delirium prevention intervention. Which medications to avoid in people at risk of delirium: For people at risk of delirium, avoid new prescriptions of benzodiazepines or consider reducing or stopping these medications where possible. Opioids should be prescribed with caution in people at risk of delirium but this should be tempered by the observation that untreated severe pain can itself trigger delirium. Caution is also required when prescribing dihydropyridines and antihistamine H1 antagonists for people at risk of delirium and considered individual patient assessment is advocated. Conclusion: Delirium is common, distressing to patients, relatives and carers and is associated with important adverse outcomes. Multicomponent delirium prevention interventions can reduce the incidence of delirium by approximately one third and usually incorporate a medication review. Identification of which medications to avoid in people at
Personnel Risks in Ensuring Safety of Medical Activity

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O. L. Zadvornaya

2017-01-01

Full Text Available Purpose: modern strategies of management of the organization require the formation of special management approaches based on the analysis of the mechanisms and processes of the organization of medical activities related to possible risks in activity of medical personnel. Based on international experience and own research the authors have identified features of a system of management of personnel risk in medical activities, examined approaches showing the sequence and contents of the main practical activities of the formation, maintenance and development of the system of management of personnel risks. Emphasized is the need for further research and implementation of the system of management of personnel risk in health care organizations. Study and assessment of personnel risks affecting the security of medical activities aimed at the development of the system of personnel risk management, development of a system of identification and monitoring of HR risk indicators with a purpose to improve institutional management and increase efficiency of activity of medical organizations. Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, method of statistical processing of information. Results: approaches to predict the occurrence and development of personnel risks have been reviewed and proposed. Conclusions and Relevance: patient safety is a global issue affecting countries at all levels of development. Each year, the WHO identifies a number of systemic and technical aspects and trends in the field of patient safety related to actions of medical workers. Existing imbalances in the staffing of the health system of the Russian Federation increase the probability of potential risks in medical practice. The personnel policy of healthcare of the Russian Federation requires further improvement and
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......: 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......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...
Overview of Risk Management for Engineered Nanomaterials

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Schulte, P. A.; Geraci, C. L.; Hodson, L. L.; Zumwalde, R. D.; Kuempel, E. D.; Murashov, V.; Martinez, K. F.; Heidel, D. S.

2013-04-01

Occupational exposure to engineered nanomaterials (ENMs) is considered a new and challenging occurrence. Preliminary information from laboratory studies indicates that workers exposed to some kinds of ENMs could be at risk of adverse health effects. To protect the nanomaterial workforce, a precautionary risk management approach is warranted and given the newness of ENMs and emergence of nanotechnology, a naturalistic view of risk management is useful. Employers have the primary responsibility for providing a safe and healthy workplace. This is achieved by identifying and managing risks which include recognition of hazards, assessing exposures, characterizing actual risk, and implementing measures to control those risks. Following traditional risk management models for nanomaterials is challenging because of uncertainties about the nature of hazards, issues in exposure assessment, questions about appropriate control methods, and lack of occupational exposure limits (OELs) or nano-specific regulations. In the absence of OELs specific for nanomaterials, a precautionary approach has been recommended in many countries. The precautionary approach entails minimizing exposures by using engineering controls and personal protective equipment (PPE). Generally, risk management utilizes the hierarchy of controls. Ideally, risk management for nanomaterials should be part of an enterprise-wide risk management program or system and this should include both risk control and a medical surveillance program that assesses the frequency of adverse effects among groups of workers exposed to nanomaterials. In some cases, the medical surveillance could include medical screening of individual workers to detect early signs of work-related illnesses. All medical surveillance should be used to assess the effectiveness of risk management; however, medical surveillance should be considered as a second line of defense to ensure that implemented risk management practices are effective.
Overview of Risk Management for Engineered Nanomaterials

International Nuclear Information System (INIS)

Schulte, P A; Geraci, C L; Hodson, L L; Zumwalde, R D; Kuempel, E D; Murashov, V; Martinez, K F; Heidel, D S

2013-01-01

Occupational exposure to engineered nanomaterials (ENMs) is considered a new and challenging occurrence. Preliminary information from laboratory studies indicates that workers exposed to some kinds of ENMs could be at risk of adverse health effects. To protect the nanomaterial workforce, a precautionary risk management approach is warranted and given the newness of ENMs and emergence of nanotechnology, a naturalistic view of risk management is useful. Employers have the primary responsibility for providing a safe and healthy workplace. This is achieved by identifying and managing risks which include recognition of hazards, assessing exposures, characterizing actual risk, and implementing measures to control those risks. Following traditional risk management models for nanomaterials is challenging because of uncertainties about the nature of hazards, issues in exposure assessment, questions about appropriate control methods, and lack of occupational exposure limits (OELs) or nano-specific regulations. In the absence of OELs specific for nanomaterials, a precautionary approach has been recommended in many countries. The precautionary approach entails minimizing exposures by using engineering controls and personal protective equipment (PPE). Generally, risk management utilizes the hierarchy of controls. Ideally, risk management for nanomaterials should be part of an enterprise-wide risk management program or system and this should include both risk control and a medical surveillance program that assesses the frequency of adverse effects among groups of workers exposed to nanomaterials. In some cases, the medical surveillance could include medical screening of individual workers to detect early signs of work-related illnesses. All medical surveillance should be used to assess the effectiveness of risk management; however, medical surveillance should be considered as a second line of defense to ensure that implemented risk management practices are effective.
Identifying and managing the risks of medical ionizing radiation in endourology.

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Yecies, Todd; Averch, Timothy D; Semins, Michelle J

2018-02-01

The risks of exposure to medical ionizing radiation is of increasing concern both among medical professionals and the general public. Patients with nephrolithiasis are exposed to high levels of ionizing radiation through both diagnostic and therapeutic modalities. Endourologists who perform a high-volume of fluoroscopy guided procedures are also exposed to significant quantities of ionizing radiation. The combination of judicious use of radiation-based imaging modalities, application of new imaging techniques such as ultra-low dose computed tomography (CT) scan, and modifying use of current technology such as increasing ultrasound and pulsed fluoroscopy utilization offers the possibility of significantly reducing radiation exposure. We present a review of the literature regarding the risks of medical ionizing radiation to patients and surgeons as it pertains to the field of endourology and interventions that can be performed to limit this exposure. A review of the current state of the literature was performed using MEDLINE and PubMed. Interventions designed to limit patient and surgeon radiation exposure were identified and analyzed. Summaries of the data were compiled and synthesized in the body of the text. While no level 1 evidence exists demonstrating the risk of secondary malignancy with radiation exposure, the preponderance of evidence suggests a dose and age dependent increase in malignancy risk from ionizing radiation. Patients with nephrolithiasis were exposed to an average effective dose of 37mSv over a 2 year period. Multiple evidence-based interventions to limit patient and surgeon radiation exposure and associated risk were identified. Current evidence suggest an age and dose dependent risk of secondary malignancy from ionizing radiation. Urologists must act in accordance with ALARA principles to safely manage nephrolithiasis while minimizing radiation exposure.
Risk management in medical product development process using traditional FMEA and fuzzy linguistic approach: a case study

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Kirkire, Milind Shrikant; Rane, Santosh B.; Jadhav, Jagdish Rajaram

2015-12-01

Medical product development (MPD) process is highly multidisciplinary in nature, which increases the complexity and the associated risks. Managing the risks during MPD process is very crucial. The objective of this research is to explore risks during MPD in a dental product manufacturing company and propose a model for risk mitigation during MPD process to minimize failure events. A case study approach is employed. The existing MPD process is mapped with five phases of the customized phase gate process. The activities during each phase of development and risks associated with each activity are identified and categorized based on the source of occurrence. The risks are analyzed using traditional Failure mode and effect analysis (FMEA) and fuzzy FMEA. The results of two methods when compared show that fuzzy approach avoids the duplication of RPNs and helps more to convert cognition of experts into information to get values of risk factors. The critical, moderate, low level and negligible risks are identified based on criticality; risk treatments and mitigation model are proposed. During initial phases of MPD, the risks are less severe, but as the process progresses the severity of risks goes on increasing. The MPD process should be critically designed and simulated to minimize the number of risk events and their severity. To successfully develop the products/devices within the manufacturing companies, the process risk management is very essential. A systematic approach to manage risks during MPD process will lead to the development of medical products with expected quality and reliability. This is the first research of its kind having focus on MPD process risks and its management. The methodology adopted in this paper will help the developers, managers and researchers to have a competitive edge over the other companies by managing the risks during the development process.
Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

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Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

2011-01-01

The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.
Urolithiasis: evaluation, dietary factors, and medical management

DEFF Research Database (Denmark)

Jung, Helene; Andonian, Sero; Assimos, Dean

2017-01-01

PURPOSE: The aim of this review was to provide current best evidence for evaluation, dietary, and medical management of patients with urolithiasis. METHODS: Literature addressing evaluation, dietary, and medical management of urolithiasis was searched. Papers were analyzed and rated according...... the life of stone-forming individuals very differently, and that evaluation and medical management should be personalized according to risk of recurrence, severity of stone disease, presence of associated medical conditions, and patient's motivation. With regard to evaluation, dietary and medical...... management of patients with urolithiasis evidence from the literature suggest that selective metabolic evaluation may lead to rational dietary and medical management. Statements based on LOE and GOR are provided to guide clinical practice. CONCLUSION: The provided evidence for evaluation of patients...
Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

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Serxner, Seth; Alberti, Angela; Weinberger, Sarah

2012-01-01

To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n = 49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.
Assessment of Medical Risks and Optimization of their Management using Integrated Medical Model

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Fitts, Mary A.; Madurai, Siram; Butler, Doug; Kerstman, Eric; Risin, Diana

2008-01-01

The Integrated Medical Model (IMM) Project is a software-based technique that will identify and quantify the medical needs and health risks of exploration crew members during space flight and evaluate the effectiveness of potential mitigation strategies. The IMM Project employs an evidence-based approach that will quantify probability and consequences of defined in-flight medical risks, mitigation strategies, and tactics to optimize crew member health. Using stochastic techniques, the IMM will ultimately inform decision makers at both programmatic and institutional levels and will enable objective assessment of crew health and optimization of mission success using data from relevant cohort populations and from the astronaut population. The objectives of the project include: 1) identification and documentation of conditions that may occur during exploration missions (Baseline Medical Conditions List [BMCL), 2) assessment of the likelihood of conditions in the BMCL occurring during exploration missions (incidence rate), 3) determination of the risk associated with these conditions and quantify in terms of end states (Loss of Crew, Loss of Mission, Evacuation), 4) optimization of in-flight hardware mass, volume, power, bandwidth and cost for a given level of risk or uncertainty, and .. validation of the methodologies used.
Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

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Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

2017-03-01

Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality assurance in military medical research and medical radiation accident management.

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Hotz, Mark E; Meineke, Viktor

2012-08-01

The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within
Risk evaluation mitigation strategies: the evolution of risk management policy.

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Hollingsworth, Kristen; Toscani, Michael

2013-04-01

The United States Food and Drug Administration (FDA) has the primary regulatory responsibility to ensure that medications are safe and effective both prior to drug approval and while the medication is being actively marketed by manufacturers. The responsibility for safe medications prior to marketing was signed into law in 1938 under the Federal Food, Drug, and Cosmetic Act; however, a significant risk management evolution has taken place since 1938. Additional federal rules, entitled the Food and Drug Administration Amendments Act, were established in 2007 and extended the government's oversight through the addition of a Risk Evaluation and Mitigation Strategy (REMS) for certain drugs. REMS is a mandated strategy to manage a known or potentially serious risk associated with a medication or biological product. Reasons for this extension of oversight were driven primarily by the FDA's movement to ensure that patients and providers are better informed of drug therapies and their specific benefits and risks prior to initiation. This article provides an historical perspective of the evolution of medication risk management policy and includes a review of REMS programs, an assessment of the positive and negative aspects of REMS, and provides suggestions for planning and measuring outcomes. In particular, this publication presents an overview of the evolution of the REMS program and its implications.
[Design and application of implantable medical device information management system].

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Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

2013-03-01

Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.
Trust and risk: a model for medical education.

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Damodaran, Arvin; Shulruf, Boaz; Jones, Philip

2017-09-01

Health care delivery, and therefore medical education, is an inherently risky business. Although control mechanisms, such as external audit and accreditation, are designed to manage risk in clinical settings, another approach is 'trust'. The use of entrustable professional activities (EPAs) represents a deliberate way in which this is operationalised as a workplace-based assessment. Once engaged with the concept, clinical teachers and medical educators may have further questions about trust. This narrative overview of the trust literature explores how risk, trust and control intersect with current thinking in medical education, and makes suggestions for potential directions of enquiry. Beyond EPAs, the importance of trust in health care and medical education is reviewed, followed by a brief history of trust research in the wider literature. Interpersonal and organisational levels of trust and a model of trust from the management literature are used to provide the framework with which to decipher trust decisions in health care and medical education, in which risk and vulnerability are inherent. In workplace learning and assessment, the language of 'trust' may offer a more authentic and practical vocabulary than that of 'competency' because clinical and professional risks are explicitly considered. There are many other trust relationships in health care and medical education. At the most basic level, it is helpful to clearly delineate who is the trustor, the trustee, and for what task. Each relationship has interpersonal and organisational elements. Understanding and considered utilisation of trust and control mechanisms in health care and medical education may lead to systems that maturely manage risk while actively encouraging trust and empowerment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

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Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

2010-01-01

The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383
[A systemic risk analysis of hospital management processes by medical employees--an effective basis for improving patient safety].

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Sobottka, Stephan B; Eberlein-Gonska, Maria; Schackert, Gabriele; Töpfer, Armin

2009-01-01

Due to the knowledge gap that exists between patients and health care staff the quality of medical treatment usually cannot be assessed securely by patients. For an optimization of safety in treatment-related processes of medical care, the medical staff needs to be actively involved in preventive and proactive quality management. Using voluntary, confidential and non-punitive systematic employee surveys, vulnerable topics and areas in patient care revealing preventable risks can be identified at an early stage. Preventive measures to continuously optimize treatment quality can be defined by creating a risk portfolio and a priority list of vulnerable topics. Whereas critical incident reporting systems are suitable for continuous risk assessment by detecting safety-relevant single events, employee surveys permit to conduct a systematic risk analysis of all treatment-related processes of patient care at any given point in time.
Information and communication on risks related to medications and proper use of medications for healthcare professionals and the general public: precautionary principle, risk management, communication during and in the absence of crisis situations.

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Molimard, Mathieu; Bernaud, Corine; Lechat, Philippe; Bejan-Angoulvant, Theodora; Benattia, Cherif; Benkritly, Amel; Braunstein, David; Cabut, Sandrine; David, Nadine; Fourrier-Réglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Véronique; Le Jeunne, Claire; Leurs, Irina; Liard, François; Malbezin, Muriel; Micallef, Joelle; Nguon, Marina

2014-01-01

Recent drug crises have highlighted the complexity, benefits and risks of medication communication. The difficulty of this communication is due to the diversity of the sources of information and the target audience, the credibility of spokespersons, the difficulty to communicate on scientific uncertainties and the precautionary principle, which is influenced by variable perceptions and tolerances of the risk. Globally, there is a lack of training in risk management with a tendency of modern society to refuse even the slightest risk. Communication on medications is subject to regulatory or legal requirements, often uses tools and messages that are not adapted to the target audience and is often based on a poor knowledge of communication techniques. In order to improve this situation, the available information must be coordinated by reinforcing the unique medication information website and by coordinating communication between authorities by means of a single spokesperson. A particular effort must be made in the field of training in the proper use and risk of medications for both the general population and patients but also for healthcare professionals, by setting up a unified academic on-line teaching platform for continuing medical education on medications and their proper use. © 2014 Société Française de Pharmacologie et de Thérapeutique.
[The relevance of clinical risk management].

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Gulino, Matteo; Vergallo, Gianluca Montanari; Frati, Paola

2011-01-01

Medical activity includes a risk of possible injury or complications for the patients, that should drive the Health Care Institutions to introduce and/ or improve clinical Risk management instruments. Although Italy is still lacking a National project of Clinical Risk Management, a number of efforts have been made by different Italian Regions to introduce instruments of risk management. In addition, most of National Health Care Institutions include actually a Department specifically in charge to manage the clinical risk. Despite the practical difficulties, the results obtained until now suggest that the risk management may represent a useful instrument to contribute to the reduction of errors in clinical conduct. Indeed, the introduction of adequate instruments of prevention and management of clinical risk may help to ameliorate the quality of health care Institution services.
Nurses Knowledge Regarding Risk Factors And Management Of Stroke At Rajshahi Medical College Hospital Bangladesh

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Nahid Uz Zaman

2015-08-01

Full Text Available The study was carried out with a view to assess the nurses knowledge regarding the risk factors and management of stroke following a cross type descriptive study. Nurses having academic qualification were S.S.C 32 and H.S.C 68. Nurses having professional qualification were Diploma in Nursing amp Midwifery 50 because this degree was compulsory and basic for all. During the data collection there were also 42 B.Sc. in Nursing and 8 MPHM.Sc. among those respondents. Length of Service of the respondents nurses were 6 1 to 10 years followed by 24 58 amp 12 were in the 11 to 20 years 21 to 30 years and 31 to 40 years. The Nurses were given correct answer about 74 knowledge regarding stroke 50 types of stroke 82 controllable risk factor of stroke 76 uncontrollable risk factor of stroke 85 positioning needed for patients and 86 management of stroke. Considering the above discussion it was obviously clear that the Senior Staff Nurses SSN were much conscious regarding the risk factors and management of stroke working at Rajshahi Medical College Hospital RMCH.
Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

Science.gov (United States)

Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

2009-12-01

The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.
Medication adherence, comorbidities, and health risk impacts on workforce absence and job performance.

Science.gov (United States)

Loeppke, Ronald; Haufle, Vince; Jinnett, Kim; Parry, Thomas; Zhu, Jianping; Hymel, Pamela; Konicki, Doris

2011-06-01

To understand impacts of medication adherence, comorbidities, and health risks on workforce absence and job performance. Retrospective observational study using employees' medical/pharmacy claims and self-reported health risk appraisals. Statin medication adherence in individuals with Coronary Artery Disease was significant predictor (P absenteeism. Insulin, oral hypoglycemic, or metformin medication adherence in type 2 diabetics was significant (P performance. Number of comorbidities was found as significant (P absenteeism in five of nine subsamples. Significant links (P performance were found across all nine subsamples. Results suggest integrated health and productivity management strategies should include an emphasis on primary and secondary prevention to reduce health risks in addition to tertiary prevention efforts of disease management and medication management.
Controlling Legal Risk for Effective Hospital Management

Directory of Open Access Journals (Sweden)

Hyun Jun Park

2016-04-01

Full Text Available Purpose: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. Materials and Methods: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Results: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%. The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years, and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months. Conclusions: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.
Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

Science.gov (United States)

2014-01-01

Background The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. Discussion The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. Summary In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor. PMID:25023339
Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics.

Science.gov (United States)

Turillazzi, Emanuela; Neri, Margherita

2014-07-15

The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor's own, and the other's (the patient's) dignity and liberty; on the other is the physician's developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor.
Impact of cardiovascular risk factors on medical expenditure: evidence from epidemiological studies analysing data on health checkups and medical insurance.

Science.gov (United States)

Nakamura, Koshi

2014-01-01

Concerns have increasingly been raised about the medical economic burden in Japan, of which approximately 20% is attributable to cardiovascular disease, including coronary heart disease and stroke. Because the management of risk factors is essential for the prevention of cardiovascular disease, it is important to understand the relationship between cardiovascular risk factors and medical expenditure in the Japanese population. However, only a few Japanese epidemiological studies analysing data on health checkups and medical insurance have provided evidence on this topic. Patients with cardiovascular risk factors, including obesity, hypertension, and diabetes, may incur medical expenditures through treatment of the risk factors themselves and through procedures for associated diseases that usually require hospitalization and sometimes result in death. Untreated risk factors may cause medical expenditure surges, mainly due to long-term hospitalization, more often than risk factors preventively treated by medication. On an individual patient level, medical expenditures increase with the number of concomitant cardiovascular risk factors. For single risk factors, personal medical expenditure may increase with the severity of that factor. However, on a population level, the medical economic burden attributable to cardiovascular risk factors results largely from a single, particularly prevalent risk factor, especially from mildly-to-moderately abnormal levels of the factor. Therefore, cardiovascular risk factors require management on the basis of both a cost-effective strategy of treating high-risk patients and a population strategy for reducing both the ill health and medical economic burdens that result from cardiovascular disease.
Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

Science.gov (United States)

Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja

2018-03-16

The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources
Nuclear risk: information of medical practitioners in Isere Department. Impact of the booklet: 'doctors and nuclear risk'

International Nuclear Information System (INIS)

Jonquet, M.E.

1990-02-01

In this thesis, the author first presents 'Isere, pilot department' operation, then the importance of nuclear risks in Isere, considers the role and place of medical practitioners in the management of this risk and in information request of medical personnel. The author also presents the booklet 'Doctors and nuclear risk' and analyzes the results of study on its impact close to medical population. 9 tabs., 25 figs
How to manage a claim for medical and technical error

International Nuclear Information System (INIS)

Nguyen, T.D.

2012-01-01

Purpose. - The fast modifications in French medical legislation, the increasing number of litigations and the professional consequences for the practitioner warrant the necessity to recall the 'how to manage' a claim for medical error. Patients and methods. - Four cases of legal action against oncologists are presented. Results and discussion. - The importance of quality and traceability of the given information, the essential pieces of the medical file, the description of the different process steps and of the contradictory meeting are presented and discussed. Conclusion. - Beyond the control of medical and technical risks, the practitioners in general and the radiation oncologist in particular should learn on the daily management of the risk related to medical claim. (authors)
Making Management Skills a Core Component of Medical Education.

Science.gov (United States)

Myers, Christopher G; Pronovost, Peter J

2017-05-01

Physicians are being called upon to engage in greater leadership and management in increasingly complex and dynamic health care organizations. Yet, management skills are largely undeveloped in medical education. Without formal management training in the medical curriculum, physicians are left to cultivate their leadership and management abilities through a haphazard array of training programs or simply through trial and error, with consequences that may range from frustration among staff to reduced quality of care and increased risk of patient harm. To address this issue, the authors posit that medical education needs a more systematic focus on topics related to management and organization, such as individual decision making, interpersonal communication, team knowledge sharing, and organizational culture. They encourage medical schools to partner with business school faculty or other organizational scholars to offer a "Management 101" course in the medical curriculum to provide physicians-in-training with an understanding of these topics and raise the quality of physician leadership and management in modern health care organizations.
Unnatural birth? : medical pain management technology and the naturalness of birth

OpenAIRE

Gihle, Marte

2008-01-01

The aim of this thesis is to explore how medical pain management technology affects the concept of natural birth.The relationship between medical pain management technology and natural birth is discussed in a structural framework in which medicalization, risk, and identity are acknowledged as important issues within the current childbirth paradigm. The analysis is based on thirteen in-depth interviews with Norwegian midwives and mothers on their perceptions of medical pain management technolo...

Telephone Care Management of Fall Risk:: A Feasibility Study.

Science.gov (United States)

Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

2017-03-01

Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Medical Management

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... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...
Medical equipment management

CERN Document Server

Willson, Keith; Tabakov, Slavik

2013-01-01

Know What to Expect When Managing Medical Equipment and Healthcare Technology in Your Organization As medical technology in clinical care becomes more complex, clinical professionals and support staff must know how to keep patients safe and equipment working in the clinical environment. Accessible to all healthcare professionals and managers, Medical Equipment Management presents an integrated approach to managing medical equipment in healthcare organizations. The book explains the underlying principles and requirements and raises awareness of what needs to be done and what questions to ask. I
Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.
The Modified Risk Factors of Health Heads of the Medical Organizations

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O. L. Zadvornaya

2017-01-01

Full Text Available Purpose: study and evaluation of modifiable potential risk factors of health of heads of medical organizations in terms of structural and technological modernization of the health system, the growing need for highly qualified management personnel. Efficiency of activity of medical associations largely due to the level of health managers, allowing to solve problems of activities of medical organizations in the modern fastchanging environmental conditions. Based on international experience and our own research the authors identified features of the state of health of heads of medical organizations, and the degree of exposure to risk factors for no communicable diseases; considered approaches to assess motivation and psychological readiness to promote the health and potential of managerial personnel in the formation of health-saving behavior. Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, and method of statistical processing of information. Results: reviewed and proposed approaches to use preventive measures prevention of risk factors of non-communicable diseases healthcare leaders, forming health-preserving behavior. Conclusions and Relevance: in modern scientific studies on the health of medical workers, including heads of medical institutions, defined the modern methodological approaches to formation of health-saving behavior and maintaining healthy lifestyle health care workers. Despite the high awareness of heads of medical organizations in the area of influence of risk factors on health, accessibility of medical care for the diagnosis and correction of risk factors of chronic no communicable diseases, risk factors of health among healthcare leaders have sufficient prevalence. Health-promoting behavior model is not a conscious lifestyle leader and formed as a reaction if you have
ASSESSMENT OF MEDICAL WASTE MANAGEMENT IN EDUCATIONAL HOSPITALS OF TEHRAN UNIVERSITY MEDICAL SCIENCES

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M. H. Dehghani, K. Azam, F. Changani, E. Dehghani Fard

2008-04-01

Full Text Available The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past, medical waste was often mixed with municipal solid waste and disposed in residential waste landfills or improper treatment facilities in Iran. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better managing the wastes from healthcare facilities. This study was carried in 12 educational hospitals of Tehran University of Medical Sciences. The goals of this study were to characterize solid wastes generated in healthcare hospitals, to report the current status of medical waste management and to provide a framework for the safe management of these wastes at the considered hospitals. The methodology was descriptive, cross-sectional and consisted of the use of surveys and interviews with the authorities of the healthcare facilities and with personnel involved in the management of the wastes. The results showed that medical wastes generated in hospitals were extremely heterogeneous in composition. 42% of wastes were collected in containers and plastic bags. In 75% of hospitals, the stay-time in storage sites was about 12-24h. 92% of medical wastes of hospitals were collected by covered-trucks. In 46% of hospitals, transferring of medical wastes to temporary stations was done manually. The average of waste generation rates in the hospitals was estimated to be 4.42kg/bed/day.
Risks in hospitals. Assessment and Management

Directory of Open Access Journals (Sweden)

Bradea Ioana-Alexandra

2014-12-01

Full Text Available In a complex world, characterized by a multitude of risks, managers need to manage the risks they encounter, in an efficient way and in the shortest time possible. In the current economic crisis, the concept of hospital risk management, as the process in which is identified, analyzed, reduced, or avoided a risk that may affect the hospital, gained great importance. The Romanian health system, distinguished by: lack of transparency, poor funding, the loss of the valuable medical staff, lack of hospitals in villages and small towns, inability to engage patients due to the old and poor equipment, lack of research and problems in information privacy and cyber-security, requires an appropriate management, enabling risk managers to take decisions in order to avoid the occurrence of risks. Important for the functioning of every hospital is the perception of patients and their degree of satisfaction, regarding the quality of services, which depend largely on the quality of human resources. But what are the human resources weaknesses and risks from the patient point of view? What are the risk indicators which must be monitored to avoid risks? And also, which is the most useful method for measurement and assessment of risk?
MANAGEMENT OF MEDICAL SERVICES

Directory of Open Access Journals (Sweden)

BARBU MARIA-MAGDALENA

2009-05-01

Full Text Available The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the
Managed medical education?

Science.gov (United States)

Hafferty, F W

1999-09-01

The forces of rationality and commodification, hallmarks of the managed care revolution, may soon breach the walls of organized medical education. Whispers are beginning to circulate that the cost of educating future physicians is too high. Simultaneously, managed care companies are accusing medical education of turning out trainees unprepared to practice in a managed care environment. Changes evident in other occupational and service delivery sectors of U.S. society as diverse as pre-college education and prisons provide telling insights into what may be in store for medical educators. Returning to academic medicine, the author reflects that because corporate managed care is already established in teaching hospitals, and because managed research (e.g., corporate-sponsored and -run drug trials, for-profit drug-study centers, and contract research organizations) is increasing, managed medical education could become a reality as well. Medical education has made itself vulnerable to the intrusion of corporate rationalizers because it has failed to professionalism at core of its curricula-something only it is able to do--and instead has focused unduly on the transmission of esoteric knowledge and core clinical skills, a process that can be carried out more efficiently, more effectively, and less expensively by other players in the medical education marketplace such as Kaplan, Compass, or the Princeton Review. The author explains why reorganizing medical education around professional values is crucial, why the AAMC's Medical School Objectives Project offers guidance in this area, why making this change will be difficult, and why medical education must lead in establishing how to document the presence and absence of such qualities as altruism and dutifulness and the ways that appropriate medical education can foster these and similar core competencies. "Anything less and organized medicine will acknowledged... that it has abandoned its social contract and entered the
Case histories in pharmaceutical risk management.

Science.gov (United States)

McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

2009-12-01

The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS).
WE-B-BRC-03: Risk in the Context of Medical Imaging

Energy Technology Data Exchange (ETDEWEB)

Samei, E. [Duke University Medical Center (United States)

2016-06-15

Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. We therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology
WE-B-BRC-03: Risk in the Context of Medical Imaging

International Nuclear Information System (INIS)

Samei, E.

2016-01-01

Prospective quality management techniques, long used by engineering and industry, have become a growing aspect of efforts to improve quality management and safety in healthcare. These techniques are of particular interest to medical physics as scope and complexity of clinical practice continue to grow, thus making the prescriptive methods we have used harder to apply and potentially less effective for our interconnected and highly complex healthcare enterprise, especially in imaging and radiation oncology. An essential part of most prospective methods is the need to assess the various risks associated with problems, failures, errors, and design flaws in our systems. We therefore begin with an overview of risk assessment methodologies used in healthcare and industry and discuss their strengths and weaknesses. The rationale for use of process mapping, failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by TG-100 will be described, as well as suggestions for the way forward. This is followed by discussion of radiation oncology specific risk assessment strategies and issues, including the TG-100 effort to evaluate IMRT and other ways to think about risk in the context of radiotherapy. Incident learning systems, local as well as the ASTRO/AAPM ROILS system, can also be useful in the risk assessment process. Finally, risk in the context of medical imaging will be discussed. Radiation (and other) safety considerations, as well as lack of quality and certainty all contribute to the potential risks associated with suboptimal imaging. The goal of this session is to summarize a wide variety of risk analysis methods and issues to give the medical physicist access to tools which can better define risks (and their importance) which we work to mitigate with both prescriptive and prospective risk-based quality management methods. Learning Objectives: Description of risk assessment methodologies used in healthcare and industry Discussion of radiation oncology
Framing risks and benefits of medical tourism: a content analysis of medical tourism coverage in Korean American community newspapers.

Science.gov (United States)

Jun, Jungmi; Oh, Kyeung Mi

2015-01-01

This study examines Korean American community newspapers' representation of risks and benefits involved with medical tourism offered in Korea. Using framing theory, this research attempts to explain Korean Americans' highly positive perceptions and high willingness to use health and medical services in Korea through medical tourism rather than using such services in the United States. The result of content analyses indicated that Korean American community newspapers are rarely engaged in risk communication and lack sufficient information about potential risks of medical tourism while emphasizing diverse benefits. Korean ethnic media, as the primary source of health communication for Korean Americans, should provide more reliable health and medical information for the population's appropriate health management.
Polymyositis: Medical Management

Science.gov (United States)

... Donate Search MDA.org Close Polymyositis (PM) Medical Management Polymyositis (PM) is a highly treatable disease. Some ... PM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research Find your MDA Care Center Grants at ...
Improving ICU risk management and patient safety.

Science.gov (United States)

Kielty, Lucy Ann

2017-06-12

Purpose The purpose of this paper is to describe a study which aimed to develop and validate an assessment method for the International Electrotechnical Commission (IEC) 80001-1 (IEC, 2010) standard (the Standard); raise awareness; improve medical IT-network project risk management processes; and improve intensive care unit patient safety. Design/methodology/approach An assessment method was developed and piloted. A healthcare IT-network project assessment was undertaken using a semi-structured group interview with risk management stakeholders. Participants provided feedback via a questionnaire. Descriptive statistics and thematic analysis was undertaken. Findings The assessment method was validated as fit for purpose. Participants agreed (63 per cent, n=7) that assessment questions were clear and easy to understand, and participants agreed (82 per cent, n=9) that the assessment method was appropriate. Participant's knowledge of the Standard increased and non-compliance was identified. Medical IT-network project strengths, weaknesses, opportunities and threats in the risk management processes were identified. Practical implications The study raised awareness of the Standard and enhanced risk management processes that led to improved patient safety. Study participants confirmed they would use the assessment method in future projects. Originality/value Findings add to knowledge relating to IEC 80001-1 implementation.
Risk management in technovigilance: construction and validation of a medical-hospital product evaluation instrument.

Science.gov (United States)

Kuwabara, Cleuza Catsue Takeda; Evora, Yolanda Dora Martinez; de Oliveira, Márcio Mattos Borges

2010-01-01

With the continuous incorporation of health technologies, hospital risk management should be implemented to systemize the monitoring of adverse effects, performing actions to control and eliminate their damage. As part of these actions, Technovigilance is active in the procedures of acquisition, use and quality control of health products and equipment. This study aimed to construct and validate an instrument to evaluate medical-hospital products. This is a quantitative, exploratory, longitudinal and methodological development study, based on the Six Sigma quality management model, which has as its principle basis the component stages of the DMAIC Cycle. For data collection and content validation, the Delphi technique was used with professionals from the Brazilian Sentinel Hospital Network. It was concluded that the instrument developed permitted the evaluation of the product, differentiating between the results of the tested brands, in line with the initial study goal of qualifying the evaluations performed.
A modified portfolio diet complements medical management to reduce cardiovascular risk factors in diabetic patients with coronary artery disease.

Science.gov (United States)

Keith, Mary; Kuliszewski, Michael A; Liao, Christine; Peeva, Valentina; Ahmed, Mavra; Tran, Susan; Sorokin, Kevin; Jenkins, David J; Errett, Lee; Leong-Poi, Howard

2015-06-01

Secondary prevention can improve outcomes in high risk patients. This study investigated the magnitude of cardiovascular risk reduction associated with consumption of a modified portfolio diet in parallel with medical management. 30 patients with type II diabetes, 6 weeks post bypass surgery received dietary counseling on a Modified Portfolio Diet (MPD) (low fat, 8 g/1000 kcal viscous fibres, 17 g/1000 kcal soy protein and 22 g/1000 kcal almonds). Lipid profiles, endothelial function and markers of glycemic control, oxidative stress and inflammation were measured at baseline and following two and four weeks of intervention. Seven patients with no diet therapy served as time controls. Consumption of the MPD resulted in a 19% relative reduction in LDL (1.9 ± 0.8 vs 1.6 ± 0.6 mmol/L, p managed, high risk patients resulted in important reductions in risk factors. Clinical Trials registry number NCT00462436. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Risk of arrhythmia induced by psychotropic medications

DEFF Research Database (Denmark)

Fanoe, Søren; Kristensen, Diana; Fink-Jensen, Anders

2014-01-01

with psychotropic medications. The algorithm integrates the risk categories of the individual drugs and pre-disposing risk factors and suggests a prudent follow-up for patients with an increased risk. We believe this clinically manageable guideline might improve safety in the many and rapidly increasing number...... of the major mental disorders are associated with a large risk of suicide if untreated. The observed risk of malignant arrhythmia associated with treatment with psychotropic drugs calls for clinical guidelines integrating the risk of the individual drug and other potentially interacting risk factors......Several drugs used in the treatment of mental diseases are associated with an increased risk of sudden cardiac death (SCD). A general cause-relationship between the intake of these drugs and SCD is unattainable, but numerous case reports of drug-induced malignant arrhythmia and epidemiological...
Medical wastes management in the south of Brazil

International Nuclear Information System (INIS)

Silva, C.E. da; Hoppe, A.E.; Ravanello, M.M.; Mello, N.

2005-01-01

In developing countries, solid wastes have not received sufficient attention. In many countries, hazardous and medical wastes are still handled and disposed together with domestic wastes, thus creating a great health risk to municipal workers, the public and the environment. Medical waste management has been evaluated at the Vacacai river basin in the State of Rio Grande do Sul, Brazil. A total of 91 healthcare facilities, including hospitals (21), health centers (48) and clinical laboratories (22) were surveyed to provide information about the management, segregation, generation, storage and disposal of medical wastes. The results about management aspects indicate that practices in most healthcare facilities do not comply with the principles stated in Brazilian legislation. All facilities demonstrated a priority on segregation of infectious-biological wastes. Average generation rates of total and infectious-biological wastes in the hospitals were estimated to be 3.245 and 0.570 kg/bed-day, respectively
Risk Information Management Resource (RIMR): modeling an approach to defending against military medical information assurance brain drain

Science.gov (United States)

Wright, Willie E.

2003-05-01

As Military Medical Information Assurance organizations face off with modern pressures to downsize and outsource, they battle with losing knowledgeable people who leave and take with them what they know. This knowledge is increasingly being recognized as an important resource and organizations are now taking steps to manage it. In addition, as the pressures for globalization (Castells, 1998) increase, collaboration and cooperation are becoming more distributed and international. Knowledge sharing in a distributed international environment is becoming an essential part of Knowledge Management. This is a major shortfall in the current approach to capturing and sharing knowledge in Military Medical Information Assurance. This paper addresses this challenge by exploring Risk Information Management Resource (RIMR) as a tool for sharing knowledge using the concept of Communities of Practice. RIMR is based no the framework of sharing and using knowledge. This concept is done through three major components - people, process and technology. The people aspect enables remote collaboration, support communities of practice, reward and recognize knowledge sharing while encouraging storytelling. The process aspect enhances knowledge capture and manages information. While the technology aspect enhance system integration and data mining, it also utilizes intelligent agents and exploits expert systems. These coupled with supporting activities of education and training, technology infrastructure and information security enables effective information assurance collaboration.

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
[Legal and methodical aspects of occupational risk management].

Science.gov (United States)

2011-01-01

Legal and methodical aspects of occupational risk management (ORM) are considered with account of new official documents. Introduction of risk and risk management notions into Labor Code reflects the change of forms of occupational health and safety. The role of hygienist and occupational medicine professionals in workplace conditions certification (WCC) and periodical medical examinations (PME) is strengthened. The ORM could be improved by introducing the block of prognosis and causation based on IT-technologies that could match systems of WCC and PME thus improving the effectiveness of prophylactics.
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.
Medication knowledge, certainty, and risk of errors in health care: a cross-sectional study

Directory of Open Access Journals (Sweden)

Johansson Inger

2011-07-01

Full Text Available Abstract Background Medication errors are often involved in reported adverse events. Drug therapy, prescribed by physicians, is mostly carried out by nurses, who are expected to master all aspects of medication. Research has revealed the need for improved knowledge in drug dose calculation, and medication knowledge as a whole is poorly investigated. The purpose of this survey was to study registered nurses' medication knowledge, certainty and estimated risk of errors, and to explore factors associated with good results. Methods Nurses from hospitals and primary health care establishments were invited to carry out a multiple-choice test in pharmacology, drug management and drug dose calculations (score range 0-14. Self-estimated certainty in each answer was recorded, graded from 0 = very uncertain to 3 = very certain. Background characteristics and sense of coping were recorded. Risk of error was estimated by combining knowledge and certainty scores. The results are presented as mean (±SD. Results Two-hundred and three registered nurses participated (including 16 males, aged 42.0 (9.3 years with a working experience of 12.4 (9.2 years. Knowledge scores in pharmacology, drug management and drug dose calculations were 10.3 (1.6, 7.5 (1.6, and 11.2 (2.0, respectively, and certainty scores were 1.8 (0.4, 1.9 (0.5, and 2.0 (0.6, respectively. Fifteen percent of the total answers showed a high risk of error, with 25% in drug management. Independent factors associated with high medication knowledge were working in hospitals (p Conclusions Medication knowledge was found to be unsatisfactory among practicing nurses, with a significant risk for medication errors. The study revealed a need to improve the nurses' basic knowledge, especially when referring to drug management.
Risk management

OpenAIRE

Mcmanus, John

2009-01-01

Few projects are completed on time, on budget, and to their original requirement or specifications. Focusing on what project managers need to know about risk in the pursuit of delivering projects, Risk Management covers key components of the risk management process and the software development process, as well as best practices for risk identification, risk planning, and risk analysis. The book examines risk planning, risk analysis responses to risk, the tracking and modelling of risks, intel...
[What Surgeons Should Know about Risk Management].

Science.gov (United States)

Strametz, R; Tannheimer, M; Rall, M

2017-02-01

Background: The fact that medical treatment is associated with errors has long been recognized. Based on the principle of "first do no harm", numerous efforts have since been made to prevent such errors or limit their impact. However, recent statistics show that these measures do not sufficiently prevent grave mistakes with serious consequences. Preventable mistakes such as wrong patient or wrong site surgery still frequently occur in error statistics. Methods: Based on insight from research on human error, in due consideration of recent legislative regulations in Germany, the authors give an overview of the clinical risk management tools needed to identify risks in surgery, analyse their causes, and determine adequate measures to manage those risks depending on their relevance. The use and limitations of critical incident reporting systems (CIRS), safety checklists and crisis resource management (CRM) are highlighted. Also the rationale for IT systems to support the risk management process is addressed. Results/Conclusion: No single tool of risk management can be effective as a standalone instrument, but unfolds its effect only when embedded in a superordinate risk management system, which integrates tailor-made elements to increase patient safety into the workflows of each organisation. Competence in choosing adequate tools, effective IT systems to support the risk management process as well as leadership and commitment to constructive handling of human error are crucial components to establish a safety culture in surgery. Georg Thieme Verlag KG Stuttgart · New York.
Accounting for Medication Particularities: Designing for Everyday Medication Management

DEFF Research Database (Denmark)

Dalgaard, Lea Gulstav; Grönvall, Erik; Verdezoto, Nervo

2013-01-01

Several projects have shown that self-management of medication in private homes can be challenging. Many projects focused on specific illness-related approaches (e.g. diabetes) or practical issues such as how to handle medication while travelling. However, designing for everyday medication manage....... These medication particularities can enhance the individual’s medication overview and support the understanding of medication intake in everyday life. The study also presents five design principles for future design of PHMMS....
Characterization and management of solid medical wastes in the ...

African Journals Online (AJOL)

Background: Medical establishment such as hospitals and research institutes generate sizable amount of hazardous waste. Health care workers, patients are at risk of acquiring infection from sharps and contamination of environment with multiple drug resistant microorganisms if wastes are not properly managed.
Architecture for Integrated Medical Model Dynamic Probabilistic Risk Assessment

Science.gov (United States)

Jaworske, D. A.; Myers, J. G.; Goodenow, D.; Young, M.; Arellano, J. D.

2016-01-01

Probabilistic Risk Assessment (PRA) is a modeling tool used to predict potential outcomes of a complex system based on a statistical understanding of many initiating events. Utilizing a Monte Carlo method, thousands of instances of the model are considered and outcomes are collected. PRA is considered static, utilizing probabilities alone to calculate outcomes. Dynamic Probabilistic Risk Assessment (dPRA) is an advanced concept where modeling predicts the outcomes of a complex system based not only on the probabilities of many initiating events, but also on a progression of dependencies brought about by progressing down a time line. Events are placed in a single time line, adding each event to a queue, as managed by a planner. Progression down the time line is guided by rules, as managed by a scheduler. The recently developed Integrated Medical Model (IMM) summarizes astronaut health as governed by the probabilities of medical events and mitigation strategies. Managing the software architecture process provides a systematic means of creating, documenting, and communicating a software design early in the development process. The software architecture process begins with establishing requirements and the design is then derived from the requirements.
WAIST-HIP RATIO AND WAIST CIRCUMFERENCE AS SIMPLE MEASURES OF CARDIOVASCULAR RISK ASSESSMENT AND WEIGHT MANAGEMENT AMONG MEDICAL STUDENTS

Directory of Open Access Journals (Sweden)

Sarbjit Singh

2018-01-01

Full Text Available BACKGROUND The Waist-Hip Ratio (WHR and Waist Circumference (WC were used to identify people at health risk both from being overweight and having visceral fat distribution. The aim of this study was to determine the association of WHR and WC in measuring the abdominal obesity, cardiovascular risk and weight management. MATERIALS AND METHODS The study involved 200 medical students (102 boys and 98 girls in the age group of 18-23 years (mean age 20.43 ± 8.9 years of Government Medical College, Amritsar, Punjab. WHR was divided into three groups in females- ≤0.80, 0.81-0.85 and >0.86 and males- ≤0.90, 0.90-1.0 and >1.0. WC was also divided into three groups in females- 88 cm and males- 102 cm. RESULTS The results of measurement of Waist-Hip Ratio (WHR of females were ≤0.80 (2%, 0.81-85 (10% and >0.86 (88% and males ≤90 (82%, 0.90-1.0 (15% and >1.0 (3%. Waist Circumference (WC of females was 88 cm (19% and males 102 cm (4%. CONCLUSION WHR is a better predictor of Cardiovascular Diseases (CVD than WC. WHR and WC are measures of abdominal obesity and should be incorporated in weight management. WHR 0.81-0.86 in girls and 0.90-1.0 in males have moderate health risk, while >0.86 in females and >1.0 in males have high health risk. Men with WC ≥94 cm and women ≥80 cm should gain no further weight while men with WC ≥102 cm and women with ≥88cm should reduce their weight to avoid cardiovascular risks. Waist circumference is another alternative.
Pharmacist-led admission medication reconciliation before and after the implementation of an electronic medication management system.

Science.gov (United States)

Sardaneh, Arwa A; Burke, Rosemary; Ritchie, Angus; McLachlan, Andrew J; Lehnbom, Elin C

2017-05-01

To investigate the impact of the introduction of an electronic medication management system on the proportion of patients with a recorded medication reconciliation on admission, the time from admission to when medication reconciliation was performed, and the characteristics of patients receiving this intervention pre-and post-implementation. An electronic medication management system was implemented in an Australian hospital from May to July 2015. A retrospective observational study was conducted in three wards across two phases; pre- (August 2014) and post- (August 2015) implementation. The study sample included every second patient admitted to these wards. A total of 370 patients were included, 179 pre- and 191 post-implementation. The proportion of recorded admission medication reconciliation significantly increased post-implementation in all study wards; coronary care unit (40 vs 68%, p=0.004), gastroenterology ward (39 vs 59%, p=0.015), and the neurology ward (19 vs 45%, p=0.002). The proportion of patients with recorded medication reconciliation within 24h of weekday admissions, or 48-72h of weekend admissions, increased from 47% pre- to 84% post-implementation. Admission medication reconciliation was recorded within a median of 1.0day for weekday admissions pre- and post-implementation (IQR 1.1 vs 0.2, respectively), and 3.5days (IQR 2.0) pre-implementation vs 1.5days (IQR 2.0) post-implementation for weekend admissions. Overall, across both phases pre-and post-implementation, admission medication reconciliation was recorded for patients who were significantly older (median 77 and 71 years, p<0.001), had a higher number of preadmission medications (median 6.5 and 5.0 medicines, p=0.001), and had a longer hospital stay (median 6.5 and 5.1days, p=0.003). A significantly higher proportion of patients with recorded medication reconciliation in the pre-implementation phase experienced polypharmacy (61%, p=0.002), hyperpolypharmacy (15%, p=0.001), and used a high-risk
Guidelines on the medical management of tritiated water overexposures

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab.
Guidelines on the medical management of tritiated water overexposures

International Nuclear Information System (INIS)

1995-09-01

The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab
Guidelines on the medical management of tritiated water overexposures

International Nuclear Information System (INIS)

1996-04-01

The Medical Advisers to the Atomic Energy Control Board provide advice to occupational and family physicians treating overexposed workers. GMA-7 provides information and guidance to medical practitioners on the medical management of individuals who have been overexposed to tritiated water. Various treatment principles are presented with special emphasis on techniques for facilitating removal of tritiated water from the body so as to reduce the total radiation dose. Risks and biological effects from exposures to tritiated water and various radiation protection precautions are also discussed. 32 refs., 1 tab
Project Risk Management

Science.gov (United States)

Jr., R. F. Miles

1995-01-01

Project risk management is primarily concerned with performance, reliability, cost, and schedule. Environmental risk management is primarily concerned with human health and ecological hazards and likelihoods. This paper discusses project risk management and compares it to environmental risk management, both with respect to goals and implementation. The approach of the Jet Propulsion Laboratory to risk management is presented as an example of a project risk management approach that is an extension to NASA NHB 7120.5: Management of Major System Programs and Projects.
[Discussion on logistics management of medical consumables].

Science.gov (United States)

Deng, Sutong; Wang, Miao; Jiang, Xiali

2011-09-01

Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.
Medical waste management in Ibadan, Nigeria: Obstacles and prospects

International Nuclear Information System (INIS)

Coker, Akinwale; Sangodoyin, Abimbola; Sridhar, Mynepalli; Booth, Colin; Olomolaiye, Paul; Hammond, Felix

2009-01-01

Quantification and characterization of medical waste generated in healthcare facilities (HCFs) in a developing African nation has been conducted to provide insights into existing waste collection and disposal approaches, so as to provide sustainable avenues for institutional policy improvement. The study, in Ibadan city, Nigeria, entailed a representative classification of nearly 400 healthcare facilities, from 11 local government areas (LGA) of Ibadan, into tertiary, secondary, primary, and diagnostic HCFs, of which, 52 HCFs were strategically selected. Primary data sources included field measurements, waste sampling and analysis and a questionnaire, while secondary information sources included public and private records from hospitals and government ministries. Results indicate secondary HCFs generate the greatest amounts of medical waste (mean of 10,238 kg/day per facility) followed by tertiary, primary and diagnostic HCFs, respectively. Characterised waste revealed that only ∼3% was deemed infectious and highlights opportunities for composting, reuse and recycling. Furthermore, the management practices in most facilities expose patients, staff, waste handlers and the populace to unnecessary health risks. This study proffers recommendations to include (i) a need for sustained cooperation among all key actors (government, hospitals and waste managers) in implementing a safe and reliable medical waste management strategy, not only in legislation and policy formation but also particularly in its monitoring and enforcement and (ii) an obligation for each HCF to ensure a safe and hygienic system of medical waste handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment
mHealth and mobile medical Apps: a framework to assess risk and promote safer use.

Science.gov (United States)

Lewis, Thomas Lorchan; Wyatt, Jeremy C

2014-09-15

The use of mobile medical apps by clinicians and others has grown considerably since the introduction of mobile phones. Medical apps offer clinicians the ability to access medical knowledge and patient data at the point of care, but several studies have highlighted apps that could compromise patient safety and are potentially dangerous. This article identifies a range of different kinds of risks that medical apps can contribute to and important contextual variables that can modify these risks. We have also developed a simple generic risk framework that app users, developers, and other stakeholders can use to assess the likely risks posed by a specific app in a specific context. This should help app commissioners, developers, and users to manage risks and improve patient safety.
Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

Science.gov (United States)

Butler, Doug; Bauman, David; Johnson-Throop, Kathy

2011-01-01

The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.
Cardiovascular risk in rheumatoid arthritis: assessment, management and next steps

Science.gov (United States)

Zegkos, Thomas; Kitas, George; Dimitroulas, Theodoros

2016-01-01

Rheumatoid arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality which cannot be fully explained by traditional CV risk factors; cumulative inflammatory burden and antirheumatic medication-related cardiotoxicity seem to be important contributors. Despite the acknowledgment and appreciation of CV disease burden in RA, optimal management of individuals with RA represents a challenging task which remains suboptimal. To address this need, the European League Against Rheumatism (EULAR) published recommendations suggesting the adaptation of traditional risk scores by using a multiplication factor of 1.5 if two of three specific criteria are fulfilled. Such guidance requires proper coordination of several medical specialties, including general practitioners, rheumatologists, cardiologists, exercise physiologists and psychologists to achieve a desirable result. Tight control of disease activity, management of traditional risk factors and lifestyle modification represent, amongst others, the most important steps in improving CV disease outcomes in RA patients. Rather than enumerating studies and guidelines, this review attempts to critically appraise current literature, highlighting future perspectives of CV risk management in RA. PMID:27247635

Risk factor management in a contemporary Australian population at increased cardiovascular disease risk.

Science.gov (United States)

Campbell, D J; Coller, J M; Gong, F F; McGrady, M; Prior, D L; Boffa, U; Shiel, L; Liew, D; Wolfe, R; Owen, A J; Krum, H; Reid, C M

2017-11-14

Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known heart failure or cardiac abnormality on echocardiography or other imaging. Medical history, clinical examination, full blood examination and biochemistry (without lipids and HbA1c) were performed for 3847 participants on enrolment, and blood pressure, lipids and HbA1c were measured 1-2 years after enrolment for 3202 participants. Despite 99% of 3294 participants with hypertension receiving antihypertensive medication, half had blood pressures >140/90 mmHg. Approximately 77% of participants were overweight or obese, with one third obese. Additionally, 74% of participants at high cardiovascular disease risk had low density lipoprotein cholesterol levels ≥2 mmol/l, one third of diabetic participants had HbA1c >7%, 22% had estimated glomerular filtration rate management of modifiable risk factors. This article is protected by copyright. All rights reserved.
[Hygiene and security management in medical biology laboratory].

Science.gov (United States)

Vinner, E; Odou, M F; Fovet, B; Ghnassia, J C

2013-06-01

Risk management in Medical Biology Laboratory (MBL) which includes hygiene and waste management, is an integrated process to the whole MBL organisation. It is composed of three stages: risks factors identification, grading and prioritization, and their evaluation in the system. From the legislation and NF EN ISO 15189 standard's requirements viewpoint, prevention and protection actions to implement are described, at premises level, but also at work station environment's one (human resources and equipments) towards biological, chemical, linked to gas, to ionizing or non ionizing radiations and fire riks, in order not to compromise patients safety, employees safety, and quality results. Then, although NF EN 15189 standard only enacts requirements in terms of prevention, curative actions after established blood or chemical exposure accident are defined.
Enterprise risk management

Energy Technology Data Exchange (ETDEWEB)

Eaton, C. [Enbridge, Calgary, AB (Canada)

2015-07-01

Enterprise risk management (ERM) is a relative new, holistic and strategic approach for managing risks in modern organizations. ERM builds on and extends traditional risk management (RM). Risk is the effect of uncertainty on objectives - positive and/or negative. Risk management is a set of practices used to understand and address risk. ERM is a form of RM that emphasizes risk aggregation and integration. Risk aggregation is combining individual risks into categories ({sup r}olled up{sup )}. risk integration is embedding RM into organizational contexts ({sup b}uilt in{sup )}.
[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.
Risk management and regulations for lower limb medical exoskeletons: a review

Directory of Open Access Journals (Sweden)

He Y

2017-05-01

Full Text Available Yongtian He, David Eguren, Trieu Phat Luu, Jose L Contreras-Vidal Laboratory for Noninvasive Brain-Machine Interface Systems, Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA Abstract: Gait disability is a major health care problem worldwide. Powered exoskeletons have recently emerged as devices that can enable users with gait disabilities to ambulate in an upright posture, and potentially bring other clinical benefits. In 2014, the US Food and Drug Administration approved marketing of the ReWalk™ Personal Exoskeleton as a class II medical device with special controls. Since then, Indego™ and Ekso™ have also received regulatory approval. With similar trends worldwide, this industry is likely to grow rapidly. On the other hand, the regulatory science of powered exoskeletons is still developing. The type and extent of probable risks of these devices are yet to be understood, and industry standards are yet to be developed. To address this gap, Manufacturer and User Facility Device Experience, Clinicaltrials.gov, and PubMed databases were searched for reports of adverse events and inclusion and exclusion criteria involving the use of lower limb powered exoskeletons. Current inclusion and exclusion criteria, which can determine probable risks, were found to be diverse. Reported adverse events and identified risks of current devices are also wide-ranging. In light of these findings, current regulations, standards, and regulatory procedures for medical device applications in the USA, Europe, and Japan were also compared. There is a need to raise awareness of probable risks associated with the use of powered exoskeletons and to develop adequate countermeasures, standards, and regulations for these human–machine systems. With appropriate risk mitigation strategies, adequate standards, comprehensive reporting of adverse events, and regulatory oversight, powered exoskeletons may one day allow individuals
International comparative analyses of healthcare risk management.

Science.gov (United States)

Sun, Niuyun; Wang, Li; Zhou, Jun; Yuan, Qiang; Zhang, Zongjiu; Li, Youping; Liang, Minghui; Cheng, Lan; Gao, Guangming; Cui, Xiaohui

2011-02-01

Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province, hospital, and non-governmental organization. The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an "NGO-led mode" represented by the United States and Canada and a "government-led mode" represented by the United Kingdom, Australia, and Taiwan. © 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.
A management plan for hospitals and medical centers facing radiation incidents.

Science.gov (United States)

Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.
Risk management frameworks for human health and environmental risks.

Science.gov (United States)

Jardine, Cindy; Hrudey, Steve; Shortreed, John; Craig, Lorraine; Krewski, Daniel; Furgal, Chris; McColl, Stephen

2003-01-01

A comprehensive analytical review of the risk assessment, risk management, and risk communication approaches currently being undertaken by key national, provincial/state, territorial, and international agencies was conducted. The information acquired for review was used to identify the differences, commonalities, strengths, and weaknesses among the various approaches, and to identify elements that should be included in an effective, current, and comprehensive approach applicable to environmental, human health and occupational health risks. More than 80 agencies, organizations, and advisory councils, encompassing more than 100 risk documents, were examined during the period from February 2000 until November 2002. An overview was made of the most important general frameworks for risk assessment, risk management, and risk communication for human health and ecological risk, and for occupational health risk. In addition, frameworks for specific applications were reviewed and summarized, including those for (1)contaminated sites; (2) northern contaminants; (3) priority substances; (4) standards development; (5) food safety; (6) medical devices; (7) prescription drug use; (8) emergency response; (9) transportation; (10) risk communication. Twelve frameworks were selected for more extensive review on the basis of representation of the areas of human health, ecological, and occupational health risk; relevance to Canadian risk management needs; representation of comprehensive and well-defined approaches; generalizability with their risk areas; representation of "state of the art" in Canada, the United States, and/or internationally; and extent of usage of potential usage within Canada. These 12 frameworks were: 1. Framework for Environmental Health Risk Management (US Presidential/Congressional Commission on Risk Assessment and Risk Management, 1997). 2. Health Risk Determination: The Challenge of Health Protection (Health and Welfare Canada, 1990). 3. Health Canada Decision
Model medication management process in Australian nursing homes using business process modeling.

Science.gov (United States)

Qian, Siyu; Yu, Ping

2013-01-01

One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.
Estimation of risks from medical irradiation

International Nuclear Information System (INIS)

Persson, B.R.R.

1983-01-01

This paper discuss various concepts of quantifying risks from medical irradiation. The expected individual risk from specific medical examination can be derived by estimation the dose-equivalent in different organs and tissues and apply the risk factors recommended for these tissues. A more practical way is to estimate or measure the energy imparted which has been found to correlate quite well with the total risk derived by summing up the risks for the involved tissues. The effective dose-equivalent concept can be used to derive the collective effective dose-equivalent in a population in order to compare the contribution from medical exposure with the contribution from other sources of irradiation in the society. In many countries it is thus shown that medical exposures gives the largest man-made contribution to the population dose
[Medical waste management in healthcare centres in the occupied Palestinian territory].

Science.gov (United States)

Al-Khatib, Issam A

2007-01-01

Medical waste management in primary and secondary healthcare centres in the occupied Palestinian territory was assessed. The overall monthly quantity of solid healthcare waste was estimated to be 512.6 tons. Only 10.8% of the centres completely segregated the different kinds of healthcare waste and only 15.7% treated their medical waste. In the centres that treated waste, open burning was the main method of treatment. The results indicate that Palestinians are exposed to health and environmental risks because of improper disposal of medical waste and steps are needed to improve the situation through the establishment and enforcement of laws, provision of the necessary infrastructure for proper waste management and training of healthcare workers and cleaners.
NASA's Risk Management System

Science.gov (United States)

Perera, Jeevan S.

2011-01-01

Leadership is key to success. 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.
Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership.

Science.gov (United States)

Hills, Laura

2016-01-01

Medical practice.managers spend their days surrounded by people, so the last thing they may expect to feel is lonely. Yet for many, being the manager of a medical practice can lead to feelings of isolation from the rest of the staff, and loneliness. This article explores the many reasons that managing a medical practice can be a lonely business. It considers the risks when a practice manager's loneliness goes unchecked, both to the individual and to the practice. It suggests 10 effective and healthy strategies for preventing and managing the leadership loneliness that medical practice managers sometimes experience. Next, this article argues that acceptance is the first step in overcoming loneliness in the workplace. It offers guidance for medical practice managers who wish to help lonely members of their teams. It describes the benefits of having a confidant to help support the medical practice manager, and the characteristics of an ideal confidant. Finally, this article suggests a strategy for combatting loneliness by interacting with the staff more frequently.
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.
Access database application in medical treatment management platform

International Nuclear Information System (INIS)

Wu Qingming

2014-01-01

For timely, accurate and flexible access to medical expenses data, we applied Microsoft Access 2003 database management software, and we finished the establishment of a management platform for medical expenses. By developing management platform for medical expenses, overall hospital costs for medical expenses can be controlled to achieve a real-time monitoring of medical expenses. Using the Access database management platform for medical expenses not only changes the management model, but also promotes a sound management system for medical expenses. (authors)
[Research on the Application of Lean Management in Medical Consumables Material Logistics Management].

Science.gov (United States)

Yang, Chai; Zhang, Wei; Gu, Wei; Shen, Aizong

2016-11-01

Solve the problems of high cost, low utilization rate of resources, low medical care quality problem in medical consumables material logistics management for scientific of medical consumables management. Analysis of the problems existing in the domestic medical consumables material logistics management in hospital, based on lean management method, SPD(Supply, Processing, Distribution) for specific applications, combined HBOS(Hospital Business Operation System), HIS (Hospital Information System) system for medical consumables material management. Achieve the lean management in medical consumables material purchase, warehouse construction, push, clinical use and retrospect. Lean management in medical consumables material can effectively control the cost in logistics management, optimize the alocation of resources, liberate unnecessary time of medical staff, improve the quality of medical care. It is a scientific management method.
A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

Science.gov (United States)

Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won

2018-01-01

The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.
[Global risk management].

Science.gov (United States)

Sghaier, W; Hergon, E; Desroches, A

2015-08-01

Risk management is a fundamental component of any successful company, whether it is in economic, societal or environmental aspect. Risk management is an especially important activity for companies that optimal security challenge of products and services is great. This is the case especially for the health sector institutions. Risk management is therefore a decision support tool and a means to ensure the sustainability of an organization. In this context, what methods and approaches implemented to manage the risks? Through this state of the art, we are interested in the concept of risk and risk management processes. Then we focus on the different methods of risk management and the criteria for choosing among these methods. Finally we highlight the need to supplement these methods by a systemic and global approach including through risk assessment by the audits. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Medical-Information-Management System

Science.gov (United States)

Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

1989-01-01

Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.
Managing cliques and exclusionary behavior within your medical practice team.

Science.gov (United States)

Hills, Laura

2014-01-01

Unfortunately, cliques aren't a problem that you left behind in high school. Workplace cliques can be just as or even more troubling for you today, especially if they have the potential to affect your career, employee morale and performance, and your medical practice more broadly. This article describes workplace cliques in detail. It provides examples of exclusionary and ostracizing behaviors that are often associated with cliques. And it describes the prevalence and effects of cliques in today's workplace. This article also provides practice managers with 10 tips for discouraging and managing cliques. It describes five common workplace cliques: management, veteran, prior relationship, status, and homophily. It offers medical staff employees 10 strategies for working effectively alongside of a clique. Finally this article describes the pitfalls and risks of belonging to a workplace clique.

NGNP Risk Management Database: A Model for Managing Risk

International Nuclear Information System (INIS)

Collins, John

2009-01-01

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(reg s ign) 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.
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.
Safety in home care: A research protocol for studying medication management

Directory of Open Access Journals (Sweden)

Easty Anthony

2010-06-01

Full Text Available Abstract Background Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care. Methods A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB, Ontario (ON, Quebec (QC and Nova Scotia (NS, we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research. Discussion The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange
The management object in risk management approaches

OpenAIRE

Christiansen, Ulrik

2013-01-01

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. 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 an...
The Management Object in Risk Management Approaches

DEFF Research Database (Denmark)

Christiansen, Ulrik

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....... 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...... 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....
A management plan for hospitals and medical centers facing radiation incidents

Directory of Open Access Journals (Sweden)

Fereshteh Davari

2015-01-01

Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.
Risk management and measuring productivity with POAS--Point of Act System--a medical information system as ERP (Enterprise Resource Planning) for hospital management.

Science.gov (United States)

Akiyama, M

2007-01-01

The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM (evidence-based medicine) through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man (Business Process), Material (Medical Materials and Medicine), Money (Expenditure for purchase and Receipt), and Information (Medical Records) completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.
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
Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion

Directory of Open Access Journals (Sweden)

Jaimin Shah

2017-01-01

Full Text Available Background. The detection of a morbidly adherent placenta (MAP in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case. A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion. She had a dilation and curettage that was complicated by a significant hemorrhage and ultimately required an urgent hysterectomy. Conclusion. When patients fail medical management for a missed abortion, providers need to assess the patient’s risk factors for a MAP. If risk factors are present, a series of specific evaluations should be triggered to rule out a MAP and help further guide management. Early diagnosis of a MAP allows providers to coordinate a multidisciplinary treatment approach and thoroughly counsel patients. Ensuring adequate resources and personnel at a tertiary hospital is essential to provide the highest quality of care and improve outcomes.
Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

Directory of Open Access Journals (Sweden)

Bui, Quan M.

2015-05-01

Full Text Available We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3:414–417.
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.
Rethinking risk management

International Nuclear Information System (INIS)

Kloman, H.F.

1992-01-01

The purpose of this paper is to bring together the ideas of those who currently practice the many different forms of risk management on a global basis. These forms include guidance of public policy on macro risks, risk financing and insurance for many larger commercial organizations, managing credit, currency and interest rate risks for financial institutions, plus other extensions of risk management including security, quality control, and quality assurance in a health-care environment
Disability management: corporate medical department management of employee health and productivity.

Science.gov (United States)

Burton, W N; Conti, D J

2000-10-01

This study describes a proactive in-house program for managing short-term disability (STD) in the workforce of a very large banking system. The goals of this program were to (1) minimize the personal and economic impacts of STD by early intervention, (2) validate the extent and duration of STD, and (3) coordinate medical services and provide guidance to managers that would facilitate an early return to work. This program was made possible by the installation of a comprehensive database, called Occupational Medicine and Nursing Information System. This database mainly includes employees' claims for inpatient and outpatient health services, disability and workers' compensation benefits, wellness program participation, medical examinations and laboratory tests, use of prescription drugs, and results of Health Risk Appraisals. As a result of these efforts, STD event duration declined after this STD management program was implemented in locations heretofore outside the system, and by providing full pay for part-time work after STD, within the system as well. Of note, the average number of STD days per employee showed substantial variation by health plan, including the fact that it was higher (3.9 STD days/employee) for health maintenance organization participants than for indemnity plan members (2.7 STD days/employee).
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...
[Risk Management: concepts and chances for public health].

Science.gov (United States)

Palm, Stefan; Cardeneo, Margareta; Halber, Marco; Schrappe, Matthias

2002-01-15

Errors are a common problem in medicine and occur as a result of a complex process involving many contributing factors. Medical errors significantly reduce the safety margin for the patient and contribute additional costs in health care delivery. In most cases adverse events cannot be attributed to a single underlying cause. Therefore an effective risk management strategy must follow a system approach, which is based on counting and analysis of near misses. The development of defenses against the undesired effects of errors should be the main focus rather than asking the question "Who blundered?". Analysis of near misses (which in this context can be compared to indicators) offers several methodological advantages as compared to the analysis of errors and adverse events. Risk management is an integral element of quality management.
Risk management overview

International Nuclear Information System (INIS)

McGovern, S.

1995-01-01

Launching of the first natural gas contract by the New York Mercantile Exchange (NYMEX) in April 1990 was a huge success which allowed natural gas to surpass crude oil as the most successful launch of any commodity contract. Despite this unprecedented initial success it must be kept in mind that in a competitive marketplace there are risks of many kinds (market risks, price risks, basis risks, currency risks and timing risks), that parties must deal with in everyday operations. The concept of risk management was defined, techniques and issues in risk management were explained, a glossary of fully explained industry terms, and basic financial tools most often used in risk management, were provided. 11 figs
Mortality in perforated peptic ulcer patients after selective management of stratified poor risk cases.

Science.gov (United States)

Rahman, M Mizanur; Islam, M Saiful; Flora, Sabrina; Akhter, S Fariduddin; Hossain, Shahid; Karim, Fazlul

2007-12-01

Perforated peptic ulcer disease continues to inflict high morbidity and mortality. Although patients can be stratified according to their surgical risk, optimal management has yet to be described. In this study we demonstrate a treatment option that improves the mortality among critically ill, poor risk patients with perforated peptic ulcer disease. In our study, two series were retrospectively reviewed: group A patients (n = 522) were treated in a single surgical unit at the Dhaka Medical College Hospital, Dhaka, Bangladesh during the 1980s. Among them, 124 patients were stratified as poor risk based on age, delayed presentation, peritoneal contamination, and coexisting medical problems. These criteria were the basis for selecting a group of poor risk patients (n = 84) for minimal surgical intervention (percutaneous peritoneal drainage) out of a larger group of patients, group B (n = 785) treated at Khulna Medical College Hospital during the 1990s. In group A, 479 patients underwent conventional operative management with an operative mortality of 8.97%. Among the 43 deaths, 24 patients were >60 years of age (55.8%), 12 patients had delayed presentation (27.9%), and 7 patients were in shock or had multiple coexisting medical problems (16.2%). In group B, 626 underwent conventional operative management, with 26 deaths at a mortality rate of 4.15%. Altogether, 84 patients were stratified as poor risk and were managed with minimal surgical intervention (percutaneous peritoneal drainage) followed by conservative treatment. Three of these patients died with an operative mortality of 3.5%. Minimal surgical intervention (percutaneous peritoneal drainage) can significantly lower the mortality rate among a selected group of critically ill, poor risk patients with perforated peptic ulcer disease.
RISK FACTOR EPIDEMIOLOGY OF ECTOPIC PREGNANCY AND SUCCESS OF NONSURGICAL MANAGEMENT

Directory of Open Access Journals (Sweden)

Vijayan C.P

2016-10-01

Full Text Available BACKGROUND Ectopic pregnancies are increasing in number and proportions. Real increase and better detection methods are contributing for this rise. All the cases diagnosed now are not surgical emergencies. Medical management and expectant line of management are possible. Revised clinical guidelines are there for the selection of cases for nonsurgical management. Knowledge about the risk factors is good for prophylaxis and to have a high suspicion about ectopic pregnancy in high-risk individuals. Knowing the success rate is absolutely essential for counselling before starting the therapy. Aim of the study- 1. To study the risk factor profile of ectopic pregnancies and to compare them with the old data of the study setting. 2. To follow up the cases receiving nonsurgical treatment and to assess the success rate. MATERIALS AND METHODS Study Setting- Department of Obstetrics and Gynaecology, Government Medical College, Kottayam. It is a tertiary care centre with 1500 beds and catering for the population of five districts of Kerala. Study Design- Observational Study Study Period- This study was completed by eighteen months from April 2014 to September 2015. RESULTS 219 cases of ectopic pregnancies were diagnosed during the study period. The ratio of this number with the total number of deliveries during that period is 3.48% and this is three times higher than that of the ratio twenty years ago (1.23%. Risk factor profile is also showing changes over this period. 15.1% had medical treatment and 11% had expectant line of therapy. Success rates are 87.87% and 95.65%, respectively. CONCLUSIONS Incidence and detection of ectopic pregnancies are increasing and the risk factor profile is changing. In properly selected cases, the success of nonsurgical management is excellent.
The power of management in medical services. Can we manage better for higher quality and more productive medical services?

Directory of Open Access Journals (Sweden)

Magdalena BARBU

2010-06-01

Full Text Available Medical services are the most important services of all since we all depend on them. Their quality and productivity can assure a wealthy nation and therefore good economical results. The offer of medical services depends on medical personnel and more than this, on the management in the medical field since any resource not managed well or not managed at all is only a lost one, regardless its value. Management is therefore the key, the “how to” method of obtaining the desired result. The same approach can be applied into our study in order to reach more productive medical services which to prove high quality to all patients. We need to use and to squeeze the entire force of management tools in order to reach our goal: accessible medical services full of quality. The current worldwide crisis situation makes us think that after job and food, even medical services (also a basic thing after all can become a “luxury” although this should never happen. Therefore we must do whatever needed to improve the way medical organizations are driven so that the quality of their medical services will be better and better and the productivity will be at a higher level. Medical management should have as a goal making it possible for patients to be able to solve their health problems as soon as possible and as good as possible.
Developing an electronic system to manage and track emergency medications.

Science.gov (United States)

Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

2018-03-01

The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Use of failure mode effect analysis (FMEA) to improve medication management process.

Science.gov (United States)

Jain, Khushboo

2017-03-13

Purpose Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self-reliable by ensuring prevention of errors and/or error detection at subsequent stages. The purpose of this paper is to use failure mode effect analysis (FMEA), a systematic proactive tool, to identify the likelihood and the causes for the process to fail at various steps and prioritise them to devise risk reduction strategies to improve patient safety. Design/methodology/approach The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. FMEA tool was used. Corrective actions were developed based on the prioritised failure modes which were implemented and monitored. Findings The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37 per cent) followed by administration errors (29 per cent) indicating the need to identify the causes and effects of their occurrence. In all, 11 failure modes were identified out of which major five were prioritised based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40 per cent (average) and around 60 per cent reduction in the RPN of prioritised failure modes. Research limitations/implications FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing
[Evidence-based management of medical disposable materials].

Science.gov (United States)

Yang, Hai

2009-03-01

Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.
Investigation of risk management auditing

International Nuclear Information System (INIS)

Cao Lu

2012-01-01

2004, COSO published 'Enterprise Risk Management Framework', 2009, SASAC issued the 'central enterprise-wide risk management guidelines' to promote risk management within the formal state-owned enterprises in medium and large. Nuclear Group, which risk management in all branches to carry out the project homeopathic, and A Ⅱ will carry out risk management program as the first unit has accumulated more experience. This article from the perspective of internal control, based on the company's risk management practices carried out to try for the nuclear power enterprise risk management audit to describe and propose new ideas. Which expounds the significance of risk management, audit, risk management audit of the ways and means, for practical application of risk management audit of a representative summary of the issues and the ways and means to solve the problem of forward-looking recommendations. (authors)
RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

Directory of Open Access Journals (Sweden)

Szabo Alina

2012-12-01

Full Text Available Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the â€˜top 8-12â€™ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in the area and the professional expertise, this article outlines an integrated approach to risk assessment and risk management reporting processes, by separating the risk in two main categories: strategic and operational risks. The focus is on risk prioritization and scoring; the final output will comprise a mix of strategic and operational (â€˜top 8-12â€™ risks, which should be used to establish the annual Internal Audit plan. Originality/value: By using an integrated approach to risk assessment and risk management will eliminate the need for a separate Internal Audit risk assessment over prevailing risks. It will reduce the level of risk assessment overlap by different functions (Tax, Treasury, Information System over the same risk categories as a single methodology, is used and will align timings of risk assessment exercises. The risk prioritization by usage of risk and control scoring criteria highlights the combination between financial and non-financial impact criteria allowing risks that do not naturally lend themselves to a financial amount to be also assessed consistently. It is emphasized the usage of score method to prioritize the risks included in the annual audit plan in order to increase accuracy and timelines.
Managing Cardiovascular Disease Risk in Rheumatoid Arthritis: Clinical Updates and Three Strategic Approaches.

Science.gov (United States)

Chodara, Ann M; Wattiaux, Aimée; Bartels, Christie M

2017-04-01

ᅟ: The increase in cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) is well known; however, appropriate management of this elevated risk in rheumatology clinics is less clear. By critically reviewing literature published within the past 5 years, we aim to clarify current knowledge and gaps regarding CVD risk management in RA. We examine recent guidelines, recommendations, and evidence and discuss three approaches: (1) RA-specific management including treat-to-target and medication management, (2) assessment of comprehensive individual risk, and (3) targeting traditional CVD risk factors (hypertension, smoking, hyperlipidemia, diabetes, obesity, and physical inactivity) at a population level. Considering that 75% of US RA visits occur in specialty clinics, further research is needed regarding evidence-based strategies to manage and reduce CVD risk in RA. This review highlights clinical updates including US cardiology and international professional society guidelines, successful evidence-based population approaches from primary care, and novel opportunities in rheumatology care to reduce CVD risk in RA.
Continuous Risk Management: An Overview

Science.gov (United States)

Rosenberg, Linda; Hammer, Theodore F.

1999-01-01

Software risk management is important because it helps avoid disasters, rework, and overkill, but more importantly because it stimulates win-win situations. The objectives of software risk management are to identify, address, and eliminate software risk items before they become threats to success or major sources of rework. In general, good project managers are also good managers of risk. It makes good business sense for all software development projects to incorporate risk management as part of project management. The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to implement risk management. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This is an introductory tutorial to continuous risk management based on this course. The rational for continuous risk management and how it is incorporated into project management are discussed. The risk management structure of six functions is discussed in sufficient depth for managers to understand what is involved in risk management and how it is implemented. These functions include: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.
Telemedicine to Reduce Medical Risk in Austere Medical Environments: The Virtual Critical Care Consultation (VC3) Service.

Science.gov (United States)

Powell, Douglas; McLeroy, Robert D; Riesberg, Jamie; Vasios, William N; Miles, Ethan A; Dellavolpe, Jeffrey; Keenan, Sean; Pamplin, Jeremy C

One of the core capabilities of prolonged field care is telemedicine. We developed the Virtual Critical Care Consult (VC3) Service to provide Special Operations Forces (SOF) medics with on-demand, virtual consultation with experienced critical care physicians to optimize management and improve outcomes of complicated, critically injured or ill patients. Intensive-care doctors staff VC3 continuously. SOF medics access this service via phone or e-mail. A single phone call reaches an intensivist immediately. An e-mail distribution list is used to share information such as casualty images, vital signs flowsheet data, and short video clips, and helps maintain situational awareness among the VC3 critical care providers and other key SOF medical leaders. This real-time support enables direct communication between the remote provider and the clinical subject matter expert, thus facilitating expert management from near the point of injury until definitive care can be administered. The VC3 pilot program has been extensively tested in field training exercises and validated in several real-world encounters. It is an immediately available capability that can reduce medical risk and is scalable to all Special Operations Command forces. 2016.
Data-Driven Identification of Risk Factors of Patient Satisfaction at a Large Urban Academic Medical Center.

Science.gov (United States)

Li, Li; Lee, Nathan J; Glicksberg, Benjamin S; Radbill, Brian D; Dudley, Joel T

2016-01-01

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is the first publicly reported nationwide survey to evaluate and compare hospitals. Increasing patient satisfaction is an important goal as it aims to achieve a more effective and efficient healthcare delivery system. In this study, we develop and apply an integrative, data-driven approach to identify clinical risk factors that associate with patient satisfaction outcomes. We included 1,771 unique adult patients who completed the HCAHPS survey and were discharged from the inpatient Medicine service from 2010 to 2012. We collected 266 clinical features including patient demographics, lab measurements, medications, disease categories, and procedures. We developed and applied a data-driven approach to identify risk factors that associate with patient satisfaction outcomes. We identify 102 significant risk factors associating with 18 surveyed questions. The most significantly recurrent clinical risk factors were: self-evaluation of health, education level, Asian, White, treatment in BMT oncology division, being prescribed a new medication. Patients who were prescribed pregabalin were less satisfied particularly in relation to communication with nurses and pain management. Explanation of medication usage was associated with communication with nurses (q = 0.001); however, explanation of medication side effects was associated with communication with doctors (q = 0.003). Overall hospital rating was associated with hospital environment, communication with doctors, and communication about medicines. However, patient likelihood to recommend hospital was associated with hospital environment, communication about medicines, pain management, and communication with nurse. Our study identified a number of putatively novel clinical risk factors for patient satisfaction that suggest new opportunities to better understand and manage patient satisfaction. Hospitals can use a data-driven approach to
Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

Science.gov (United States)

Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

2011-04-01

To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.
[A medical consumable material management information system].

Science.gov (United States)

Tang, Guoping; Hu, Liang

2014-05-01

Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.
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....
The medical risks of obesity.

Science.gov (United States)

Pi-Sunyer, Xavier

2009-11-01

Obesity is at epidemic proportions in the United States and in other developed and developing countries. The prevalence of obesity is increasing not only in adults, but especially among children and adolescents. In the United States in 2003 to 2004, 17.1% of children and adolescents were overweight, and 32.2% of adults were obese. Obesity is a significant risk factor for and contributor to increased morbidity and mortality, most importantly from cardiovascular disease (CVD) and diabetes, but also from cancer and chronic diseases, including osteoarthritis, liver and kidney disease, sleep apnea, and depression. The prevalence of obesity has increased steadily over the past 5 decades, and obesity may have a significant impact on quality-adjusted life years. Obesity is also strongly associated with an increased risk of all-cause mortality as well as cardiovascular and cancer mortality. Despite the substantial effects of obesity, weight loss can result in a significant reduction in risk for the majority of these comorbid conditions. Those comorbidities most closely linked to obesity must be identified to increase awareness of potential adverse outcomes. This will allow health care professionals to identify and implement appropriate interventions to reduce patient risk and mortality. A systematic search strategy was used to identify published literature between 1995 and 2008 that reported data from prospective longitudinal studies of obesity and comorbid medical conditions. This article will review evidence for significant associations of obesity with comorbidities to provide information useful for optimal patient management.
RISK MANAGEMENT: AN INTEGRATED APPROACH TO RISK MANAGEMENT AND ASSESSMENT

OpenAIRE

Szabo Alina

2012-01-01

Purpose: The objective of this paper is to offer an overview over risk management cycle by focusing on prioritization and treatment, in order to ensure an integrated approach to risk management and assessment, and establish the â€˜top 8-12â€™ risks report within the organization. The interface with Internal Audit is ensured by the implementation of the scoring method to prioritize risks collected from previous generated risk report. Methodology/approach: Using evidence from other research in ...
Perceptions of personal health risks by medical and non-medical workers in a university medical center: a survey study

Directory of Open Access Journals (Sweden)

Nap Raoul E

2010-11-01

Full Text Available Abstract Background Health care workers (HCWs are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the extent to which risk perception differs in these groups. The current study thus investigates risk perception of medical and non-medical workers to inform and complement future research on safety compliance. The study has implications for the design of intervention programmes to increase the level of compliance of HCWs. Methods A survey study was conducted in which questionnaires were distributed to 6380 HCWs. The questionnaire asked for ratings of risk perception for cold, annual influenza, pandemic influenza, cancer, heart attack and food poisoning. Of 2495 returned questionnaires (response rate: 39%, 61.40% were from medical workers (24.1% of these were from physicians, 39.7% from nurses and 36.2% from paramedics and 38.60% were from non-medical workers. Results Medical workers gave lower risk perception ratings than did non-medical workers for cancer, but not for other health risks. Within the medical workers, physicians rated the risk of getting a cold as higher, but of having a heart attack as lower than did nurses and paramedics; physicians also rated their risk of getting cancer as lower than did nurses. Perceived risk was higher as a function of age for pandemic influenza, cancer and heart attack, but lower for cold and annual influenza. HCWs who lived with a partner and children rated the risk of getting a cold or annual influenza higher than those who lived alone or with a partner only. Full-time HCWs gave lower ratings for annual influenza than did part-time HCWs. Conclusions Different base levels of risk perception between medical and non-medical workers need to be taken into account for successful implementation of safety regulations
Commodity risk management

Directory of Open Access Journals (Sweden)

Hilary Till

2016-09-01

Full Text Available This article discusses the practical issues involved in applying a disciplined risk management methodology to commodity futures trading. Accordingly, the paper shows how to apply methodologies derived from both conventional asset management and hedge fund management to futures trading. The article also discusses some of the risk management issues that are unique to leveraged futures trading.
[Application of information management system about medical equipment].

Science.gov (United States)

Hang, Jianjin; Zhang, Chaoqun; Wu, Xiang-Yang

2011-05-01

Based on the practice of workflow, information management system about medical equipment was developed and its functions such as gathering, browsing, inquiring and counting were introduced. With dynamic and complete case management of medical equipment, the system improved the management of medical equipment.
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...
Medication management strategies used by older adults with heart failure: A systems-based analysis.

Science.gov (United States)

Mickelson, Robin S; Holden, Richard J

2017-09-01

Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood. Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals. This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases. Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies. Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.
Hog Producers' Risk Management Attitudes and Desire for Additional Risk Management Education

OpenAIRE

Patrick, George F.; Peiter, Amy J.; Knight, Thomas O.; Coble, Keith H.; Baquet, Alan E.

2007-01-01

Hog producers in Indiana and Nebraska were surveyed about sources of risk, effectiveness of risk management strategies, and prior participation in and desire for additional risk management education. Ownership of hogs by the producer, size of the operation, and age did have significant effects on ratings of both sources of risk and effectiveness of risk management strategies. Probit analysis found age, prior attendance, knowledge and prior use of the tool, level of integration, and concern ab...
UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers.

Science.gov (United States)

Rouhani, Maral J; Burleigh, Eleanor J; Hobbis, Chloe; Dunford, Charlotte; Osman, Nadir I; Gan, Christine; Gibbons, Norma B; Ahmed, Hashim U; Miah, Saiful

2018-01-01

We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership training they received during medical school as "very poor" or "poor" (54.4%). Our study suggests that UK medical students have an appetite for management and leadership training and appreciate its importance but feel that the training they are receiving is poor. This suggests that there is a gap between the demand for management and leadership training and the quality of training supplied by UK medical schools.

21 CFR 880.6315 - Remote Medication Management System.

Science.gov (United States)

2010-04-01

... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication..., and medication packaging. The system is intended to store the patient's prescribed medications in a... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315...
Photosensitizing medication use and risk of skin cancer

DEFF Research Database (Denmark)

Kaae, Jeanette; Boyd, Heather A; Hansen, Anne

2010-01-01

Many commonly used medications, including both medications for long-term (daily) use and short-term use (treatment courses of finite duration), have photosensitizing properties. Whether use of these medications affects skin cancer risk, however, is unclear.......Many commonly used medications, including both medications for long-term (daily) use and short-term use (treatment courses of finite duration), have photosensitizing properties. Whether use of these medications affects skin cancer risk, however, is unclear....
Certification and risk management

International Nuclear Information System (INIS)

Villanueva Fernandez, M.

2015-01-01

Nowadays more organizations are increasingly aware of the importance of properly managing the uncertainty of its activities and build competitive advantages through the identification, assessment and management of risks that they face. Risk management is also an aspect of great importance within the new version of ISO fact it is one of the most innovative and also the most laborious, because an appropriate risk management achieves expected results and customer satisfaction. In conclusion, risk management is a new field of business and can be considered a cross-cutting component for other relevant factors of organizational change management. (Author)
Risk attitudes and personality traits predict perceptions of benefits and risks for medicinal products: a field study of European medical assessors.

Science.gov (United States)

Beyer, Andrea R; Fasolo, Barbara; de Graeff, P A; Hillege, H L

2015-01-01

Risk attitudes and personality traits are known predictors of decision making among laypersons, but very little is known of their influence among experts participating in organizational decision making. Seventy-five European medical assessors were assessed in a field study using the Domain Specific Risk Taking scale and the Big Five Inventory scale. Assessors rated the risks and benefits for a mock "clinical dossier" specific to their area of expertise, and ordinal regression models were used to assess the odds of risk attitude or personality traits in predicting either the benefit or the risk ratings. An increase in the "conscientiousness" score predicted an increase in the perception of the drug's benefit, and male assessors gave higher scores for the drug's benefit ratings than did female assessors. Extraverted assessors saw fewer risks, and assessors with a perceived neutral-averse or averse risk profile saw greater risks. Medical assessors perceive the benefits and risks of medicines via a complex interplay of the medical situation, their personality traits and even their gender. Further research in this area is needed to determine how these potential biases are managed within the regulatory setting. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
CHOSEN ASPECTS OF RISK MANAGEMENT OCCUPATIONAL

Directory of Open Access Journals (Sweden)

Benedykt Bober

2015-06-01

Full Text Available In the present chapter there are discussed the threats appearing in the diagnostic and therapeutic process with particular consideration of ionizing radiation. The implementation of medical e-records, while creating the conditions of sharing them with patients and the medical staff, reduces the decision-making risk in the process of providing hospital services. Restructuring radiological diagnostics allows for the elimination of emission of dangerous substances and the implementation of eco-friendly procedures. The implementation of the process-based approach in servicing X-ray apparatus and controlling the dose of ionizing radiation brings about the quality, accuracy and effectiveness of the diagnosis. The process of reduction of the occupational exposure to cytostatic drugs is an essential element of total management of the public hospital.
Risk management in Takaful

OpenAIRE

Akhter, Waheed

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...
Retrospective Analysis of Medication Adherence and Cost Following Medication Therapy Management

Directory of Open Access Journals (Sweden)

Ashley Branham, PharmD

2010-01-01

Full Text Available Objective: To determine if pharmacist-provided medication therapy management (MTM improves medication adherence in Medicare patients. A secondary objective is to compare the total monthly cost of a patient’s prescription medication regimen 6 months before and 6 months following a comprehensive medication review (CMR. Design: Retrospective analysis of medication adherence, pre-post comparison. Setting: Three independent pharmacies in North Carolina. Patients: 97 Medicare Part D beneficiaries with one or more chronic disease states who participated in a comprehensive medication review (CMR. Intervention: MTM services provided by community pharmacists. Main outcome measure: Change in adherence as measured by the proportion of days covered (PDC and change in medication costs for patients and third party payers. Results: Patients were adherent to chronic disease-state medications before and after MTM (PDC≥ 0.8. Overall, change in mean adherence before and after MTM did not change significantly (0.87 and 0.88, respectively; p = 0.43. However, patients taking medications for cholesterol management, GERD, thyroid and BPH demonstrated improved adherence following a CMR. No change in adherence was noted for patients using antihypertensives and antidiabetic agents. Average total chronic disease-state medication costs for participants were reduced from $210.74 to $193.63 (p=0.08 following the comprehensive medication review. Total costs for patient and third party payers decreased from patients prescribed antilipemics, antihypertensives, GERD and thyroid disorders following a CMR. Conclusions: Pharmacist-provided MTM services were effective at improving medication adherence for some patients managed with chronic medications. Pharmacist-provided MTM services also were effective in decreasing total medication costs.
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).
Governmental management of chemical risk

International Nuclear Information System (INIS)

Zimmerman, R.

1990-01-01

This book is organized under the following headings: risk management in the government context; legal and regulatory decrees and directives for managing chemical risk; incentive-based approaches for regulating risk; risk management in the federal system; and traditional approaches and new initiatives for managing chemical risk
Managing the risks of risk management on large fires

Science.gov (United States)

Donald G. MacGregor; Armando González-Cabán

2013-01-01

Large fires pose risks to a number of important values, including the ecology, property and the lives of incident responders. A relatively unstudied aspect of fire management is the risks to which incident managers are exposed due to organizational and sociopolitical factors that put them in a position of, for example, potential liability or degradation of their image...
A probabilistic method for computing quantitative risk indexes from medical injuries compensation claims.

Science.gov (United States)

Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R

2013-01-01

The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.
Risk management in customs control

OpenAIRE

Drobot, Elena; Klevleeva, Aziza

2016-01-01

The particularities of risk-management system implementation within customs control are discussed in the article. The authors single out the elements of risk-management system, evaluate effectiveness of risk-management in customs control. The main reasons for non-implementation of risk-management system in customs control are described, as well. Particular attention is paid to the benefits of customs risk management.
Knowledge, attitudes and management skills of medical practitioners regarding weight management.

Science.gov (United States)

Mkhatshwa, Vangile B; Ogunbanjo, Gboyega A; Mabuza, Langalibalele H

2016-11-29

Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa. We conducted a cross-sectional study on 48 medical practitioners at Odi Hospital between 01 October and 31 October 2013. A self-administered questionnaire was used to assess their knowledge, attitudes and management skills in weight management. The SPSS® statistical software (Version 22) was used for data analysis. A p < 0.05 was considered significant. Fifty medical practitioners were recruited, 48 consented to participate and 28 (58.3%) were male. Their categories were community service doctors (3), medical officers (21), registrars (22) and others (2). Thirty-seven (77.1%) never received training in weight management (p < 0.001). Thirty-two (66.7%) regarded weight management as not confined to a dietician (p < 0.001) and 27 (56.2%) regarded weight management as usually unsuccessful (p = 0.004). Forty-seven (97.9%) provided lifestyle modifications and 43 (89.6%) involved the patient's family in weight management (p < 0.001). More non-registrars [14 (77.8%)] than registrars [8 (38.1%)] measured the body mass index (BMI) routinely (p = 0.013). Few medical practitioners received training in weight management. They regarded weight management as usually unsuccessful and lacked confidence in the same owing to lack of training. They provided lifestyle modifications and involved the patient's family in weight management. Non-registrars measured the BMI routinely. There is a need for training in weight management at undergraduate and post-graduate levels.
Financial Risk Management

OpenAIRE

Catalin-Florinel Stanescu; Laurentiu Mircea Simion

2011-01-01

Concerns about the financial risk is increasing. In this climate, companies of all types and sizes want a robust framework for financial risk management to meet compliance requirements, contribute to better decision making and increase performance. Financial risk management professionals working with financial institutions and other corporate clients to achieve these objectives.
Information Risk Management: Qualitative or Quantitative? Cross industry lessons from medical and financial fields

OpenAIRE

Upasna Saluja; Norbik Bashah Idris

2012-01-01

Enterprises across the world are taking a hard look at their risk management practices. A number of qualitative and quantitative models and approaches are employed by risk practitioners to keep risk under check. As a norm most organizations end up choosing the more flexible, easier to deploy and customize qualitative models of risk assessment. In practice one sees that such models often call upon the practitioners to make qualitative judgments on a relative rating scale which brings in consid...
Optimizing risk management

International Nuclear Information System (INIS)

Kindred, G.W.

2000-01-01

Commercial nuclear power plant management is focussed on the safe, efficient, economical production of electricity. To accomplish the safe aspect of the equation, risk must be determined for the operation and maintenance of the facility. To accomplish the efficient aspect of the equation, management must understand those risks and factor risk insights into their decision process. The final piece of the equation is economical which is accomplished by minimizing, plant outage durations and proper utilization of resources. Probabilistic Risk Assessment can provide the risk insights to accomplish all three; safety, efficiency, and economically. How? Safe production of electricity can be quantified by use of PRA modeling and other risk insights that can determine the core damage frequency. Efficient production of electricity can be influenced by providing management with quantified risk insights for use in decision making. And, one example of economical production of electricity is by not having over conservative deterministic based defense in depth approaches to system maintenance and availability. By using risk-informed insights nuclear safety can be quantified and risk can be managed. Confidence in this approach can be achieved by ensuring the content and quality of the PRA is standardized throughout the industry. The time has arrived for Probabilistic Risk Assessment to take an active position as a major role player in the safe, efficient, and economical operation of commercial nuclear power plants. (author)
As good as it gets? Managing risks of cardiovascular disease in California's top-performing physician organizations.

Science.gov (United States)

Rodriguez, Hector P; Ivey, Susan L; Raffetto, Brian J; Vaughn, Jennifer; Knox, Margae; Hanley, Hattie Rees; Mangione, Carol M; Shortell, Stephen M

2014-04-01

The California Right Care Initiative (RCI) accelerates the adoption of evidence-based guidelines and improved care management practices for conditions for which the gap between science and practice is significant, resulting in preventable disability and death. Medical directors and quality improvement leaders from 11 of the 12 physician organizations that met the 2010 national 90th percentile performance benchmarks for control of hyperlipidemia and glycated hemoglobin in 2011 were interviewed in 2012. Interviews, as well as surveys, assessed performance reporting and feedback to individual physicians; medication management protocols; team-based care management; primary care team huddles; coordination of care between primary care clinicians and specialists; implementation of shared medical appointments; and telephone visits for high-risk patients. All but 1 of 11 organizations implemented electronic health records. Electronic information exchange between primary care physicians and specialists, however, was uncommon. Few organizations routinely used interdisciplinary team approaches, shared medical appointments, or telephonic strategies for managing cardiovascular risks among patients. Implementation barriers included physicians' resistance to change, limited resources and reimbursement for team approaches, and limited organizational capacity for change. Implementation facilitators included routine use of reliable data to guide improvement, leadership facilitation of change, physician buy-in, health information technology use, and financial incentives. To accelerate improvements in managing cardiovascular risks, physician organizations may need to implement strategies involving extensive practice reorganization and work flow redesign.
Risk management and safety

International Nuclear Information System (INIS)

Niehaus, F.; Novegno, A.

1985-01-01

Risk assessment, including probabilistic analyses, has made great progress over the past decade. In spite of the inherent uncertainties it has now become possible to utilize methods and results for decision making at various levels. This paper will, therefore, review risk management in industrial installations, risk management for energy safety policy and prospects of risk management in highly industrialized areas. (orig.) [de
Publication ethics and the ghost management of medical publication.

Science.gov (United States)

Sismondo, Sergio; Doucet, Mathieu

2010-07-01

It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.
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 ...

[Risk Assessment and Risk Management of Chemicals in China].

Science.gov (United States)

Wang, Tie-yu; Zhou, Yun-qiao; Li, Qi-feng; Lü, Yong-long

2016-02-15

Risk assessment and risk management have been increasingly approved as an effective approach for appropriate disposal and scientific management of chemicals. This study systematically analyzed the risk assessment methods of chemicals from three aspects including health risk, ecological risk and regional risk. Based on the current situation of classification and management towards chemicals in China, a specific framework of risk management on chemicals was proposed by selecting target chemicals, predominant industries and related stakeholders as the objects. The results of the present study will provide scientific support for improving risk assessment and reasonable management of chemicals in China.
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.
Total Risk Management for Low Dose Radiation Exposures

International Nuclear Information System (INIS)

Simic, Z.; Mikulicic, V.; Sterc, D.

2012-01-01

health. This view is supported with numerous evidences, and explained with beneficial effects from the increased activity of immune system activated with small radiation exposures. Finally, theory in between is that small doses are less than linearly proportionally harmful and that they are presenting a much smaller risks than according to the LNT. This view is derived from the use of different evidences. Difficulties to find one single theory about effects of small radiation doses are related to existence of huge variability and uncertainty in the evidence data. This is very hard experimental and theoretical problem. It will require lots of additional research to reduce these uncertainties and find final theory. This might be too late for the number of people affected in different ways with current single most conservative LNT approach. The problem with the conservative LNT regulatory approach is resulting in enormous additional costs of nuclear energy and medical applications. Which is reasonable and acceptable during the regular operation when source is high and concentrated. But, this becomes unreasonable huge economic burden after accidents and for cleanups with nuclear facilities. Similar problem arises with restriction of medical examinations and treatments based on over conservative risk estimate. Special circumstances are with evacuated people from contaminated areas where they are on the one side saved from small radiation exposures, and on the other side exposed to years of life away from their home and with numerous direct and indirect additional risks (i.e., stress, social problems, etc.). It seems reasonable that some alternative (total) risk management approach might be much more suitable for this situation. Evacuation of people from contaminated area with small doses sources should not be done when that induces larger risks from even what is expected from radiation based on LNT. Similar total risk management could be also applied for with medical
Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review.

Science.gov (United States)

Schlussel, Andrew T; Cherng, Nicole B; Alavi, Karim

2017-11-01

Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Improving Operational Risk Management Using Business Performance Management Technologies

OpenAIRE

Bram Pieket Weeserik; Marco Spruit

2018-01-01

Operational Risk Management (ORM) comprises the continuous management of risks resulting from: human actions, internal processes, systems, and external events. With increasing requirements, complexity and a growing volume of risks, information systems provide benefits for integrating risk management activities and optimizing performance. Business Performance Management (BPM) technologies are believed to provide a solution for effective Operational Risk Management by offering several combined ...
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.
RISK MANAGEMENT IN CUSTOMS CONTROL

Directory of Open Access Journals (Sweden)

Elena Valerievna Drobot

2017-06-01

Full Text Available Customs administrations operating in the modern global economy are faced with a complex range of challenges. The prime responsibilities remain the collection of revenues and the protection of the society, but these demanding tasks must be performed effectively and efficiently, whilst at the same time facilitating the flow of legitimate goods. Risk management is a logical and systematic method of identifying, analyzing and managing risks. Risk management can be associated with any activity, function or process within the organization and will enable the organization to take advantage of opportunities and minimize potential losses. Minimization of the human factor in customs control through the implementation of non-intrusive inspection equipment can be very useful. The particularities of risk-management system (RMS implementation within customs control are discussed in the article. The authors single out the elements of the risk-management system, evaluate the effectiveness of risk-management in customs control. The main reasons for non-implementation of the risk-management system in customs control are described as well. The particular attention is paid to the benefits of customs risk management. The authors’ hypothesis is that risk management in customs control must find a balance between costs and benefits to address all risks equally. Criteria are needed to decide what constitutes an acceptable or unacceptable risk. Thus, system analysis and risk management system are the effective mechanisms for acceleration of customs clearance and improve the quality of customs control. As a conclusion, the authors give recommendations for the improvement of the effectiveness of risk management system in customs control.
The medical management of glaucoma

African Journals Online (AJOL)

medical and surgical interventions are accessible in the management of glaucoma. This article ..... Cannabinoids. With the recent attention cannabis has been receiving in the management of pain and other cancer related conditions, it.
UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

Directory of Open Access Journals (Sweden)

Rouhani MJ

2018-02-01

Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership
Genomic-based tools for the risk assessment, management, and prevention of type 2 diabetes

Directory of Open Access Journals (Sweden)

Johansen Taber KA

2015-01-01

Full Text Available Katherine A Johansen Taber, Barry D DickinsonDepartment of Science and Biotechnology, American Medical Association, Chicago, IL, USAAbstract: Type 2 diabetes (T2D is a common and serious disorder and is a significant risk factor for the development of cardiovascular disease, neuropathy, nephropathy, retinopathy, periodontal disease, and foot ulcers and amputations. The burden of disease associated with T2D has led to an emphasis on early identification of the millions of individuals at high risk so that management and intervention strategies can be effectively implemented before disease progression begins. With increasing knowledge about the genetic basis of T2D, several genomic-based strategies have been tested for their ability to improve risk assessment, management and prevention. Genetic risk scores have been developed with the intent to more accurately identify those at risk for T2D and to potentially improve motivation and adherence to lifestyle modification programs. In addition, evidence is building that oral antihyperglycemic medications are subject to pharmacogenomic variation in a substantial number of patients, suggesting genomics may soon play a role in determining the most effective therapies. T2D is a complex disease that affects individuals differently, and risk prediction and treatment may be challenging for health care providers. Genomic approaches hold promise for their potential to improve risk prediction and tailor management for individual patients and to contribute to better health outcomes for those with T2D.Keywords: diabetes, genomic, risk prediction, management
Risk management in nuclear projects

International Nuclear Information System (INIS)

Salles, Claudio J.R.

2002-01-01

The risk management will be defined by different aspects: danger or loss possibility, or responsibility for damage. The risk management is one stage of project management. The risk management is a continuous process of planning, identification, quantification, answer and risk control to maximize the success potential of activity. The reduction of risk is part of priority establishment. This work will indicate how introduce this important instrument in the management of nuclear projects. (author)
Maternal medical risks during pregnancy and childhood externalizing behavior.

Science.gov (United States)

Jackson, Dylan B; Vaughn, Michael G

2018-04-25

Research has indicated that maternal health during the prenatal period and at delivery carries far reaching significance for the development of offspring. Even so, the role of the accumulation of maternal medical risks during pregnancy in the development of externalizing behavior during childhood has generally been overlooked. The present study investigates whether the accumulation of maternal medical risks during the prenatal period is positively associated with childhood externalizing behavior, and whether this association is stronger among male offspring. We examined a large, nationally representative sample of children who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Information concerning maternal medical history, including the presence of a number of medical risks during pregnancy, was obtained through hospital records. A subsample of children with both parent and teacher reports of externalizing behavior during kindergarten was employed in the present study. A greater number of maternal medical risks during pregnancy increased the odds of childhood externalizing behavior across settings, but only among male offspring. The predicted probability of persistent externalizing behavior among males increased from .084 in the absence of maternal medical risks during pregnancy to .241 in the presence of three or more maternal medical risks during pregnancy. Our findings suggest that maternal medical risks during the prenatal period can have far-reaching consequences for the behavioral development of male offspring. Treatment of medical risks among expectant mothers may have the added benefit of reducing the likelihood of childhood externalizing behavior among male progeny. Copyright © 2018 Elsevier Ltd. All rights reserved.
Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients

Directory of Open Access Journals (Sweden)

Shinya Yamazaki

2008-09-01

Full Text Available Shinya Yamazaki, Hiroyoshi Kawaai, Shigeo Sasaki, Kazuhiro Shimamura, Hiroshi Segawa, Takahiro SaitoSpecial Care Department in Dentistry, Ohu University Dental Hospital, Koriyama city, Fukushima prefecture, JapanAbstract: The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases. The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%, checking vital signs after an interview (15.3%, and monitoring under sedation (13.3%. There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management.Keywords: online, high-risk patient, dental treatment, medical cooperation, medical accident, risk management
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.
Decisionmaking under risk in invasive species management: risk management theory and applications

Science.gov (United States)

Shefali V. Mehta; Robert G. Haight; Frances R. Homans

2010-01-01

Invasive species management is closely entwined with the assessment and management of risk that arises from the inherently random nature of the invasion process. The theory and application of risk management for invasive species with an economic perspective is reviewed in this synthesis. Invasive species management can be delineated into three general categories:...
[A Medical Devices Management Information System Supporting Full Life-Cycle Process Management].

Science.gov (United States)

Tang, Guoping; Hu, Liang

2015-07-01

Medical equipments are essential supplies to carry out medical work. How to ensure the safety and reliability of the medical equipments in diagnosis, and reduce procurement and maintenance costs is a topic of concern to everyone. In this paper, product lifecycle management (PLM) and enterprise resource planning (ERP) are cited to establish a lifecycle management information system. Through integrative and analysis of the various stages of the relevant data in life-cycle, it can ensure safety and reliability of medical equipments in the operation and provide the convincing data for meticulous management.
Medical emergency management among Iranian dentists.

Science.gov (United States)

Khami, Mohammad Reza; Yazdani, Reza; Afzalimoghaddam, Mohammad; Razeghi, Samaneh; Moscowchi, Anahita

2014-11-01

More than 18,000 patients need medical emergencies management in dental offices in Iran annually. The present study investigates medical emergencies management among Iranian dentists. From the list of the cell phone numbers of the dentists practicing in the city of Tehran, 210 dentists were selected randomly. A self-administered questionnaire was used as the data collection instrument. The questionnaire requested information on personal and professional characteristics of the dentists, as well as their knowledge and self-reported practice in the field of medical emergency management, and availability of required drugs and equipments to manage medical emergencies in their offices. Totally, 177 dentists (84%) completed the questionnaire. Less than 60% of the participants were knowledgeable about characteristics of hypoglycemic patient, chest pain with cardiac origin, and true cardiopulmonary resuscitation (CPR) practice. Regarding practice, less than one quarter of the respondents acquired acceptable scores. In regression models, higher practice scores were significantly associated with higher knowledge scores (p < 0.001). The results call for a need to further education on the subject for dentists. Continuing education and changing dental curriculum in the various forms seems to be useful in enhancement of the self-reported knowledge and practice of dentists. To successful control of medical emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.
Medical management of radiation emergencies

International Nuclear Information System (INIS)

Bongirwar, P.R.

2002-01-01

This review deals specifically with the medical management of victims, such as, the triage of exposed individuals on the basis of preliminary observations and investigations, planning priority of treatment to different groups, emergency care, and definitive care. The infrastructure for appropriate management involves first aid posts, decontamination centre, Site Hospital and Specialized Central Hospital. Medical management of life threatening radiation doses involve haematological examinations, blood component therapy, treatment with growth factors and if necessary, bone marrow transplantation as the last option. Most of the radiation accidents involving partial body and localized exposures are associated with industrial radiography sources. Such exposures are generally not life threatening but may involve serious skin injury, such as, ulceration, necrosis and gangrene. Methods have been developed to carry out decontamination of skin and decorporation of internally deposited radio nuclides. This article also provides information on the Radiation Emergency Medical Preparedness and Assistance Network and also outlines the role of media in reducing the human suffering in the event of an accident
Relationship between Risk Factor Control and Compliance with a Lifestyle Modification Program in the Stenting Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis Trial.

Science.gov (United States)

Turan, Tanya N; Al Kasab, Sami; Nizam, Azhar; Lynn, Michael J; Harrell, Jamie; Derdeyn, Colin P; Fiorella, David; Janis, L Scott; Lane, Bethany F; Montgomery, Jean; Chimowitz, Marc I

2018-03-01

Lifestyle modification programs have improved the achievement of risk factor targets in a variety of clinical settings, including patients who have previously suffered a stroke or transient ischemic attack and those with multiple risk factors. Stenting Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) was the first vascular disease prevention trial to provide a commercially available lifestyle modification program to enhance risk factor control. We sought to determine the relationship between compliance with this program and risk factor control in SAMMPRIS. SAMMPRIS aggressive medical management included a telephonic lifestyle modification program provided free of charge to all subjects (n = 451) during their participation in the study. Subjects with fewer than 3 expected lifestyle-coaching calls were excluded from these analyses. Compliant subjects (n = 201) had greater than or equal to 78.5% of calls (median % of completed/expected calls). Noncompliant subjects (n = 200) had less than 78.5% of calls or refused to participate. Mean risk factor values or % in-target for each risk factor was compared between compliant versus noncompliant subjects, using t tests and chi-square tests. Risk factor changes from baseline to follow-up were compared between the groups to account for baseline differences. Compliant subjects had better risk factor control throughout follow-up for low-density lipoprotein, systolic blood pressure (SBP), hemoglobin A1c (HgA1c), non-high-density lipoprotein, nonsmoking, and exercise than noncompliant subjects, but there was no difference for body mass index. After adjusting for baseline differences between the groups, compliant subjects had a greater change from baseline than noncompliant subjects for SBP did at 24 months and HgA1c at 6 months. SAMMPRIS subjects who were compliant with the lifestyle modification program had better risk factor control during the study for almost
Knowledge, attitudes and management skills of medical practitioners regarding weight management

OpenAIRE

Vangile B. Mkhatshwa; Gboyega A. Ogunbanjo; Langalibalele H. Mabuza

2016-01-01

Background: Overweight and obesity have become a global problem. Health professionals are poorly prepared in weight management, which has an effect on their attitudes and management skills with regard to overweight and obese patients.Aim and setting: To assess the knowledge, attitudes and management skills of medical practitioners regarding weight management at Odi District Hospital, Gauteng Province, South Africa.Methods: We conducted a cross-sectional study on 48 medical practitioners at Od...

[Protocols of health security in the light of some examples of risk management].

Science.gov (United States)

Postel-Vinay, Nicolas; Coquin, Yves

2005-11-30

Throughout medical training, medical risk management is a subject that has been insufficiently addressed and treated without a global vision. Yet the different dangers often make the front page of a media that addresses the question of health security when there is a failure of the system or new legal developments. Added to this disequilibrium of communication and training is the great complexity of risk management. Not only is the nature of the potentially dangerous agents extraordinarily varied but also the entity that detects the risk is sometimes a stranger to the causes of its appearance. The surrounding regulations are themselves complex and dense. Using the examples that have arisen over the last 2 or 3 years, this article describes the current French protocols in risk management, that rely upon the agencies delivering their expertise, certain of which are endowed with the power of policing these regulations. In practice, the doctor should understand the role of these agencies, know how to find the validated information that they can provide, and understand his role in this picture. A role that is perceived as far away as long as the risk has not emerged, but is in the forefront once the event arises.
Construction Management Risk System (CMRS for Construction Management (CM Firms

Directory of Open Access Journals (Sweden)

Kyungmo Park

2017-02-01

Full Text Available After the global financial crisis of 2008, the need for risk management arose because it was necessary to minimize the losses in construction management (CM firms. This was caused by a decreased amount of orders in the Korean CM market, which intensified order competition between companies. However, research results revealed that risks were not being systematically managed owing to the absence of risk management systems. Thus, it was concluded that it was necessary to develop standard operating systems and implement risk management systems in order to manage risks effectively. Therefore, the purpose of this study was to develop a construction risk management system (CRMS for systematically managing risks. For this purpose, the field operation managers of CM firms were interviewed and surveyed in order to define risk factors. Upon this, a risk assessment priority analysis was performed. Finally, a risk management system that comprised seven modules and 20 sub-modules and was capable of responding systematically to risks was proposed. Furthermore, the effectiveness of this system was verified through on-site inspection. This system allows early response to risks, accountability verification and immediate response to legal disputes with clients by managing risk records.
The Integrated Medical Model: Statistical Forecasting of Risks to Crew Health and Mission Success

Science.gov (United States)

Fitts, M. A.; Kerstman, E.; Butler, D. J.; Walton, M. E.; Minard, C. G.; Saile, L. G.; Toy, S.; Myers, J.

2008-01-01

The Integrated Medical Model (IMM) helps capture and use organizational knowledge across the space medicine, training, operations, engineering, and research domains. The IMM uses this domain knowledge in the context of a mission and crew profile to forecast crew health and mission success risks. The IMM is most helpful in comparing the risk of two or more mission profiles, not as a tool for predicting absolute risk. The process of building the IMM adheres to Probability Risk Assessment (PRA) techniques described in NASA Procedural Requirement (NPR) 8705.5, and uses current evidence-based information to establish a defensible position for making decisions that help ensure crew health and mission success. The IMM quantitatively describes the following input parameters: 1) medical conditions and likelihood, 2) mission duration, 3) vehicle environment, 4) crew attributes (e.g. age, sex), 5) crew activities (e.g. EVA's, Lunar excursions), 6) diagnosis and treatment protocols (e.g. medical equipment, consumables pharmaceuticals), and 7) Crew Medical Officer (CMO) training effectiveness. It is worth reiterating that the IMM uses the data sets above as inputs. Many other risk management efforts stop at determining only likelihood. The IMM is unique in that it models not only likelihood, but risk mitigations, as well as subsequent clinical outcomes based on those mitigations. Once the mathematical relationships among the above parameters are established, the IMM uses a Monte Carlo simulation technique (a random sampling of the inputs as described by their statistical distribution) to determine the probable outcomes. Because the IMM is a stochastic model (i.e. the input parameters are represented by various statistical distributions depending on the data type), when the mission is simulated 10-50,000 times with a given set of medical capabilities (risk mitigations), a prediction of the most probable outcomes can be generated. For each mission, the IMM tracks which conditions
Information Risk Management and Resilience

Science.gov (United States)

Dynes, Scott

Are the levels of information risk management efforts within and between firms correlated with the resilience of the firms to information disruptions? This paper examines the question by considering the results of field studies of information risk management practices at organizations and in supply chains. The organizations investigated differ greatly in the degree of coupling from a general and information risk management standpoint, as well as in the levels of internal awareness and activity regarding information risk management. The comparison of the levels of information risk management in the firms and their actual or inferred resilience indicates that a formal information risk management approach is not necessary for resilience in certain sectors.
Cardiovascular Risk Factors among First Year Medical Students

Directory of Open Access Journals (Sweden)

Raj Krishna Dangol

2017-12-01

Full Text Available Introduction: Detection of cardiovascular risk in young age is important to motivate them to modify life styles and seek health care early to lower the chances of acquiring cardiovascular disease in later age. This study was done to assess cardiovascular risk factors among first year medical students. Methods: A cross-sectional study was conducted throughout September and October 2017 in which all first year medical students from a medical college were assessed for the presence of cardiovascular risk factors. Participants’ demography, family history of illness, anthropometric measurements, and blood reports of lipid profile and fasting glucose were acquired. Data were analyzed with Statistical Package for Social Sciences (SPSS-21. Result: There were 99 participants; 55 males and 44 females. One or more risk factors were present in 87 (87.9% participants. Moreover, 67.7% (n = 67 participants had more than one risk factors. Low HDL-cholesterol was the most common (n = 55, 55.6% risk factor followed by elevated triacylglycerol (n = 47, 47.5% and family history of hypertension (n = 45, 45.5%. There was no significant difference in presence of various risk factors between genders. Conclusion: There was higher prevalence of cardiovascular risk factors among first year medical students. Majority of them had more than one risk factors. Low HDL-cholesterol was the most common risk factor. The risk factors were comparable in males and females.
A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.

Science.gov (United States)

Abrecht, Christopher R; Brovman, Ethan Y; Greenberg, Penny; Song, Ellen; Rathmell, James P; Urman, Richard D

2017-11-01

Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). The goal of this study was to identify patient medical comorbidities and aberrant drug behaviors, as well as prescriber practices associated with patient injury and malpractice claims. Another objective was to identify claims most likely to result in payments and use this information to propose a strategy for reducing medicolegal risk. The CRICO Strategies Comparative Benchmarking System is a database of claims drawing from >350,000 malpractice claims from Harvard-affiliated institutions and >400 other academic and community institutions across the United States. This database was queried for closed claims from January 1, 2009, to December 31, 2013, and identified 37 cases concerning noninterventional, outpatient chronic pain management. Each file consisted of a narrative summary, including expert witness testimony, as well as coded fields for patient demographics, medical comorbidities, the alleged damaging event, the alleged injurious outcome, the total financial amount incurred, and more. We performed an analysis using these claim files. The mean patient age was 43.5 years, with men representing 59.5% of cases. Payments were made in 27% of cases, with a median payment of $72,500 and a range of $7500-$687,500. The majority of cases related to degenerative joint disease of the spine and failed back surgery syndrome; no patients in this series received treatment of malignant pain. Approximately half (49%) of cases involved a patient death. The use of long
Continuous Risk Management at NASA

Science.gov (United States)

Hammer, Theodore F.; Rosenberg, Linda

1999-01-01

NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions. This risk management structure of functions has been taught to projects at all NASA Centers and is being successfully implemented on many projects. This presentation will give project managers the information they need to understand if risk management is to be effectively implemented on their projects at a cost they can afford.
Probability concepts in quality risk management.

Science.gov (United States)

Claycamp, H Gregg

2012-01-01

Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as
Pain management and opioid risk mitigation in the military.

Science.gov (United States)

Sharpe Potter, Jennifer; Bebarta, Vikhyat S; Marino, Elise N; Ramos, Rosemarie G; Turner, Barbara J

2014-05-01

Opioid analgesics misuse is a significant military health concern recognized as a priority issue by military leadership. Opioids are among those most commonly prescribed medications in the military for pain management. The military has implemented opioid risk mitigation strategies, including the Sole Provider Program and the Controlled Drug Management Analysis and Reporting Tool, which are used to identify and monitor for risk and misuse. However, there are substantial opportunities to build on these existing systems to better ensure safer opioid prescribing and monitor for misuse. Opioid risk mitigation strategies implemented by the civilian sector include establishing clinical guidelines for opioid prescribing and prescription monitoring programs. These strategies may help to inform opioid risk mitigation in the military health system. Reducing the risk of opioid misuse and improving quality of care for our Warfighters is necessary. This must be done through evidence-based approaches with an investment in research to improve patient care and prevent opioid misuse as well as its sequelae. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Patients’ Perspective on the Value of Medication Management Appointments

Directory of Open Access Journals (Sweden)

Mario Cruz

2015-05-01

Full Text Available Objectives: There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients’ views and opinions about the value of psychiatric medication management appointments. Methods: Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients’ views and opinions about the value of attending medication management appointments. Analysis: An iterative thematic analysis was performed. Findings: Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Conclusions: Patients’ perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.
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.
Impact of a medication therapy management intervention targeting medications associated with falling: Results of a pilot study.

Science.gov (United States)

Mott, David A; Martin, Beth; Breslow, Robert; Michaels, Barb; Kirchner, Jeff; Mahoney, Jane; Margolis, Amanda

2016-01-01

The use of fall risk-increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed. The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults. Randomized, controlled trial. One community pharmacy. Eighty older adults who completed a fall prevention workshop. The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers. Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Six Sigma Quality Management System and Design of Risk-based Statistical Quality Control.

Science.gov (United States)

Westgard, James O; Westgard, Sten A

2017-03-01

Six sigma concepts provide a quality management system (QMS) with many useful tools for managing quality in medical laboratories. This Six Sigma QMS is driven by the quality required for the intended use of a test. The most useful form for this quality requirement is the allowable total error. Calculation of a sigma-metric provides the best predictor of risk for an analytical examination process, as well as a design parameter for selecting the statistical quality control (SQC) procedure necessary to detect medically important errors. Simple point estimates of sigma at medical decision concentrations are sufficient for laboratory applications. Copyright © 2016 Elsevier Inc. All rights reserved.
CEA - 2014 risk management assessment

International Nuclear Information System (INIS)

Bonnevie, Edwige; Verwaerde, Daniel; Maillot, Bernard

2015-06-01

After introducing presentations of CEA managers in charge of risk management and controls, this document presents and comments the actions undertaken by the CEA and the obtained results in terms of risk management in different fields: protection and control of the environment, installation safety, health, safety and radiation protection, transport of hazardous materials, waste management, protection of sites, installations and heritage, management of emergency situations, management of legal risks, internal audits and controls. Other topics are addressed like the presentation of the risk management department, and the role of the CEA in the relationship between research and industry
[Medical negligence].

Science.gov (United States)

Zipper, St G

2016-06-01

Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.
Management accounting versus medical profession discourse

DEFF Research Database (Denmark)

Malmmose, Margit

2015-01-01

This study uses discourse, ideology and hegemony as a theoretical foundation to investigate the development of the polarised discourses of management accounting and the medical profession during the introduction of a NPM reform in the public health care debate, using Denmark as a case study. 194...... newspaper articles and 73 medical profession articles from 2002 to 2008 are analysed, using critical discourse analysis. The analysis shows that the management accounting discourse becomes the dominating ideology which is embedded in the public rhetorical debate. There are three peculiar outcomes...... perspective of a patient oriented focus to a quantitative focus through strong rationalised arguments. This puts the medical profession in a dilemma concerning their ideological Hippocratic Oath versus the NPM efficiency focus. However, they choose to gradually adopt management accounting terms in their own...
Family Physicians Managing Medical Requests From Family and Friends.

Science.gov (United States)

Giroldi, Esther; Freeth, Robin; Hanssen, Maurice; Muris, Jean W M; Kay, Margareth; Cals, Jochen W L

2018-01-01

Although guidelines generally state that physicians should not treat their family members or friends (nonpatients), physicians regularly receive medical requests from nonpatients. We aimed to explore junior and senior family physicians' experiences with and attitudes toward managing medical requests from nonpatients. We conducted a qualitative study with 7 focus groups with junior and senior physicians. We performed a thematic analysis during an iterative cycle of data collection and analysis. When confronted with a medical request from a nonpatient, physicians first oriented themselves to the situation: who is this person, what is he or she asking of me, and where are we? Physicians next considered the following interrelated factors: (1) nature/strength of the relationship with the nonpatient, (2) amount of trust in his/her own knowledge and skills, (3) expected consequences of making mistakes, (4) importance of work-life balance, and (5) risk of disturbing the physician-patient process. Senior physicians applied more nuanced considerations when deciding whether to respond, whereas junior physicians experienced more difficulties dealing with these requests, were less inclined to respond, and were more concerned about disturbing the existing relationship that a person had with his/her own physician. This study provides insight into the complexity that physicians face when managing medical questions and requests from nonpatients. Facilitated group discussions during which experiences are shared can help junior physicians become more confident in dealing with these complex issues as they formulate their own personal strategy regarding provision of medical advice or treatment to family and friends. © 2018 Annals of Family Medicine, Inc.
Dementia and depression with ischemic heart disease: a population-based longitudinal study comparing interventional approaches to medical management.

Science.gov (United States)

Mutch, W Alan C; Fransoo, Randall R; Campbell, Barry I; Chateau, Dan G; Sirski, Monica; Warrian, R Keith

2011-02-28

We compared the proportion of ischemic heart disease (IHD) patients newly diagnosed with dementia and depression across three treatment groups: percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical management alone (IHD-medical). De-identified, individual-level administrative records of health service use for the population of Manitoba, Canada (approximately 1.1 million) were examined. From April 1, 1993 to March 31, 1998, patients were identified with a diagnosis of IHD (ICD-9-CM codes). Index events of CABG or PCI were identified from April 1, 1998 to March 31, 2003. Outcomes were depression or dementia after the index event. Patients were followed forward to March 31, 2006 or until censored. Proportional hazards regression analysis was undertaken. Independent variables examined were age, sex, diabetes, hypertension and income quintile, medical management alone for IHD, or intervention by PCI or CABG. Age, sex, diabetes, and presence of hypertension were all strongly associated with the diagnosis of depression and dementia. There was no association with income quintile. Dementia was less frequent with PCI compared to medical management; (HR = 0.65; p = 0.017). CABG did not provide the same protective effect compared to medical management (HR = 0.90; p = 0.372). New diagnosis depression was more frequent with interventional approaches: PCI (n = 626; hazard ratio = 1.25; p = 0.028) and CABG (n = 1124, HR = 1.32; p = 0.0001) than non-interventional patients (n = 34,508). Subsequent CABG was nearly 16-fold higher (pdementia-only 65% of the risk for medical management alone. Both interventional approaches were associated with a higher risk of new diagnosed depression compared to medical management. Long-term myocardial revascularization was superior with CABG. These findings suggest that PCI may confer a long-term protective effect from dementia. The mechanism(s) of dementia protection
The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

Science.gov (United States)

Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.
Medical Management of Oral Lichen Planus: A Systematic Review

Science.gov (United States)

Chokshi, Krunal; Desai, Sachin; Malu, Rahul; Chokshi, Achala

2016-01-01

Introduction Oral Lichen Planus (OLP) is a chronic inflammatory, T-cell-mediated autoimmune oral mucosal disease with unclear aetiology. The clinical management of OLP poses considerable difficulties to the oral physician. Aim The aim was to assess the efficacy of any form of intervention used to medically manage OLP. Materials and Methods We searched and analysed the following databases (from January 1990 to December 2014):- Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. All Randomised Controlled Trials (RCTs) for the medical management of OLP which compared active treatment with placebo or between active treatments were considered in this systematic review. Participants of any age, gender or race having symptomatic OLP (including mixed forms), unconnected to any identifiable cause (e.g. lichenoid drug reactions) and confirmed by histopathology have been included. Interventions of all types, including topical treatments or systemic drugs of variable dosage, duration & frequency of delivery have been considered. All the trials identified were appraised by five review authors and the data for all the trials were synthesised using specifically designed data extraction form. Binary data has been presented as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CIs. Results A total of 35 RCTs were included in this systematic review on medical management of OLP. No strong evidence suggesting superiority of any specific intervention in reducing pain and clinical signs of OLP were shown by the RCTs included here. Conclusion Future RCTs on a larger scale, adopting standardized outcome assessing parameters should be considered. PMID:27042598

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.
Medical weather forecast as the risk management facilities of meteopathia with population

Science.gov (United States)

Efimenko, Natalya; Chalaya, Elena; Povolotskaia, Nina; Senik, Irina; Topuriya, David

2013-04-01

surface atmosphere. The correlation of the results of the research of external respiration function, cardiovascular and central nervous systems with people suffering from DA (187 people) made in days with favorable weathers, but different in natural anion quantity in the surface atmosphere, allowed us to develop similar physiological processes at the phenomena of natural deionization. When the anions amount reduces from 1255±38 ion/cm3 to 190±13 ion/cm3, we have detected the increase of tension of vegetative index (from 458±24 to 802±44), the decrease in efficiency of neurohumoral regulation (from 0,25±0,08 to 0,06±0,02), the increase of spectrum excitability of cortical activity in the wave range of delta 0 0.4 Hz by 29%, the decrease in cortical activity in the wave range of theta 4 … 8 Hz, alpha 8 … 13 Hz beta 13 … 19 Hz, gamma 19 … 25Hz by 4-10%; the decrease in organism adaptation layer by 14% and integrated health indicator by 18%. We have also detected similar processes in cardiovascular and respiratory systems. So the problem of creation of high-quality system of medical weather forecast for the population demands the performance of interdisciplinary researches in the field of medicine, biology, meteorology and the development of DMR risk management programs at various natural and anthropogenic stressors. The studies were performed by support of the Program "Basic Sciences for Medicine" and RFBR project No.10-05-01014_a.
Risk and/or resilience management

Directory of Open Access Journals (Sweden)

Jean-Paul Louisot

2015-06-01

Full Text Available Risk management aims at managing all the uncertainties that may interfere with the objectives and missions of the organization. Resilience engineering aims at building its capacity to get over disturbances or stress while keeping the functionalities needed to survive, and possibly thrive. A recently open debate on an Internet blog launched by the risk managers of the Scottish Widows Bank seems to arise from what some professionals see as two competing branches of the management sciences. Whereas through the development of ERM – Enterprise-wide Risk Management – risk management is emerging at last to become a science, as well as an art and a practice, the mentioned above centered on the role of a newly forged name “resilience management”. This opens a new front of the many debates that could derail the path to maturity of Risk Management as a science and reopen new silos much as Business Impact Analysis, BIA, or continuity management, might do if a clear distinction is not made between science, objectives and tools. However, because organizations are so interconnected today in the supply cloud that it is inevitable that they will face catastrophic risk and this is why resilience needs to be a core objective of any risk management plan? Whereas traditional risk management techniques alone may not be adequate to deal with such pervasive and insipient risk scenarios, resilience is ingrained into ERM
The Effect of Plan Type and Comprehensive Medication Reviews on High-Risk Medication Use.

Science.gov (United States)

Almodovar, Armando Silva; Axon, David Rhys; Coleman, Ashley M; Warholak, Terri; Nahata, Milap C

2018-05-01

In 2007, the Centers for Medicare & Medicaid Services (CMS) instituted a star rating system using performance outcome measures to assess Medicare Advantage Prescription Drug (MAPD) and Prescription Drug Plan (PDP) providers. To assess the relationship between 2 performance outcome measures for Medicare insurance providers, comprehensive medication reviews (CMRs), and high-risk medication use. This cross-sectional study included Medicare Part C and Part D performance data from the 2014 and 2015 calendar years. Performance data were downloaded per Medicare contract from the CMS. We matched Medicare insurance provider performance data with the enrollment data of each contract. Mann Whitney U and Spearman rho tests and a hierarchical linear regression model assessed the relationship between provider characteristics, high-risk medication use, and CMR completion rate outcome measures. In 2014, an inverse correlation between CMR completion rate and high-risk medication use was identified among MAPD plan providers. This relationship was further strengthened in 2015. No correlation was detected between the CMR completion rate and high-risk medication use among PDP plan providers in either year. A multivariate regression found an inverse association with high-risk medication use among MAPD plan providers in comparison with PDP plan providers in 2014 (beta = -0.358, P plan providers and higher CMR completion rates were associated with lower use of high-risk medications among beneficiaries. No outside funding supported this study. Silva Almodovar reports a fellowship funded by SinfoniaRx, Tucson, Arizona, during the time of this study. The other authors have nothing to disclose.
Analysis of Medical Equipment Management in Relation to the Mandatory Medical Equipment Safety Manager (MESM in Japan

Directory of Open Access Journals (Sweden)

Kai Ishida

2014-01-01

Full Text Available Half a decade has passed since the fifth revision of the medical law and mandatory appointment of a medical equipment safety manager (MESM in hospitals in Japan. During this period, circumstances have changed regarding maintenance of medical equipment (ME. We conducted a survey to examine these changes and the current situation in ME management. Maintenance of ME and related work were found to have increased in many hospitals, but the number of clinical engineering technologists (CETs has only slightly increased. The appointed MESM was a CET or physician in most hospitals. In hospitals where physicians were appointed as the MESM, 81% had operation managers. Many respondents commented that it was difficult for one person to cover all the tasks required by the MESM, due to a lack of knowledge, too much work, or other reasons. This suggests the importance of an operation manager for ME to work under the MESM.
Medical management of three workers following a radiation exposure incident

International Nuclear Information System (INIS)

House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

1992-01-01

The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms
Medical management of three workers following a radiation exposure incident

Energy Technology Data Exchange (ETDEWEB)

House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

1992-01-01

The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.
Supply chain risk management

OpenAIRE

Christian Hollstein; Frank Himpel

2013-01-01

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-induct...
When bad things happen: adverse event reporting and disclosure as patient safety and risk management tools in the neonatal intensive care unit.

Science.gov (United States)

Donn, Steven M; McDonnell, William M

2012-01-01

The Institute of Medicine has recommended a change in culture from "name and blame" to patient safety. This will require system redesign to identify and address errors, establish performance standards, and set safety expectations. This approach, however, is at odds with the present medical malpractice (tort) system. The current system is outcomes-based, meaning that health care providers and institutions are often sued despite providing appropriate care. Nevertheless, the focus should remain to provide the safest patient care. Effective peer review may be hindered by the present tort system. Reporting of medical errors is a key piece of peer review and education, and both anonymous reporting and confidential reporting of errors have potential disadvantages. Diagnostic and treatment errors continue to be the leading sources of allegations of malpractice in pediatrics, and the neonatal intensive care unit is uniquely vulnerable. Most errors result from systems failures rather than human error. Risk management can be an effective process to identify, evaluate, and address problems that may injure patients, lead to malpractice claims, and result in financial losses. Risk management identifies risk or potential risk, calculates the probability of an adverse event arising from a risk, estimates the impact of the adverse event, and attempts to control the risk. Implementation of a successful risk management program requires a positive attitude, sufficient knowledge base, and a commitment to improvement. Transparency in the disclosure of medical errors and a strategy of prospective risk management in dealing with medical errors may result in a substantial reduction in medical malpractice lawsuits, lower litigation costs, and a more safety-conscious environment. Thieme Medical Publishers, Inc.
Knowledge network for medical technology management in Mexico.

Science.gov (United States)

Licona, Fabiola Martínez; Leehan, Joaquín Azpiroz; Méndez, Miguel Cadena; Yuriar, Salvador Duarte; Salazar, Raúl Molina; Gilmore, Amador Terán

2009-10-01

The role of biomedical engineers (BMEs) has changed widely over the years, from managing a group of technicians to the planning of large installations and the management of medical technology countrywide. As the technology has advanced, the competence of BMEs has been challenged because it is no longer possible to be an expert in every component of the technology involved in running a hospital. Our approach has been to form a network of professionals that are experts in different fields related to medical technology, where work is coordinated to provide high quality services at the planning and execution stages of projects related to medical technology. A study of the procedures involved in the procurement of medical technology has been carried out over the years. These experiences have been compared with several case studies where the approach to problem solving in this area has been multidisciplinary. Planning and execution phases of projects involving medical technology management have been identified. After several instances of collaboration among experts from different fields, a network for management of healthcare technology has been formed at our institution that incorporates the experience from different departments that were dealing separately with projects involving medical technology. This network has led us to propose this approach to solve medical technology management projects, where the strengths of each subgroup complement each other. This structure will lead to a more integrated approach to healthcare technology management and will ensure higher quality solutions.
Managing Your COPD Medications

Science.gov (United States)

... Lookup > COPD > Diagnosing and Treating COPD Managing Your COPD Medications There are a range of treatment options ... each use . Types of medicines often prescribed for COPD: Bronchodilator Bronchodilators relax the muscles around the airways ...
Company project: "Evaluation of the quality of medical records as a tool of clinical risk management"

OpenAIRE

Anna Santa Guzzo; Mario Tecca; Enrico Marinelli; Claudio Bontempi; Caterina Palazzo; Paolo Ursillo; Giuseppe Ferro; Anna Miani; Annunziata Salvati; Stefania Catanzaro; Massimiliano Chiarini; Domenica Vittoria Colamesta; Domenico Cacchio; Patrizia Sposato; Anna Maria Lombardi

2017-01-01

Introduction: The medical record was defined by the Italian Ministry of Health in 1992 as "the information tool designed to record all relevant demographic and clinical information on a patient during a single hospitalization episode". Retrospective analysis of medical records is a tool for selecting direct and indirect indicators of critical issues (organizational, management, technical and professional issues). The project’s purpose being the promotion of an evaluation and self-evaluation ...
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.
Implementation of a Pharmacist-Directed Cardiovascular Risk and Medication Management Program for Participants in a Construction Trade Benefit Trust Fund

Directory of Open Access Journals (Sweden)

Yifei Liu, PhD

2010-01-01

Full Text Available Objectives: (1 To report the results of a pharmacist-directed cardiovascular risk management program; and (2 to identify obstacles faced by the pharmacists in the program implementation. Methods: The collaborators in this study included two local unions, a health benefit consulting company, and a community pharmacy. A total of 750 union workers with cardiovascular risk were informed about the cardiovascular risk management program. The program lasted six months, and the participation was voluntary. There were three group educational sessions with each session followed by a medication management service. A staff person of the health benefit consulting company and two pharmacists were interviewed via telephone. The interview questions were created according to the Gaps Model of Service Quality. The Gaps Model theorizes five gaps among consumerexpectations, consumer perceptions, management perceptions of consumer expectations, service quality, service delivery, and external communications to consumers. The following data were collected: (1 types and quantity of drug therapy problems, (2 pharmacists’ recommendations and prescribers' response, (3 patients’ quality of life, disability days, and sick days, and (4 the experience of involved parties. Descriptive statistics were calculated.Results: Fifteen union workers participated in the program. For the participants, 35 drug-related problems were identified, with “need for additional therapy” and “dose too low” being the most common problems. To address these drug-related problems, pharmacists made 33 recommendations to prescribers, and prescribers accepted 55% of the recommendations. According to the interviews, there were three barriers faced by pharmacists to implement the program: lack of consensus about the recruitment, union workers’ unawareness of the program’s benefits, and limited support from the unions and the health benefitconsulting company.Conclusions: It was difficult to
Implementation of a Pharmacist-Directed Cardiovascular Risk and Medication Management Program for Participants in a Construction Trade Benefit Trust Fund

Directory of Open Access Journals (Sweden)

Yifei Liu

2010-06-01

Full Text Available Objectives: (1 To report the results of a pharmacist-directed cardiovascular risk management program; and (2 to identify obstacles faced by the pharmacists in the program implementation. Methods: The collaborators in this study included two local unions, a health benefit consulting company, and a community pharmacy. A total of 750 union workers with cardiovascular risk were informed about the cardiovascular risk management program. The program lasted six months, and the participation was voluntary. There were three group educational sessions with each session followed by a medication management service. A staff person of the health benefit consulting company and two pharmacists were interviewed via telephone. The interview questions were created according to the Gaps Model of Service Quality. The Gaps Model theorizes five gaps among consumer expectations, consumer perceptions, management perceptions of consumer expectations, service quality, service delivery, and external communications to consumers. The following data were collected: (1 types and quantity of drug therapy problems, (2 pharmacists' recommendations and prescribers' response, (3 patients' quality of life, disability days, and sick days, and (4 the experience of involved parties. Descriptive statistics were calculated. Results: Fifteen union workers participated in the program. For the participants, 35 drug-related problems were identified, with "need for additional therapy" and "dose too low" being the most common problems. To address these drug-related problems, pharmacists made 33 recommendations to prescribers, and prescribers accepted 55% of the recommendations. According to the interviews, there were three barriers faced by pharmacists to implement the program: lack of consensus about the recruitment, union workers' unawareness of the program's benefits, and limited support from the unions and the health benefit consulting company. Conclusions: It was difficult to recruit
Tank waste remediation system risk management plan

International Nuclear Information System (INIS)

Zimmerman, B.D.

1998-01-01

The purpose of the Tank Waste Remediation System (TWRS) Risk Management Plan is to describe a consistent approach to risk management such that TWRS Project risks are identified and managed to achieve TWRS Project success. The Risk Management Plan implements the requirements of the Tank Waste Remediation System Systems Engineering Management Plan in the area of risk management. Figure ES-1 shows the relationship of the TWRS Risk Management Plan to other major TWRS Project documents. As the figure indicates, the Risk Management Plan is a tool used to develop and control TWRS Project work. It provides guidance on how TWRS Project risks will be assessed, analyzed, and handled, and it specifies format and content for the risk management lists, which are a primary product of the risk management process. In many instances, the Risk Management Plan references the TWRS Risk Management Procedure, which provides more detailed discussion of many risk management activities. The TWRS Risk Management Plan describes an ongoing program within the TWRS Project. The Risk Management Plan also provides guidance in support of the TWRS Readiness To-Proceed (RTP) assessment package
Automation of a high risk medication regime algorithm in a home health care population.

Science.gov (United States)

Olson, Catherine H; Dierich, Mary; Westra, Bonnie L

2014-10-01

Create an automated algorithm for predicting elderly patients' medication-related risks for readmission and validate it by comparing results with a manual analysis of the same patient population. Outcome and Assessment Information Set (OASIS) and medication data were reused from a previous, manual study of 911 patients from 15 Medicare-certified home health care agencies. The medication data was converted into standardized drug codes using APIs managed by the National Library of Medicine (NLM), and then integrated in an automated algorithm that calculates patients' high risk medication regime scores (HRMRs). A comparison of the results between algorithm and manual process was conducted to determine how frequently the HRMR scores were derived which are predictive of readmission. HRMR scores are composed of polypharmacy (number of drugs), Potentially Inappropriate Medications (PIM) (drugs risky to the elderly), and Medication Regimen Complexity Index (MRCI) (complex dose forms, instructions or administration). The algorithm produced polypharmacy, PIM, and MRCI scores that matched with 99%, 87% and 99% of the scores, respectively, from the manual analysis. Imperfect match rates resulted from discrepancies in how drugs were classified and coded by the manual analysis vs. the automated algorithm. HRMR rules lack clarity, resulting in clinical judgments for manual coding that were difficult to replicate in the automated analysis. The high comparison rates for the three measures suggest that an automated clinical tool could use patients' medication records to predict their risks of avoidable readmissions. Copyright © 2014 Elsevier Inc. All rights reserved.
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 .
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...
Risk assessment and risk management in managed aquifer recharge

CSIR Research Space (South Africa)

Page, D

2012-06-01

Full Text Available This chapter presents the methodologies used for risk assessment and risk management in MAR in Australia and the European Union, qualitative and quantitative approaches adopted within the RECLAIM Water project and case studies where the outcomes...

Value of risk management

OpenAIRE

Vik, Marie Amdal

2012-01-01

Master's thesis in Risk management The overall aim of this study was to discuss the validity of the hypothesis that risk management contributes with added value to projects and the enterprise holding the projects, and consequently to the enterprise’s stakeholders. To examine this hypothesis, a case study of three projects taken from the same portfolio at Statoil was selected. The projects were said to have an active risk management. Data was collected from the project’s documentation as...
Supply Cain Risk Management

OpenAIRE

Goodwin, Les

2011-01-01

“The management of supply chain risk is crucial to any business, more so to Rolls Royce who face an almost doubling of load within the next 10 years. So what is supply chain risk management and how well is it deployed within an operational business of Rolls Royce? What are the tools and techniques available and what are the key issues around implementing world class supply chain risk management with a Supply Chain Unit within Rolls Royce?”
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...
Management of business risks

OpenAIRE

BAZARBAY A.

2015-01-01

The article presents methodological ideas concerning the problem of risk management. Special attention is paid to increasing of enterprises' operating efficiency by means of risk-management system development in business organizations.
The Uncertainties of Risk Management

DEFF Research Database (Denmark)

Vinnari, Eija; Skærbæk, Peter

2014-01-01

for expanding risk management. More generally, such uncertainties relate to the professional identities and responsibilities of operational managers as defined by the framing devices. Originality/value – The paper offers three contributions to the extant literature: first, it shows how risk management itself......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...
Ransomware: Minimizing the Risks

OpenAIRE

Pope, Justin

2016-01-01

This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professional liabili...
Effective stakeholder management for medical practitioners

Directory of Open Access Journals (Sweden)

E Zigiriadis

2014-01-01

Full Text Available The importance of organizational-stakeholder relationships is highlighted in most organizational studies literature. This article investigates the relationship between medical practices and their stakeholders and has been developed to provide guidance on stakeholder engagement and communication. It is intended to provide a useful reference point for all medical practices concerning stakeholder engagement activities. Direction is provided on how to identify and ultimately engage with stakeholders. It should hopefully further develop the effectiveness of engagement efforts that are undertaken between a medical practice and its stakeholders. The ability of a medical practice to cultivate and sustain strong relationships with its prominent stakeholder groups greatly enhances the likelihood that the relationship will endure. Medical practitioners in South Africa are generally in urgent need of pursuing new ways of delivering quality health care through developing new service models that have been developed with the help of relevant stakeholders. Since stakeholder relationship management is critical for corporate sustainability, medical practice management should seek strategic direction by investigating the relative competitive threat and relative supportive value of each stakeholder and then classify them accordingly.
Risk management and corporate value

Directory of Open Access Journals (Sweden)

Milan Cupic

2015-12-01

Full Text Available The paper presents a theoretical framework for assessing the impact of risk management on corporate value. As the relevant factors that determine this impact, the paper analyzes market imperfections and investors’ risk aversion. The results of the present research indicate that risk management contributes to an increase in corporate value if, under the influence of market imperfections, corporate risk exposure is concave. As an expression of market imperfections, the paper analyzes the costs of financial distress, agency costs, and taxation. The results of the research also indicate that the risk management policy should not aim to minimize, but rather optimize risk exposure, by taking into account the costs of risk management, investors’ risk aversion and the competitive advantage a corporation has on the relevant market.
CEA: risk management assessment 2011

International Nuclear Information System (INIS)

Bigot, Bernard; Bonnevie, Edwige; Maillot, Bernard

2012-01-01

This report proposes a qualitative and quantitative overview of CEA activities in the field of risk management during 2011. These activities concerned the impact on the environment, the safety of installations, the management of professional risks (safety and health at work), the radiological protection of workers, the transports of hazardous materials, waste management, protection of sites, installations and heritage, the management of emergency situations, the management of law risks, controls and audits
CEA: assessment of risk management 2011

International Nuclear Information System (INIS)

2012-06-01

This report proposes an overview of CEA activities in the field of risk management in different areas: impact on the environment, installation safety, management of occupational risks (occupational health and safety), radiological protection of workers, transportation of hazardous materials, waste management, protection of sites, installations and heritage, management of emergency situations, management of law risks, controls and audits. It finally presents the risk management department
Medication Errors: New EU Good Practice Guide on Risk Minimisation and Error Prevention.

Science.gov (United States)

Goedecke, Thomas; Ord, Kathryn; Newbould, Victoria; Brosch, Sabine; Arlett, Peter

2016-06-01

A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. Reducing the risk of medication errors is a shared responsibility between patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. In 2015, the EU regulatory network released a two-part good practice guide on medication errors to support both the pharmaceutical industry and regulators in the implementation of the changes introduced with the EU pharmacovigilance legislation. These changes included a modification of the 'adverse reaction' definition to include events associated with medication errors, and the requirement for national competent authorities responsible for pharmacovigilance in EU Member States to collaborate and exchange information on medication errors resulting in harm with national patient safety organisations. To facilitate reporting and learning from medication errors, a clear distinction has been made in the guidance between medication errors resulting in adverse reactions, medication errors without harm, intercepted medication errors and potential errors. This distinction is supported by an enhanced MedDRA(®) terminology that allows for coding all stages of the medication use process where the error occurred in addition to any clinical consequences. To better understand the causes and contributing factors, individual case safety reports involving an error should be followed-up with the primary reporter to gather information relevant for the conduct of root cause analysis where this may be appropriate. Such reports should also be summarised in periodic safety update reports and addressed in risk management plans. Any risk minimisation and prevention strategy for medication errors should consider all stages of a medicinal product's life-cycle, particularly the main sources and types of medication errors during product development. This article
Rehabilitation Risk Management: Enabling Data Analytics with Quantified Self and Smart Home Data.

Science.gov (United States)

Hamper, Andreas; Eigner, Isabella; Wickramasinghe, Nilmini; Bodendorf, Freimut

2017-01-01

A variety of acute and chronic diseases require rehabilitation at home after treatment. Outpatient rehabilitation is crucial for the quality of the medical outcome but is mainly performed without medical supervision. Non-Compliance can lead to severe health risks and readmission to the hospital. While the patient is closely monitored in the hospital, methods and technologies to identify risks at home have to be developed. We analyze state-of-the-art monitoring systems and technologies and show possibilities to transfer these technologies into rehabilitation monitoring. For this purpose, we analyze sensor technology from the field of Quantified Self and Smart Homes. The available sensor data from this consumer grade technology is summarized to give an overview of the possibilities for medical data analytics. Subsequently, we show a conceptual roadmap to transfer data analytics methods to sensor based rehabilitation risk management.
Risk evaluation of medical and industrial radiation devices

International Nuclear Information System (INIS)

Jones, E.D.; Cunningham, R.E.; Rathbun, P.A.

1994-03-01

In 1991, the NRC, Division of Industrial and Medical Nuclear Safety, began a program to evaluate the use of probabilistic risk assessment (PRA) in regulating medical devices. This program represents an initial step in an overall plant to evaluate the use of PRA in regulating the use of nuclear by-product materials. The NRC envisioned that the use of risk analysis techniques could assist staff in ensuring that the regulatory approach was standardized, understandable, and effective. Traditional methods of assessing risk in nuclear power plants may be inappropriate to use in assessing the use of by-product devices. The approaches used in assessing nuclear reactor risks are equipment-oriented. Secondary attention is paid to the human component, for the most part after critical system failure events have been identified. This paper describes the risk methodology developed by Lawrence Livermore National Laboratory (LLNL), initially intended to assess risks associated with the use of the Gamma Knife, a gamma stereotactic radiosurgical device. For relatively new medical devices such as the Gamma Knife, the challenge is to perform a risk analysis with very little quantitative data but with an important human factor component. The method described below provides a basic approach for identifying the most likely risk contributors and evaluating their relative importance. The risk analysis approach developed for the Gamma Knife and described in this paper should be applicable to a broader class of devices in which the human interaction with the device is a prominent factor. In this sense, the method could be a prototypical model of nuclear medical or industrial device risk analysis
MINIMASI RESIKO DALAM SISTEM PENGELOLAAN LIMBAH MEDIS DI KOTA BANDUNG, INDONESIA DENGAN PENDEKATAN LINEAR PROGRAMMING (Risk Minimization for Medical Waste Management System in Bandung City, Indonesia: A Linear Programming Approach

Directory of Open Access Journals (Sweden)

Mochammad Chaerul

2013-07-01

Full Text Available ABSTRAK Berbagai macam pelayanan perawatan kesehatan yang disediakan oleh rumah sakit akan berpotensi menghasilkan limbah medis. Walaupun sebagian besar limbah rumah sakit dapat dikelompokkan sebagai limbah yang tidak berbahaya yang memiliki sifat yang sama dengan sampah rumah tangga dan dapat dibuang ke tempat penimbunan sampah, sebagian kecil dari limbah medis harus dikelola dengan tepat untuk meminimasi resiko terhadap kesehatan masyarakat. Model pengelolaan limbah medis yang dikembangkan ditujukan untuk meminimasi resiko terhadap fasilitas umum dan komersial seperti fasilitas ibadah, bank, perkantoran, restoran, hotel, stasiun pengisian bahan bakar, fasilitas pendidikan, mall dan pusat perbelanjaan, taman dan pusat olahraga/kebugaran, akibat pengangkutan limbah medis dan abu hasil pengolahannya. Tingkat resiko dari setiap fasilitas di atas ditentukan menggunakan metode Analytical Hierarchy Process (AHP. Permasalahan diselesaikan dengan mengaplikasikan linear programming menggunakan software optimimasi LINGO®. Output model berupa optimasi alokasi limbah medis dari setiap rumah sakit ke fasilitas pengolahan dan alokasi abu dari fasilitas pengolahan ke tempat penimbunan akhir. Hasil model memperlihatkan bahwa rute terpendek tidak menghasilkan total resiko terkecil karena dipengaruhi oleh jumlah dan tingkat resiko dari setiap fasilitas yang dilalui oleh kemdaraan pengangkut limbah medis dan abu. Perbedaan fasilitas yang berada di sekitar pengolahan limbah medis juga akan menghasilkan total resiko yang berbeda. ABSTRACT A broad range of healthcare services provided by hospital may generate medical waste. Although a large percentage of hospital waste is classified as general waste, which has similar nature as that of municipal solid waste and, therefore, could be disposed in municipal landfill, a small portion of medical waste has to be managed in a proper manner to minimize risk to public health. A medical waste management model is proposed in
Risk management at university

OpenAIRE

Ivanova, H.; Abramovich, S.

2013-01-01

This article observes the basic recommendations for the risk management system in higher education as an example Yanka Kupala State University of Grodno. Consider the risk-management standard that based in a process approach
Role of NDT in risk management

International Nuclear Information System (INIS)

Porter, Jr. James F.

2009-01-01

Risk management is identifying and then managing threats that could severely affect or bring down a company. This involves reviewing the operations of the company to include the process, equipment, procedures and personnel. Potential threats are then identified including their probability of occurrence, and then taking appropriate actions to address the most likely threats. Traditionally, risk management was thought of as mostly getting the right insurance. However, this impression of risk management has changed dramatically. With the recent increase in rules and regulations and optimizing utilization of key resources, risk management is becoming a management practice that is as important as financial or facilities management. In ideal risk management, a prioritization process is followed whereby the risks with the greatest loss and greatest probability of occurring are handled first, and risks with lower probability of occurrence and lower loss are handled in descending order. In practice the process can be very difficult, and balancing between risks with a high probability of occurrence but lower loss versus a risk with high but lower probability of occurrence can often be mishandled. (author)
Cattle farmers’ perceptions of risk and risk management strategies

DEFF Research Database (Denmark)

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

2018-01-01

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...
The Key to Risk Management: Management

OpenAIRE

Adrian E. Tschoegl

2000-01-01

The Barings, Daiwa Bank and Sumitomo Corp. financial debacles in the mid-1990s suggest that management failures rather than misfortune, errors, or complexity are a major source of the risk of financial debacles. These errors are systematic and are a concommittant of the structure of trading and of human nature. Risk management systems must take these facts into account.
Stimulant ADHD medication and risk for substance abuse.

Science.gov (United States)

Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik

2014-08-01

There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Framework for systematic risk management

International Nuclear Information System (INIS)

Knief, R.A.; Mahn, J.A.; Briant, V.S.; Lee, R.B.; Long, R.L.

1991-01-01

The first paper of the Symposium described GPU Nuclear's Risk Management Group (RMG) and the use of literature search and interviews in a extensive study of risk management. One of the most important goals of the study was to identify comprehensive approaches to managing risk in the nuclear and major high-technology industries. This paper discusses RMG's multi-step generic risk-management process consisting of the following steps to: identify hazards; screen hazards and identify preventive actions, including costs; evaluate hazards for severity, probable frequency, and cost of preventive actions; prioritize preventive actions (preference to high risk and low cost); implement preventive actions; monitor and provide feedback

Medical Professionals Designing Hospital Management Models

DEFF Research Database (Denmark)

Byg, Vibeke

Health care administration in many OECD countries has undergone substantial changes in recent years as a consequence of NPM reforms, rising costs, the pace of technological innovation, heightened competition for patients and resources, quality of managed care and demographic shifts. Hospitals...... especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however......, is insight into how we can understand and explain how medical professionals adapt hospital management over time in relation to changing hospital management models that are global in their influence in hospital organizations. The aim of this dissertation is to understand and explain how medical professionals...
Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

Science.gov (United States)

Steele, Ian H; Thrower, Natasha; Noroian, Paul; Saleh, Fabian M

2018-01-01

Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety. © 2017 American Academy of Forensic Sciences.
Efficient discovery of risk patterns in medical data.

Science.gov (United States)

Li, Jiuyong; Fu, Ada Wai-chee; Fahey, Paul

2009-01-01

This paper studies a problem of efficiently discovering risk patterns in medical data. Risk patterns are defined by a statistical metric, relative risk, which has been widely used in epidemiological research. To avoid fruitless search in the complete exploration of risk patterns, we define optimal risk pattern set to exclude superfluous patterns, i.e. complicated patterns with lower relative risk than their corresponding simpler form patterns. We prove that mining optimal risk pattern sets conforms an anti-monotone property that supports an efficient mining algorithm. We propose an efficient algorithm for mining optimal risk pattern sets based on this property. We also propose a hierarchical structure to present discovered patterns for the easy perusal by domain experts. The proposed approach is compared with two well-known rule discovery methods, decision tree and association rule mining approaches on benchmark data sets and applied to a real world application. The proposed method discovers more and better quality risk patterns than a decision tree approach. The decision tree method is not designed for such applications and is inadequate for pattern exploring. The proposed method does not discover a large number of uninteresting superfluous patterns as an association mining approach does. The proposed method is more efficient than an association rule mining method. A real world case study shows that the method reveals some interesting risk patterns to medical practitioners. The proposed method is an efficient approach to explore risk patterns. It quickly identifies cohorts of patients that are vulnerable to a risk outcome from a large data set. The proposed method is useful for exploratory study on large medical data to generate and refine hypotheses. The method is also useful for designing medical surveillance systems.
Integrated medication management in mHealth applications.

Science.gov (United States)

Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

2014-01-01

Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service.
The NASA risk management program

International Nuclear Information System (INIS)

Buchbinder, B.; Philipson, L.L.

1989-01-01

This paper reports that the NASA Risk Management Program has been established to ensure the appropriate application of risk-based procedures in support of the elimination, reduction, or acceptance of significant safety risks of concern in NASA. The term appropriate is emphasized, in that the particular procedures applied to each given risk are to reflect its character and prioritized importance, the technological and economic feasibility of its treatment. A number of key documents have been produced in support of this implementation. Databases, risk analysis tools, and risk communication procedures requisite to the execution of the risk management functions also are being developed or documented. Several risk management applications have been made and a comprehensive application to a major new NASA program is underway. This paper summarizes the development and current status of the NASA Risk Management Program. Some principal actions that have been carried out in NASA in consonance with the program are noted particularly, and views are presented on the program's likely future directions
Risk Management in Mergers and Acquisitions

Directory of Open Access Journals (Sweden)

Dmitry O. Verdiev

2015-01-01

Full Text Available M&A statistics show that less than a third of newly merged companies has realized their planned synergistic effects and increased shareholder value. According to the author, such disgusting situation is due to improper planning and failure of corporate management to understand the importance of risk management in M&A. Lack of practice in identification, evaluation, mitigation and regular monitoring of risks leads to the situation when many companies merge despite the fact that the merger bears substantial risks. Corporate management fails to include risk mitigation expenses in merger costs. In many cases, risk mitigation expenses may be so substantive that the merger loses its attractiveness. Only few companies implement risk management methodology while planning M&A activity. This methodology may anticipate and minimize the consequences of various risk factors that negatively influence integration process. The article suggests an implementation of risk management best practice. This risk management best practice may act as an effective tool of successful realization of synergistic effects in M&A and may be helpful in increasing shareholder value in post-merger period. Risk management is conducted throughout the stages of merger and includes identification, analysis, assessment, management and monitoring of risks. Implementation of risk management at early stages of merger planning significantly decreases uncertainty in relation to achievement of financial and operational goals of newly merged company. The article provides with typical M&A risk matrix that may be adapted for specific M&A project. Risk matrix includes a register of risks sorted by stages of M&A deal, quality assessment of their probability, influence and impact on merger as well as risk mitigation methods.
Risk Management in Cocurricular Activities.

Science.gov (United States)

Webb, Edward M.

1988-01-01

Discusses risk management for colleges' cocurricular activities. Discusses tort liability, contributory negligence, and assumption of risk. Provides six concrete steps for managing risks responsibly and professionally: adopting an educational mission statement, assigning risk to others, establishing safety standards, training club advisors,…
RISK MANAGEMENT OF GERMAN FRUIT PRODUCERS

Directory of Open Access Journals (Sweden)

Annkatrin PORSCH

2018-03-01

Full Text Available Horticultural farms in Germany face substantial business risks. However, fruit farms often struggle to implement appropriate risk management processes, and the risk management literature widely has ignored this farm type. The aim of the study was to improve the assessment of risks by farmers and the choice of suitable risk management instruments. Therefore, a risk management process based on subjective probabilities and suitable for small and medium-sized farms was developed, considering the specific needs of family run businesses. An online survey was conducted to achieve a comprehensive view of the risk perception and risk management practices of German fruit producers. Price and production risks are the most relevant risk categories for fruit farmers. However, among single risk sources, those in the people risk category were seen as the most important. Results show significant interactions among risk categories and a significant correlation between loss experience and the rating of risk categories. The assumption that risk averse farmers generally rate risks higher than risk neutral or risk seeking farmers cannot be confirmed. Diversification seems to be the most important risk management instrument for many fruit producers, especially diversification of marketing channels, farm income, and production activities. Further research should focus on the apparent inconsistency between the satisfaction with instruments reported by farmers and the actual implementation of many of them (e.g., hail insurance and anti-hail net. Furthermore, there is a need for research, to develop decision models considering the interactions of risks and risk management instruments, loss experience and risk seeking attitudes.
Decision making under uncertainty, therapeutic inertia, and physicians' risk preferences in the management of multiple sclerosis (DIScUTIR MS).

Science.gov (United States)

Saposnik, Gustavo; Sempere, Angel Perez; Raptis, Roula; Prefasi, Daniel; Selchen, Daniel; Maurino, Jorge

2016-05-04

The management of multiple sclerosis (MS) is rapidly changing by the introduction of new and more effective disease-modifying agents. The importance of risk stratification was confirmed by results on disease progression predicted by different risk score systems. Despite these advances, we know very little about medical decisions under uncertainty in the management of MS. The goal of this study is to i) identify whether overconfidence, tolerance to risk/uncertainty, herding influence medical decisions, and ii) to evaluate the frequency of therapeutic inertia (defined as lack of treatment initiation or intensification in patients not at goals of care) and its predisposing factors in the management of MS. This is a prospective study comprising a combination of case-vignettes and surveys and experiments from Neuroeconomics/behavioral economics to identify cognitive distortions associated with medical decisions and therapeutic inertia. Participants include MS fellows and MS experts from across Spain. Each participant will receive an individual link using Qualtrics platform(©) that includes 20 case-vignettes, 3 surveys, and 4 behavioral experiments. The total time for completing the study is approximately 30-35 min. Case vignettes were selected to be representative of common clinical encounters in MS practice. Surveys and experiments include standardized test to measure overconfidence, aversion to risk and ambiguity, herding (following colleague's suggestions even when not supported by the evidence), physicians' reactions to uncertainty, and questions from the Socio-Economic Panel Study (SOEP) related to risk preferences in different domains. By applying three different MS score criteria (modified Rio, EMA, Prosperini's scheme) we take into account physicians' differences in escalating therapy when evaluating medical decisions across case-vignettes. The present study applies an innovative approach by combining tools to assess medical decisions with experiments from
The political economy of a public health case management program's transition into medical homes.

Science.gov (United States)

Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

2015-11-01

Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.
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.
Nephrologists' management of patient medications in kidney transplantation: results of an online survey.

Science.gov (United States)

Crawford, Kimberley; Low, Jac Kee; Manias, Elizabeth; Walker, Rowan; Toussaint, Nigel D; Mulley, William; Dooley, Michael; Ierino, Francesco L; Hughes, Peter; Goodman, David J; Williams, Allison

2015-10-01

Medication adherence is essential in kidney transplant recipients to reduce the risk of rejection and subsequent allograft loss. The aim of this study was to delineate what 'usual care' entails, in relation to medication management, for adult kidney transplant recipients. An online survey was developed to explore how nephrologists promote and assess medication adherence, the management of prescriptions, the frequency of clinic appointments and the frequency of clinical screening tests. Nephrologists from all acute kidney transplant units in Victoria, Australia, were invited to participate. Data were collected between May and June 2014. Of 60 nephrologists invited to participate, 22 completed the survey (response rate of 36.6%). Respondents had a mean age of 49.1 ± 10.1 years, with a mean of 20.1 ± 9.9 years working in nephrology and 14 were men. Descriptive analysis of responses showed that nephrologists performed frequent screening for kidney graft dysfunction that may indicate medication non-adherence, maintained regular transplant clinic visits with patients and emphasized the importance of medication education. However, time constraints during consultations impacted on extensive patient education and the long-term medication follow-up support was often delivered by the renal transplant nurse coordinator or pharmacist. This study highlighted that nephrologists took an active approach in the medication management of kidney transplant recipients, which may assist with facilitating long-term graft survival. Ultimately, promoting medication adherence needs to be patient centred, involving an interdisciplinary team of nephrologists, pharmacists and renal transplant nurse coordinators, working together with the patient to establish optimal adherence. © 2015 John Wiley & Sons, Ltd.
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.
Development of total medical material distribution management system.

Science.gov (United States)

Uto, Y; Kumamoto, I

1994-07-01

Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.
Enterprise Content Management Implementation and Risk

Directory of Open Access Journals (Sweden)

Jaroslava Klegová

2015-01-01

Full Text Available Enterprise Content Management (ECM solutions are commonly used in many areas such as document management, record management, digital asset management, etc. Key features of ECM systems are capturing, indexing, preserving and retrieving of digital information. The state-of-the- art ECM solution can help revolutionize document management and further automated business processes which can lead to better decisions and competitive advantage. Risk management can reduce project failure and that is why controlling risk in ECM implementation projects is considered to be a major contributor to project success. To manage software risk, the first step is to identify a list of ECM projects’ risks. The present paper provides an overview of ECM implementation risks and contains findings from a small survey on experience of ECM implementation and risk in Czech enterprises. Risk of implementation in the public sector is discussed more deeply with case study examples.
Safety management as a foundation for evidence-based aeromedical standards and reporting of medical events.

Science.gov (United States)

Evans, Anthony D; Watson, Dougal B; Evans, Sally A; Hastings, John; Singh, Jarnail; Thibeault, Claude

2009-06-01

The different interpretations by States (countries) of the aeromedical standards established by the International Civil Aviation Organization has resulted in a variety of approaches to the development of national aeromedical policy, and consequently a relative lack of harmonization. However, in many areas of aviation, safety management systems have been recently introduced and may represent a way forward. A safety management system can be defined as "A systematic approach to managing safety, including the necessary organizational structures, accountabilities, policies, and procedures" (1). There are four main areas where, by applying safety management principles, it may be possible to better use aeromedical data to enhance flight safety. These are: 1) adjustment of the periodicity and content of routine medical examinations to more accurately reflect aeromedical risk; 2) improvement in reporting and analysis of routine medical examination data; 3) improvement in reporting and analysis of in-flight medical events; and 4) support for improved reporting of relevant aeromedical events through the promotion of an appropriate culture by companies and regulatory authorities. This paper explores how the principles of safety management may be applied to aeromedical systems to improve their contribution to safety.
Perceptions of personal health risks by medical and non-medical workers in a university medical center : a survey study

NARCIS (Netherlands)

Listyowardojo, Tita Alissa; Nap, Raoul E.; Johnson, Addie

2010-01-01

Background: Health care workers (HCWs) are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the
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...
Knowledge Management within the Medical University.

Science.gov (United States)

Rauzina, Svetlana Ye; Tikhonova, Tatiana A; Karpenko, Dmitriy S; Bogopolskiy, Gennady A; Zarubina, Tatiana V

2015-01-01

The aim of the work is studying the possibilities of ontological engineering in managing of medical knowledge. And also practical implementation of knowledge management system (KMS) in medical university. The educational process model is established that allows analyzing learning results within time scale. Glossary sub-system has been developed; ontologies of educational disciplines are constructed; environment for setup and solution of situational cases is established; ontological approach to assess competencies is developed. The possibilities of the system for solving situation tasks have been described. The approach to the evaluation of competence has been developed.
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 management...

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

OpenAIRE

Enrique Jiménez-Rodríguez; José Manuel Feria-Domínguez; Alonso Sebastián-Lacave

2018-01-01

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identificati...
Hanford Tanks Initiative risk management guide

International Nuclear Information System (INIS)

Schaus, P.S.

1997-01-01

This project-specific Risk Management Guide describes the general approach and process being used by the HTI Project to manage risk associated with execution of the HTI mission. It includes the initial identification of risk and the quantification of its likelihood and severity of its consequences. It further addresses the formulation of risk mitigation plans, periodic statusing of the Risk Management List, and risk closure
From aviation to medicine: applying concepts of aviation safety to risk management in ambulatory care.

Science.gov (United States)

Wilf-Miron, R; Lewenhoff, I; Benyamini, Z; Aviram, A

2003-02-01

The development of a medical risk management programme based on the aviation safety approach and its implementation in a large ambulatory healthcare organisation is described. The following key safety principles were applied: (1). errors inevitably occur and usually derive from faulty system design, not from negligence; (2). accident prevention should be an ongoing process based on open and full reporting; (3). major accidents are only the "tip of the iceberg" of processes that indicate possibilities for organisational learning. Reporting physicians were granted immunity, which encouraged open reporting of errors. A telephone "hotline" served the medical staff for direct reporting and receipt of emotional support and medical guidance. Any adverse event which had learning potential was debriefed, while focusing on the human cause of error within a systemic context. Specific recommendations were formulated to rectify processes conducive to error when failures were identified. During the first 5 years of implementation, the aviation safety concept and tools were successfully adapted to ambulatory care, fostering a culture of greater concern for patient safety through risk management while providing support to the medical staff.
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.
At your own risk. An inquiry about risk management in the ESI

International Nuclear Information System (INIS)

Anon.

1996-01-01

The UNIPEDE survey on Risk Management within the Electricity Supply Industry has provided a picture of the risks facing the Industry at present and an insight into the management of tomorrow's risks. The survey, in which 81 companies (85 respondents) from 31 countries took part shows that: nearly all types of risk identified in the questionnaire are perceived to be growing : the Risk Management role has become more centralized over the past three years: change will slow in the coming three ; the amount of top level attention given to Risk Management is increasing. However only 37 % of respondent companies have Risk Management as a regular top level management item ; environment-related risks and the safety of both employees and the public are perceived as the most critical risks facing the Industry. Over 80 % of surveyed companies consider that both are of increasing concern ; almost 90 % of respondents agreed that risk management processes should be implemented for both pure and speculative risks. Those who disagreed maintained that Risk Management should be 'realistic not theoretical' ; respondents from the US gave markedly different answers to those from the rest of the world. Risk Management in the US receives top level attention, with numerous separated risk management departments handling risk strategy
Managing information technology security risk

Science.gov (United States)

Gilliam, David

2003-01-01

Information Technology (IT) Security Risk Management is a critical task for the organization to protect against the loss of confidentiality, integrity and availability of IT resources. As systems bgecome more complex and diverse and and attacks from intrusions and malicious content increase, it is becoming increasingly difficult to manage IT security risk. This paper describes a two-pronged approach in addressing IT security risk and risk management in the organization: 1) an institutional enterprise appraoch, and 2) a project life cycle approach.
The Supply Chain Risk Management

OpenAIRE

Skitsko Volodymyr I.; Voynikov Mykola Yu.

2018-01-01

The article considers current approaches of risk-management in supply chains, the main steps of the risk management process are analyzed and detailed both for a separate enterprise – participant of supply chain, for the supply chain in general, and for the Beer game, based on the international risk management standards. The article provides a way to assess the risks of the «producer» in the Beer game according to the three strategies of its behavior, which presumably can correspond to differe...
Tank waste remediation system risk management list

International Nuclear Information System (INIS)

Collard, L.B.

1995-01-01

The Tank Waste Remedation System (TWRS) Risk Management List and it's subset of critical risks, the Critical Risk Management List, provide a tool to senior RL and WHC management (Level-1 and -2) to manage programmatic risks that may significantly impact the TWRS program. The programmatic risks include cost, schedule, and performance risks. Performance risk includes technical risk, supportability risk (such as maintainability and availability), and external risk (i.e., beyond program control, for example, changes in regulations). The risk information includes a description, its impacts, as evaluation of the likelihood, consequences and risk value, possible mitigating actions, and responsible RL and WHC managers. The issues that typically form the basis for the risks are presented in a separate table and the affected functions are provided on the management lists
Risk management versus incentives

International Nuclear Information System (INIS)

Aven, E.; Lovas, K.; Osmundsen, P.

2006-01-01

Portfolio theory indicates that risk management should take place at the group level. Hedging at the project level or in the individual business areas may lead to suboptimal results. However, the efficiency of a profit centre depends on its management's being able to influence factors that are crucial to the unit's financial results. Price hedging could be one such factor. In the wider perspective, this constitutes part of the balancing between centralisation and decentralisation. This article covers important elements of risk management and incentive design. It goes on to discuss the balancing of overall risk management at the group level and incentive design in profit centres and corporate units. Throughout the article, the oil industry serves as a case. (author)
Medication therapy management and condition care services in a community-based employer setting.

Science.gov (United States)

Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

2010-08-15

A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical
Science-Driven Approach to Disaster Risk and Crisis Management

Science.gov (United States)

Ismail-Zadeh, A.

2014-12-01

Disasters due to natural extreme events continue to grow in number and intensity. Disaster risk and crisis management requires long-term planning, and to undertake that planning, a science-driven approach is needed to understand and assess disaster risks and to help in impact assessment and in recovery processes after a disaster. Science is used in assessments and rapid modeling of the disaster impact, in forecasting triggered hazards and risk (e.g., a tsunami or a landslide after a large earthquake), in contacts with and medical treatment of the affected population, and in some other actions. At the stage of response to disaster, science helps to analyze routinely the disaster happened (e.g., the physical processes led to this extreme event; hidden vulnerabilities; etc.) At the stage of recovery, natural scientists improve the existing regional hazard assessments; engineers try to use new science to produce new materials and technologies to make safer houses and infrastructure. At the stage of disaster risk mitigation new scientific methods and approaches are being developed to study natural extreme events; vulnerability of society is periodically investigated, and the measures for increasing the resilience of society to extremes are developed; existing disaster management regulations are improved. At the stage of preparedness, integrated research on disaster risks should be developed to understand the roots of potential disasters. Enhanced forecasting and early warning systems are to be developed reducing predictive uncertainties, and comprehensive disaster risk assessment is to be undertaken at local, regional, national and global levels. Science education should be improved by introducing trans-disciplinary approach to disaster risks. Science can help society by improving awareness about extreme events, enhancing risk communication with policy makers, media and society, and assisting disaster risk management authorities in organization of local and regional
Risk Management Practices by Barbadian Banks

Directory of Open Access Journals (Sweden)

Anthony Wood

2013-07-01

The main findings of the paper are: risk managers perceive risk management as critical to their banks’ performance; the types of risks causing the greatest exposures are credit risk, operational risk, country/sovereign risk, interest rate risk and market risk; there was a high level of success with current risk management practices and these practices have evolved over time in line with the changing economic environment and regulatory updates. Overall, the findings suggest strongly that in light of the current depressed economic climate, banks operating in Barbados are indeed risk-focused or might we say “risk intelligent”.
Consolidation of medical groups into physician practice management organizations.

Science.gov (United States)

Robinson, J C

1998-01-14

Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality
Probabilistic risk assessment as an aid to risk management

International Nuclear Information System (INIS)

Garrick, B.J.

1982-01-01

Probabilistic risk assessments are providing important insights into nuclear power plant safety. Their value is two-fold: first as a means of quantifying nuclear plant risk including contributors to risk, and second as an aid to risk management. A risk assessment provides an analytical plant model that can be the basis for performing meaningful decision analyses for controlling safety. It is the aspect of quantitative risk management that makes probabilistic risk assessment an important technical discipline of the future
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.
Branding and the Risk Management Imperative

OpenAIRE

Fournier Susan; Srinivasan Shuba

2018-01-01

In an increasingly risky socioeconomic environment, management needs to proactively consider brand-related risks. To understand brands as tools for risk management, they need to understand four types of brand risk: brand reputation risk, brand dilution risk, brand cannibalization risk and brand stretch risk.
Assessment of medical waste management in seven hospitals in Lagos, Nigeria

Directory of Open Access Journals (Sweden)

Olufunsho Awodele

2016-03-01

Full Text Available Abstract Background Medical waste (MW can be generated in hospitals, clinics and places where diagnosis and treatment are conducted. The management of these wastes is an issue of great concern and importance in view of potential public health risks associated with such wastes. The study assessed the medical waste management practices in selected hospitals and also determined the impact of Lagos Waste Management Authority (LAWMA intervention programs. A descriptive cross-sectional survey method was used. Methods Data were collected using three instrument (questionnaire, site visitation and in –depth interview. Two public (hospital A, B and five private (hospital C, D, E, F and G which provide services for low, middle and high income earners were used. Data analysis was done with SPSS version 20. Chi-squared test was used to determine level of significance at p < 0.05. Results The majority 56 (53.3 % of the respondents were females with mean age of 35.46 (±1.66 years. The hospital surveyed, except hospital D, disposes both general and medical waste separately. All the facilities have the same process of managing their waste which is segregation, collection/on-site transportation, on-site storage and off–site transportation. Staff responsible for collecting medical waste uses mainly hand gloves as personal protective equipment. The intervention programs helped to ensure compliance and safety of the processes; all the hospitals employ the services of LAWMA for final waste disposal and treatment. Only hospital B offered on-site treatment of its waste (sharps only with an incinerator while LAWMA uses hydroclave to treat its wastes. There are no policies or guidelines in all investigated hospitals for managing waste. Conclusions An awareness of proper waste management amongst health workers has been created in most hospitals through the initiative of LAWMA. However, hospital D still mixes municipal and hazardous wastes. The treatment of waste
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 management...
Forty project management strategies for the medical practice staff.

Science.gov (United States)

Hills, Laura Sachs

2010-01-01

Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget.
Medical waste management training for healthcare managers - a necessity?

Science.gov (United States)

Ozder, Aclan; Teker, Bahri; Eker, Hasan Huseyin; Altındis, Selma; Kocaakman, Merve; Karabay, Oguz

2013-07-16

This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management. The study was conducted on 240 volunteers during June - August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups. 67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (pnecessity for the safety of patients and important for its contribution to the economy of the country.

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.
Risk Management and Risk Psychology in Romanian Sme’s

Directory of Open Access Journals (Sweden)

Irina Dănciulescu

2015-12-01

Full Text Available Risk is one of the biggest and most fascinating challenges of all times for humanity, because of its presence in all fields. Risk management as a component of modern management, has become a main concern for the modern world and one of the “key mechanisms” of economic development, a complex processn that includes a series of activities meant to alleviate the impact of risk over business and planed or foreseen results. This paper wants to bring to attention the importance of risks and their management in today’s economic crisis. The sector presented is the IT& C, especially software, because Romania had a growth in this area for a few years but beginning the crisis this segment in economy had known a serious decrease. This paper tries to connect risk management and risk psychology to Romanian economy, culture and mentality. The paper presents in short some of risk management characteristics, definitions and few opinions; why in Romania this subject is not treated with the appropriate attention. The paper at hand focuses on the psychology of risk and how it affects the life of individuals and the existence of companies, the importance it should have on day to day basis, especially in Romania
MANAGEMENT OF SECURITY FOR BANK LOANS ON THE BASIS OF RISK MANAGEMENT

Directory of Open Access Journals (Sweden)

Viktoriia Kovalenko

2016-03-01

Full Text Available The article aims to study methods and tools for risk management to ensure bank loans. Proved that the effectiveness of risk management to ensure bank loans depends on consistency, adequacy methods of evaluation, quality monitoring and timely response system of the banks and the regulator. The article is to develop recommendations to improve the effectiveness of risk management providing bank loans considering the risks inherent in the process support mortgage portfolio of banks in the face of considerable uncertainty functioning banks. It is proved that the risk provision of bank loans in the loan management should be considered through risk characteristics that form the aggregate credit risk. Substantiated that risk management software meets the classic risk management, which identifies four main stages: identification; risk assessment software; control risk; minimizing risk. Keywords: credit risk provision, loan, risk management, reserves.JEL: G 28
Branding and the Risk Management Imperative

Directory of Open Access Journals (Sweden)

Fournier Susan

2018-05-01

Full Text Available In an increasingly risky socioeconomic environment, management needs to proactively consider brand-related risks. To understand brands as tools for risk management, they need to understand four types of brand risk: brand reputation risk, brand dilution risk, brand cannibalization risk and brand stretch risk.
Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies.

Science.gov (United States)

Haddad, Peter M; Brain, Cecilia; Scott, Jan

2014-01-01

Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness's association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive
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.
Competing risk bias was common in Kaplan-Meier risk estimates published in prominent medical journals.

Science.gov (United States)

van Walraven, Carl; McAlister, Finlay A

2016-01-01

Risk estimates from Kaplan-Meier curves are well known to medical researchers, reviewers, and editors. In this study, we determined the proportion of Kaplan-Meier analyses published in prominent medical journals that are potentially biased because of competing events ("competing risk bias"). We randomly selected 100 studies that had at least one Kaplan-Meier analysis and were recently published in prominent medical journals. Susceptibility to competing risk bias was determined by examining the outcome and potential competing events. In susceptible studies, bias was quantified using a previously validated prediction model when the number of outcomes and competing events were given. Forty-six studies (46%) contained Kaplan-Meier analyses susceptible to competing risk bias. Sixteen studies (34.8%) susceptible to competing risk cited the number of outcomes and competing events; in six of these studies (6/16, 37.5%), the outcome risk from the Kaplan-Meier estimate (relative to the true risk) was biased upward by 10% or more. Almost half of Kaplan-Meier analyses published in medical journals are susceptible to competing risk bias and may overestimate event risk. This bias was found to be quantitatively important in a third of such studies. Copyright © 2016 Elsevier Inc. All rights reserved.
Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program

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Mallory C. McKenzie

2012-01-01

Full Text Available Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization's outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM, lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC and the Medication Possession Ratio (MPR. Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01. The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01. The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence pre enrollment versus post enrollment (+10%, P=0.086. The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for
Epilepsy, anti-epileptic medication use and risk of cancer

DEFF Research Database (Denmark)

Kaae, Jeanette; Carstensen, Lisbeth; Wohlfahrt, Jan

2014-01-01

Whether the powerful medications used to treat epilepsy increase the risk of cancer has been debated for decades, but until now no study could disentangle the contributions of anti-epileptic medications and epilepsy itself to cancer risk. Using a cohort comprising all Danish residents ≥ 16 years ...
Considerations on Integrating Risk and Quality Management

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Maria POPESCU

2011-03-01

Full Text Available This paper aims to highlight the links between risk management and quality management and to study the possibility of their integrated approach. The study reviews the evolution of risk approach within organizations and stresses the need to increase the effectiveness of this approach by incorporating risk management methodology in the quality management system. Starting from this idea, the authors present the current state of risk approach into quality management, basic rules of integrated quality-risk management and major difficulties which may arise in the implementation of integrated quality–risk systems.
Records management and risk management at Kenya Commercial Bank Limited, Nairobi

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Cleophas Ambira

2011-03-01

Full Text Available Background: This paper reported empirical research findings of an MPhil in Information Sciences (Records and Archives Management study conducted at Moi University in Eldoret, Kenya between September 2007 and July 2009.Objectives: The aim of the study was to investigate records management and risk management at Kenya Commercial Bank (KCB Ltd, in the Nairobi area and propose recommendations to enhance the functions of records and risk management at KCB. The specific objectives of the study were to, (1 establish the nature and type of risks to which KCB is exposed, (2 conduct business process analysis and identify the records generated by KCB, (3 establish the extent to which records management is emphasised within KCB as a tool to managing risk, (4 identify which vital records of KCB need protection because of their nature and value to the bank and (5 make recommendations to enhance current records management practices to support the function of risk management in KCB.Method: The study was qualitative. Data were collected through face-to-face interviews. The theoretical framework of the study involved triangulation of the records continuum model by Frank Upward (1980 and the integrated risk management model by the Government of Canada (2000.Results: The key findings of the study were, (1 KCB is exposed to a wide range of risks by virtue of its business, (2 KCB generates a lot of records in the course of its business activities and (3 there are inadequate records management practices and systems, the lack of which undermines the risk management function.Conclusion: The findings of this study have revealed the need to strengthen records management as a critical success factor in risk mitigation within KCB and, by extension, the Kenyan banking industry. A records management model was proposed to guide the management of records within an enterprise-wide risk management framework in the bank.
Teaching Disaster Risk Management: Lessons from the Rotman School of Management

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ANDRÁS TILCSIK

Full Text Available This article describes how disaster risk management topics are taught at the Rotman School of Management at the University of Toronto and thus highlights opportunities for developing similar course modules on disaster risk management at other institutions. An undergraduate and MBA elective course, titled Catastrophic Failure in Organizations, contains four modules that are directly relevant to disaster risk management. The first module focuses on the need to move from risk indifference to risk sensitivity. The second module considers the importance of business continuity and crisis management plans and explores their common shortcomings. The third module uses a case study to examine the topic of prospective risk management. The fourth module focuses on the vulnerability of supply chains and other complex systems to disaster risk. The article describes the details of implementing these modules and discusses opportunities for further integration of disaster risk management topics in other parts of the curriculum.
International and Russian practice of banking risk-management. Mortgage risks

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A. V. Nikolaeva

2016-01-01

Full Text Available The goal of the work is to compare Russian norms and standards of risk management of mortgage lending with international standards of risk management based on the documents of the Basel Committee. The article also aims to analyze new banking tools of risk management of mortgage lending, that arise in connection with the application of international norms and standards of risk management.Materials and Methods: The main documents considered in the article are the agreements on capital, issued by the Basel Committee on Banking Supervision: Basel-I (1988, Basel-II (2004 and Basel-III (2010, as well as instructions and standing orders issued by the Central Bank of Russia, including: Instruction № 139-I "Ob obiazatel'nykh normativakh bankov", instruction № 1 "O poriadke regulirovaniia deiatel'nosti kommercheskikh bankov", the standing order number 215-P "O metodike opredeleniia sobstvennykh sredstv (kapitala kreditnykh organizatsii", the standing order № 395-P "O metodike opredeleniia velichiny sobstvennykh sredstv (kapitala kreditnykh organizatsii («BAZEL III»" and others. On the basis of these documents the work examines and summarizes the main methods of risk management of mortgage lending, such as: comparison and analysis of risk management techniques, study of the basic documents regulating risk management in banks and generalization of risk management methods in the segment of mortgage lending.Results: The article analyzes the legal and methodological basis of risk management and provides practical methods that can be used in practice for managerial decisions in a constantly changing external economic environment. It also analyses international and native risk management. Russian standards of risk-management are compared with international. The work conducts a critical review of the effects of introduction of international standards in Russia. Special attention is paid to the practice of mortgage risk-management
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....
Overview of the Hanford risk management plan

International Nuclear Information System (INIS)

Halverson, T.G.

1998-01-01

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
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.
INTERNAL AUDIT AND RISK MANAGEMENT

OpenAIRE

Elena RUSE; Georgiana SUSMANSCHI (BADEA); Daniel DĂNECI-PĂTRĂU

2014-01-01

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 (un)chance 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 int...
Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.

Science.gov (United States)

Sendlhofer, Gerald; Brunner, Gernot; Tax, Christa; Falzberger, Gebhard; Smolle, Josef; Leitgeb, Karina; Kober, Brigitte; Kamolz, Lars Peter

2015-01-01

For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks. CRM implementation into routine procedures within complex hospital organizations is challenging, as in the past, organizational change strategies using a top-down approach have often failed. Therefore, one of our main objectives was to educate a certain number of risk managers in facilitating CRM using a bottom-up approach. To achieve our primary purpose, five project strands were developed, and consequently followed, introducing CRM: corporate governance, risk management (RM) training, CRM process, information, and involvement. The core part of the CRM process involved the education of risk managers within each organizational unit. To account for the size of the existing organization, we assumed that a minimum of 1 % of the workforce had to be trained in RM to disseminate the continuous improvement of quality and safety. Following a roll-out plan, CRM was introduced in each unit and potential risks were identified. Alongside the changes in the corporate governance, a hospital-wide CRM process was introduced resulting in 158 trained risk managers correlating to 2.0 % of the total workforce. Currently, risk managers are present in every unit and have identified 360 operational risks. Among those, 176 risks were scored as strategic and clustered together into top risks. Effective meeting structures and opportunities to share information and knowledge were introduced. Thus far, 31 units have been externally audited in CRM. The CRM approach is unique with respect to its dimension; members of all health care professions were trained to be able to identify potential risks. A network of risk
Generic learning skills in academically-at-risk medical students: a development programme bridges the gap.

Science.gov (United States)

Burch, Vanessa C; Sikakana, Cynthia N T; Gunston, Geney D; Shamley, Delva R; Murdoch-Eaton, Deborah

2013-08-01

Widening access to medical students from diverse educational backgrounds is a global educational mandate. The impact, on students' generic learning skills profiles, of development programmes designed for students at risk of attrition is unknown. This study investigated the impact of a 12-month Intervention Programme (IP) on the generic learning skills profile of academically-at-risk students who, after failing at the end of the first semester, completed the IP before entering the second semester of a conventional medical training programme. This prospective study surveyed medical students admitted in 2009 and 2010, on entry and on completion of first year, on their reported practice and confidence in information handling, managing own learning, technical and numeracy, computer, organisational and presentation skills. Of 414 first year students, 80 (19%) entered the IP. Levels of practice and confidence for five of the six skills categories were significantly poorer at entry for IP students compared to conventional stream students. In four categories these differences were no longer statistically significant after students had completed the IP; 62 IP students (77.5%) progressed to second year. A 12-month development programme, the IP, effectively addressed generic learning skills deficiencies present in academically-at-risk students entering medical school.
Risk Management in Insurance Companies

OpenAIRE

Yang, Xufeng

2006-01-01

Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...

Financial risk management of pharmacy benefits.

Science.gov (United States)

Saikami, D

1997-10-01

Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.
Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

Directory of Open Access Journals (Sweden)

Makowsky MJ

2014-02-01

Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary
Gender, Race, and Risk: Intersectional Risk Management in the Sale of Sex Online.

Science.gov (United States)

Moorman, Jessica D; Harrison, Kristen

2016-09-01

Sex worker experience of risk (e.g., physical violence or rape) is shaped by race, gender, and context. For web-based sex workers, experience of risk is comparatively minimal; what is unclear is how web-based sex workers manage risk and if online advertising plays a role in risk management. Building on intersectionality theory and research exploring risk management in sex work, we content-analyzed 600 escort advertisements from Backpage.com ( http://www.backpage.com ) to explore risk management in web-based sex work. To guide our research we asked: Do advertisements contain risk management messages? Does the use of risk management messaging differ by sex worker race or gender? Which groups have the highest overall use of risk management messages? Through a multivariate analysis of covariance (MANCOVA) we found that advertisements contained risk management messages and that uses of these phrases varied by race and gender. Blacks, women, and transgender women drove the use of risk management messages. Black and White transgender women had the highest overall use of these phrases. We conclude that risk management is an intersectional practice and that the use of risk management messages is a venue-specific manifestation of broader risk management priorities found in all venues where sex is sold.
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
PERFORMANCE IN INTERNAL CONTROL AND RISK MANAGEMENT

Directory of Open Access Journals (Sweden)

JELER (POPA IOANA

2017-06-01

Full Text Available The purpose of this article is to highlight the importance of internal control and risk management. In practice, economic entities meet a variety of risks that have the origins from the internal environment or the external one. Although there are different of views on addressing the concept of risk - threats or opportunities, event or action, accordingly uncertain, proposed by specialists in risk management in this article we try to present these issues and identify techniques to counter risks occurrence. In this article we present also means managing risk and why needs to be implemented at institutional level a risk management. The paper concludes by highlight the role of efficient risk management in the company’s management and company's activities.
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.
The Role of Medical Expenditure Risk in Portfolio Allocation Decisions.

Science.gov (United States)

Ayyagari, Padmaja; He, Daifeng

2017-11-01

Economic theory suggests that medical spending risk affects the extent to which households are willing to accept financial risk, and consequently their investment portfolios. In this study, we focus on the elderly for whom medical spending represents a substantial risk. We exploit the exogenous reduction in prescription drug spending risk because of the introduction of Medicare Part D in the U.S. in 2006 to identify the causal effect of medical spending risk on portfolio choice. Consistent with theory, we find that Medicare-eligible persons increased risky investment after the introduction of prescription drug coverage, relative to a younger, ineligible cohort. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Medical leadership and management in the United Kingdom.

Science.gov (United States)

Kyratsis, Yiannis; Armit, Kirsten; Zyada, Azra; Lees, Peter

2016-06-01

This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, and discuss professional development and future prospects. With increasing involvement of medical professionals in top managerial roles in the UK over the last 30 years, leadership development initiatives have been growing steadily and there is increasing recognition of the need for leadership and management skills for doctors. Such skills can help to greatly improve patient care as well as enhance organisational effectiveness and productivity. The central involvement of professional bodies such as the UK Faculty of Medical Leadership and Management, and the establishment of medical fellowship schemes, have provided a solid foundation for a new generation of aspiring medical leaders but there is still a long way to go to achieve a higher degree of professionalism for clinical leadership in the UK. The evidence base is weak such that integrated efforts by clinicians and management academics have much to offer in achieving the vision of socially responsible, clinically relevant and research informed medical leadership training. © The Royal Australian and New Zealand College of Psychiatrists 2016.
The Strategic-Renovation Banks’ Risks Management

Directory of Open Access Journals (Sweden)

Yeremeychuk Raisa A.

2017-04-01

Full Text Available The article is aimed at developing approaches to implementation of the strategic-renovation risk management. Essence of risk theories was researched, the concept of «risk» in the bank’s management system were analyzed. On the basis of a theoretical generalization of scientific literature and the carried out analysis of existing risk management strategies to ensure the security of banking business, the strategy of renovation management has been selected. Because bank risks are part of the economic risk system, they are complex in their nature. However, given the importance of bank risks, the interpretation of their essence is still a debating matter. In a certain number of cases, their essence is replaced by the cause of occurrence, that is, all the different circumstances, factors that lead to the losses. So today, banks are considering risks, in particular, not only as a source of possible losses, but also as an opportunity to generate additional profits. An algorithm for taking a strategic-renovation decision on the banks’ risks management system has been proposed.
Risk, innovation and change : design propositions for implementing risk management in organizations

NARCIS (Netherlands)

van Staveren, 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
Medical Data Architecture Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.
An enhanced data-analytic framework for integrating risk management and performance management

International Nuclear Information System (INIS)

Thekdi, Shital; Aven, Terje

2016-01-01

There is increasing interest for agencies and industries to develop risk management processes for a wide variety of applications. Traditional risk management processes are motivated by controlling risk and avoiding losses. In contrast, other organizational processes focus on managing performance and value generation. In this paper we argue that risk management also adds an important contribution to these processes. However, this requires “proper” risk management extending beyond narrow safety oriented perspectives built on quantitative risk analysis and tolerability/acceptance criteria. There is need for a broad risk-performance framework with uncertainty being a main component of risk, and where knowledge and surprises are adequately reflected. In the paper we present and discuss such a framework. The framework is developed on the basis of an analysis of combinations of different risk management and performance management practices/policies. We show how the risk and performance management processes can be improved by proper risk conceptualization and a holistic thinking on how to develop and use goals in the organization, how to balance different concerns, and consider the need for agility – “sensitivity to operations”, as well as how to give weight to vulnerabilities, resilience, and antifragility. - Highlights: • We relate key performance management and risk management principles. • We propose an enhanced framework to unify thinking of performance and risk. • We apply the framework to a public-private partnership case study.
Tank waste remediation system programmatic risk management plan

International Nuclear Information System (INIS)

Seaver, D.A.

1995-01-01

This risk management plan defines the approach to be taken to managing risks in the Tank Waste Remediation System (TWRS) program. It defines the actions to be taken at the overall program level, and the risk management requirements for lower-level projects and other activities. The primary focus of this plan is on ''programmatic'' risks, i.e., risks with respect to the cost, schedule, and technical performance of the program. The plan defines an approach providing managers with the flexibility to manage risks according to their specific needs, yet creates. The consistency needed for effectiveness across the program. The basic risk management approach uses a risk management list for the program, each project, and additional lower-level activities. The risk management list will be regularly reviewed and updated by appropriate level of management. Each list defines key risks, their likelihood and consequences, risk management actions to be taken, responsible individuals, and other management information
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…
Information systems for risk management

OpenAIRE

Michael S. Gibson

1997-01-01

Risk management information systems are designed to overcome the problem of aggregating data across diverse trading units. The design of an information system depends on the risk measurement methodology that a firm chooses. Inherent in the design of both a risk management information system and a risk measurement methodology is a tradeoff between the accuracy of the resulting measures of risk and the burden of computing them. Technical progress will make this tradeoff more favorable over time...
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
Medical technology management: from planning to application.

Science.gov (United States)

David, Y; Jahnke, E

2005-01-01

Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations.
An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

Science.gov (United States)

Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

2015-01-01

To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.
Enterprise risk management: A process for enhanced management and improved performance

OpenAIRE

Gates , Stephen; Nicolas , Jean-Louis; Walker , Paul L.

2012-01-01

Some company boards of directors and management teams are still reluctant to embrace enterprise risk management (ERM) because of the uncertainty regarding its value to the bottom line. A survey of audit and risk management executives suggests that the use of ERM leads to increased management consensus, better-informed decisions, enhanced communication of risk taking, and greater management accountability.
Risk Management Standards: Towards a contemporary, organisation-wide management approach

OpenAIRE

Koutsoukis, Nikitas-Spiros

2010-01-01

Risk management has been progressively evolving into a systemic approach for organisational decision making in today’s dynamic economic environment of the global era. In this context, risk management is reaching beyond its traditional finance and insurance application context and is entering the sphere of generic, organisation-wide management approaches. In support of this argument we consider four generic risk management standards issued at the institutional, national or international level...

A new Web-based medical tool for assessment and prevention of comprehensive cardiovascular risk

Directory of Open Access Journals (Sweden)

Daniele Franchi

2011-02-01

flexible tool for clinical management of patients at risk of cardiovascular disease and for epidemiological research.Keywords: internet, informatics, cardiovascular risk, evidence-based practice, medical consultation, decision support, clinical information systems
Dental management of medically compromised patients

Directory of Open Access Journals (Sweden)

Sherly Horax

2016-06-01

Full Text Available These days, treatment in dentistry is no longer for patient without complication, but also for patient with bad medical record. With correct treatment management in handling medical condition of patient, not only for dental treatment but also their systematic disease, all the dental staff also can improve for the better quality of life of the patient. Patient with medical compromised start to realize that keeping good oral hygiene is so important for their lives, therefore dental staff need to improve their science and technology and also for facing patient with medical compromised. This article will discuss and suggest various treatment consideration and protocol for the patient of with medical compromised.
Biological risks of medical irradiations: Medical physics monograph 5

International Nuclear Information System (INIS)

Fullerton, G.D.; Kopp, D.T.; Waggener, R.G.; Webster, E.W.

1980-01-01

This book is the fifth in a series of monographs by the American Association of Physicists in Medicine (AAPM) and is a compendium of papers presented at an AAPM regional symposium conducted in San Antonio in July 1980. The book is divided into three sections: (1) biological fundamentals of ionizing radiation, (2) risk evaluation and reduction in three principle radiologic subspecialties (diagnostic radiology, nuclear medicine and radiation therapy), and (3) medical-legal implications. The first section includes a historical review of radiation biology, including a discussion of somatic and genetic effects and statistical approaches to risk estimates. The section on risk evaluation and reduction includes a good review of the units of exposure and activity including the international (SI) system employing the gray, becquerel, and seivert that respectively replace the rad, Curie, and rem. The unavoidable problem of legal responsibility and liability is the subject of the third, and last, section of the monograph. A chapter summarizing the legal history of medical irradiation also includes a glossary of pertinent legal terms. Recent court decisions that impact upon the clinical use of radiation are presented and discussed as well as proposed changes in federal guidelines that could have a large impact on the practice of medicine in general and radiology in particular
Self-Medication: potential risks and hazards among pregnant ...

African Journals Online (AJOL)

Self-Medication: potential risks and hazards among pregnant women in Uyo, ... Reasons for using these substances range from protection from witches and ... shows that self-medication is common among pregnant women in our environment.
Evaluation Apprehension and Impression Management in Clinical Medical Education.

Science.gov (United States)

McGaghie, William C

2018-05-01

Historically, clinical medical education has relied on subjective evaluations of students and residents to judge their clinical competence. The uncertainty associated with these subjective clinical evaluations has produced evaluation apprehension among learners and attempts to manage one's professional persona (impression management) among peers and supervisors. Such behavior has been documented from antiquity through the Middle Ages to the present, including in two new qualitative studies in this issue of Academic Medicine on the social psychology of clinical medical education. New approaches to medical education, including competency-based education, mastery learning, and assessment methods that unite evaluation and education, are slowly changing the culture of clinical medical education. The author of this Invited Commentary argues that this shift will bring greater transparency and accountability to clinical medical education and gradually reduce evaluation apprehension and the impression management motives it produces.
Development of computerized risk management tool

International Nuclear Information System (INIS)

Kil Yoo Kim; Mee Jung Hwang; Seung Cheol Jang; Sang Hoon Han; Tae Woon Kim

1997-01-01

The author describes the kinds of efforts for the development of computerized risk management tool; (1) development of a risk monitor, Risk Monster, (2) improvement of McFarm (Missing Cutsets Finding Algorithm for Risk Monitor) and finally (3) development of reliability database management system, KwDBMan. Risk Monster supports for plant operators and maintenance schedulers to monitor plant risk and to avoid high peak risk by rearranging maintenance work schedule. Improved McFarm significantly improved calculation speed of Risk Monster for the cases of supporting system OOS (Out Of Service). KwDBMan manages event data, generic data and CCF (Common Cause Failure) data to support Risk Monster as well as PSA tool, KIRAP (KAERI Integrated Reliability Analysis Package)
Understanding and managing risk attitude

National Research Council Canada - National Science Library

Hillson, David; Murray-Webster, Ruth

2007-01-01

... This book highlights how risk attitude factors influence the human psyche, and carefully explains the impacts. Organisations seeking to dramatically improve the effectiveness of their risk management process will want to use this book's insights. Craig Peterson, President, PMI Risk Management SIG This book has prompted me to think more deeply as a change d...
Risk Management and Value Creation

DEFF Research Database (Denmark)

Andersen, Torben Juul; Roggi, Oliviero

Corporate failures, periodic recessions, regional debt crises and volatile financial markets have intensified the focus on risk management as the means to deal with turbulent conditions. The ability to respond effectively to abrupt environmental impacts is considered an important source...... 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...
Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

Science.gov (United States)

Alagiakrishnan, Kannayiram; Wilson, Patricia; Sadowski, Cheryl A; Rolfson, Darryl; Ballermann, Mark; Ausford, Allen; Vermeer, Karla; Mohindra, Kunal; Romney, Jacques; Hayward, Robert S

2016-01-01

Background Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. Methods Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR). The “Seniors Medication Alert and Review Technologies” (SMART) intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages) and active (order-entry alerts) prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed. Results Analysis of subjective data revealed that most clinicians agreed that CDS appeared at appropriate times during patient care. Although managing alerts incurred a modest time burden, most also agreed that workflow was not disrupted. Prevalent concerns related to clinician accountability and potential liability. Approximately 36% of eligible encounters triggered at least one SMART alert, with GFR alert, and most frequent medication warnings were with hypnotics and anticholinergics. Approximately 25% of alerts were overridden and ~15% elicited an evidence check. Conclusion While most SMART alerts validated clinician choices, they were received as valuable reminders for evidence-informed care and education. Data from this study may aid other attempts to implement Beers’ Criteria in
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.
From aviation to medicine: applying concepts of aviation safety to risk management in ambulatory care

Science.gov (United States)

Wilf-Miron, R; Lewenhoff, I; Benyamini, Z; Aviram, A

2003-01-01

   The development of a medical risk management programme based on the aviation safety approach and its implementation in a large ambulatory healthcare organisation is described. The following key safety principles were applied: (1) errors inevitably occur and usually derive from faulty system design, not from negligence; (2) accident prevention should be an ongoing process based on open and full reporting; (3) major accidents are only the "tip of the iceberg" of processes that indicate possibilities for organisational learning. Reporting physicians were granted immunity, which encouraged open reporting of errors. A telephone "hotline" served the medical staff for direct reporting and receipt of emotional support and medical guidance. Any adverse event which had learning potential was debriefed, while focusing on the human cause of error within a systemic context. Specific recommendations were formulated to rectify processes conducive to error when failures were identified. During the first 5 years of implementation, the aviation safety concept and tools were successfully adapted to ambulatory care, fostering a culture of greater concern for patient safety through risk management while providing support to the medical staff. PMID:12571343
Business resilience: Reframing healthcare risk management.

Science.gov (United States)

Simeone, Cynthia L

2015-09-01

The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.
Risk Management in the Exchange Fund Account

OpenAIRE

Michel Rochette

2002-01-01

In this article, author Michel Rochette of the Bank's Risk-Management Unit briefly describes the initiatives undertaken to identify, analyze, model, and manage the principal risks inherent in the transactions of the Exchange Fund Account (EFA), where the international reserves of the federal government are held. The author focuses on five types of risk: credit risk, market risk, liquidity risk, operational risk, and legal risk. In addition, the author presents the risk-management principles u...
Framing medical tourism: an examination of appeal, risk, convalescence, accreditation, and interactivity in medical tourism web sites.

Science.gov (United States)

Mason, Alicia; Wright, Kevin B

2011-02-01

This exploratory study analyzed the content of medical tourism Web sites in an attempt to examine how they convey information about benefits and risks of medical procedures, how they frame credibility, and the degree to which these Web sites include interactive features for consumers. Drawing upon framing theory, the researchers content analyzed a sample of 66 medical tourism Web sites throughout the world. The results indicated that medical tourism Web sites largely promote the benefits of medical procedures while downplaying the risks, and relatively little information regarding the credibility of these services appears. In addition, the presentation of benefits/risks, credibility, and Web site interactivity were found to differ by region and type of facility. The authors discuss the implications of these findings concerning the framing of medical tourism Web site content, future directions for research, and limitations.
Medical Waste Management Training for Healthcare Managers - a Necessity?

Directory of Open Access Journals (Sweden)

Aclan Ozder

2013-07-01

Full Text Available Background:This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers regarding bio-medical waste management.Methods:The study was conducted on 240 volunteers during June – August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions. A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups.Results:67.5% (162 of participants were female. 42.5% (102 are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test and others who had not (p<0.01. It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session.Conclusion:On the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.
Guide on medical management of persons exposed in radiation accidents

International Nuclear Information System (INIS)

1990-01-01

The present guide has been prepared in order to provide guidance to medical and para-medical personnel regarding medical management of the different types of radiation accidents. It discusses briefly the physical aspects and biological effect of radiation, for the benefit of those who have not specialised in radiation medicine. The diagnosis, medical management and follow-up of persons involved in different types of radiation accidents are also dealt with. The implementation of the procedures described calls for organisation of appropriate facilities and provision of requisite equipment as well as education and training of the staff. It is emphasised that major radiation accidents are rare events and the multi-disciplinary nature of the response required to deal with them calls for proper planning and continuous liaison among plant management, radiation protection personnel, first-aid assistants and medical and paramedical staff. The organisation and conduct of emergency drills may help in maintaining preparedness of the medical facilities for efficient management of radiation casualities. (original). 64 refs., tabs., figs
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 take...
Ransomware: Minimizing the Risks.

Science.gov (United States)

Pope, Justin

2016-01-01

This ongoing column is dedicated to providing information to our readers on managing legal risks associated with medical practice. We invite questions from our readers. The answers are provided by PRMS, Inc. (www.prms.com), a manager of medical professional liability insurance programs with services that include risk management consultation, education and onsite risk management audits, and other resources to healthcare providers to help improve patient outcomes and reduce professional liability risk. The answers published in this column represent those of only one risk management consulting company. Other risk management consulting companies or insurance carriers may provide different advice, and readers should take this into consideration. The information in this column does not constitute legal advice. For legal advice, contact your personal attorney. Note: The information and recommendations in this article are applicable to physicians and other healthcare professionals so "clinician" is used to indicate all treatment team members.
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
[Health care waste management of potentially infectious medical waste by healthcare professionals in a private medical practice: a study of practices].

Science.gov (United States)

Brunot, Alain; Thompson, Céline

2010-01-01

A cross-sectional study was conducted with a sample of 278 health professionals (GPs and specialists, dentists, physical therapists and nurses) in a private medical practice in Paris to study the medical waste management practices related to the production and disposal of potentially hazardous health care waste. With the exception of physical therapists, most professionals produced medical waste (72% to 96,2% according to occupation), with a monthly median of 3 liters (inter-quartile range 1-15 liters). All sharp objects and needles were separated and 91% of them eliminated via a specific process for that sector. These percentages were respectively 84% and 69% concerning contaminated waste that was neither needles or used for cutting. 48% of the professionals reported the existence of documents that could track the disposal of their medical waste. To improve practice, professionals cited collection on-site at the office (74%) and reliability of the contracted service provider to collect the waste (59%). The study showed that health professionals need information on the regulations regarding potentially infectious medical waste, in particular on the traceability of its elimination. They also noted the lack of clarity and precision with regard to the definition of risk of infection: 31,7% of professionals only declare the production of sharp or cutting waste without having specified criteria for risk of infection.

U.S. academic medical centers under the managed health care environment.

Science.gov (United States)

Guo, K

1999-06-01

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.
Trends in risk management in nuclear industry

International Nuclear Information System (INIS)

Kim, Inn Seock

1996-01-01

Safety management may be classified into three dimensions: risk management, accident management, and emergency management. This paper addresses the recent trends of safety management in nuclear industry, focussing on risk management and accident management
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.
Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development.

Science.gov (United States)

Abbas, Mark R; Quince, Thelma A; Wood, Diana F; Benson, John A

2011-11-14

There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify the most effective and cost-effective curriculum innovations, this
Integrated supply chain risk management

OpenAIRE

Riaan Bredell; Jackie Walters

2007-01-01

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 ...
Managing Costs and Medical Information

Science.gov (United States)

People with cancer may face major financial challenges and need help dealing with the high costs of care. Cancer treatment can be very expensive, even when you have insurance. Learn ways to manage medical information, paperwork, bills, and other records.
[Does clinical risk management require a structured conflict management?].

Science.gov (United States)

Neumann, Stefan

2015-01-01

A key element of clinical risk management is the analysis of errors causing near misses or patient damage. After analyzing the causes and circumstances, measures for process improvement have to be taken. Process management, human resource development and other established methods are used. If an interpersonal conflict is a contributory factor to the error, there is usually no structured conflict management available which includes selection criteria for various methods of conflict processing. The European University Viadrina in Frankfurt (Oder) has created a process model for introducing a structured conflict management system which is suitable for hospitals and could fill the gap in the methodological spectrum of clinical risk management. There is initial evidence that a structured conflict management reduces staff fluctuation and hidden conflict costs. This article should be understood as an impulse for discussion on to what extent the range of methods of clinical risk management should be complemented by conflict management.
Medical and psychosocial barriers to weight management in older veterans with and without serious mental illness.

Science.gov (United States)

Muralidharan, Anjana; Klingaman, Elizabeth A; Prior, Steven J; Molinari, Victor; Goldberg, Richard W

2016-11-01

Older adults with serious mental illness (SMI) are an understudied population with complex care needs and high rates of obesity/overweight. Little is known about the experiences of older adults with SMI with weight management. The present study is an observational study of veterans ages 55 and over with a body mass index in the overweight or obese range, comparing Veterans with schizophrenia or bipolar disorder (n = 9044) to their same-age peers with no mental health disorders (n = 71156), on their responses to a questionnaire assessment of medical and psychosocial factors related to weight management. Responses to the questionnaire between August, 2005 and May, 2013 were used to examine the following: demographics, clinical characteristics, medical barriers to weight management, current weight loss plan, reliability of social support, reasons for being overweight, and weight loss barriers. Physical health concerns were highly prevalent in both groups. Veterans in the SMI group endorsed more medical issues and were significantly more likely to endorse experiences that indicated that their medical conditions were poorly controlled (e.g., shortness of breath). Veterans in the SMI group were more likely to endorse many barriers to healthy eating and physical activity, across medical, psychological, social, and environmental domains. Even within a sample at medically high-risk for complications related to obesity and metabolic syndrome, older veterans with SMI and overweight/obesity experience more challenges with weight management than their same-age peers with overweight/obesity and no mental health disorders. Weight management interventions for this population should take a multifaceted approach. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Basic management of medical emergencies: recognizing a patient's distress.

Science.gov (United States)

Reed, Kenneth L

2010-05-01

Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.
A Review of the Effect of Anticonvulsant Medications on Bone Mineral Density and Fracture Risk

Science.gov (United States)

Lee, Richard H.; Lyles, Kenneth W.; Colón-Emeric, Cathleen

2011-01-01

investigating therapeutic agents to prevent fracture in this population were identified. Consequently, there are no formal practice guidelines for the monitoring, prevention, and management of bone disease among those taking anticonvulsants. Conclusions Observational studies suggest an association between use of anticonvulsant medications, reduced bone mineral density, and increased fracture risk. Randomized clinical trials are needed to guide the management of bone disease among those who use anticonvulsants. PMID:20226391
Risk management as a social defence against anxiety

Directory of Open Access Journals (Sweden)

Dirk J. Geldenhuys

2012-03-01

Research purpose: The aim of the study is to describe how risk management unconsciously influences behaviour when doing business in an African country. Motivation for the study: Operational risk management is a rational management imperative. However, this does not take cognisance of the unconscious role of risk management. A systems-psychodynamic perspective might be particularly relevant if the anxiety implied in risk management is not appropriately contained. Awareness of these dynamics may provide an opportunity for addressing them and allow for a more holistic way of managing risk. Research design, approach and method: The researchers conducted the study as a qualitative case study in an African country. They used purposive sampling and analysed the data using qualitative content analysis. Main findings: Viewing risk management from a systems-psychodynamic perspective allowed the researchers to identify the influence of risk management on the behaviour of people. The emerging hypothesis was that, if businesses do not address the anxiety underlying risk management, managing risk becomes a social defence against the anxiety. Practical/managerial implications: Awareness of the anxiety involved in risk management may assist businesses to manage risk in a more realistic way, making provision for, and even capitalising on, the human element. Contributions/value-add: The article provides a systems-psychodynamic, and hence a more complete, perspective of operational risk management when doing business in an African country.
A risk communication case study: the Nevada risk assessment/management program

International Nuclear Information System (INIS)

Hechanova, A.E.

2001-01-01

The Nevada Risk Assessment/Management Program is part of a national effort by the U.S. Department of Energy (Grant DE-FG01-96EW56093) to develop new sources of information and approaches to risk assessment, risk management, risk communication and public outreach as these objectives relate to the ecological and human health effects of radioactive and hazardous material management and site remediation activities. This paper reviews the innovation behind the Nevada Risk Assessment/Management Program and presents a synopsis of the effort that began in 1995 and will officially conclude on April 30, 2000. (author)
Integrated Risk Management Within NASA Programs/Projects

Science.gov (United States)

Connley, Warren; Rad, Adrian; Botzum, Stephen

2004-01-01

As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the
Consumers' willingness to use a medication management service: the effect of medication-related worry and the social influence of the general practitioner.

Science.gov (United States)

Carter, Stephen R; Moles, Rebekah J; White, Lesley; Chen, Timothy F

2013-01-01

Some consumers at risk of experiencing medication-related problems have chosen not to use pharmacist-provided medication management services. Previous research has shown that consumers' willingness to use the Australian Home Medicines Review (HMR) service depends on the extent to which they believe that they will receive medication information to assist them with self-management. The aim of this study was to develop and test a model of willingness to use HMR among consumers who were eligible to receive the service but have not yet experienced it. Specifically, this study aimed to determine the effects of consumers' medication-related worry and the social influence of the consumer's general practitioner (GP) over willingness. A cross-sectional postal survey was conducted among 1600 members of Council on the Ageing (NSW, Australia). Respondents were included in the study if they had not experienced an HMR and were taking more than 5 medicines daily or more than 12 doses daily. Measurement scales were developed or were based on previous research. Confirmatory factor analysis was used to test the reliability and validity of the multi-item scales. Multiple regression analysis and structural equation modeling (SEM) were used to test the model. Surveys received from 390 respondents (24.3%) were analyzed. Respondents held overall low-to-neutral positive outcome expectancy (POE). The SEM analysis revealed that worry had a direct effect on POE (β=0.35, Psocial influence over willingness to use this medication management service. Copyright © 2013 Elsevier Inc. All rights reserved.
Prehypertension--prevalence, health risks, and management strategies.

Science.gov (United States)

Egan, Brent M; Stevens-Fabry, Sean

2015-05-01

Prehypertension (blood pressure 120-139/80-89 mmHg) affects ~25-50% of adults worldwide, and increases the risk of incident hypertension. The relative risk of incident hypertension declines by ~20% with intensive lifestyle intervention, and by 34-66% with single antihypertensive medications. To prevent one case of incident hypertension in adults with prehypertension and a 50% 5-year risk of hypertension, 10 individuals would need to receive intensive lifestyle intervention, and four to six patients would need to be treated with antihypertensive medication. The relative risk of incident cardiovascular disease (CVD) is greater with 'stage 2' (130-139/85-89 mmHg) than 'stage 1' (120-129/80-84 mmHg) prehypertension; only stage 2 prehypertension increases cardiovascular mortality. Among individuals with prehypertension, the 10-year absolute CVD risk for middle-aged adults without diabetes mellitus or CVD is ~10%, and ~40% for middle-aged and older individuals with either or both comorbidities. Antihypertensive medications reduce the relative risk of CVD and death by ~15% in secondary-prevention studies of prehypertension. Data on primary prevention of CVD with pharmacotherapy in prehypertension are lacking. Risk-stratified, patient-centred, comparative-effectiveness research is needed in prehypertension to inform an acceptable, safe, and effective balance of lifestyle and medication interventions to prevent incident hypertension and CVD.
Managing IT Integration Risk in Acquisitions

DEFF Research Database (Denmark)

Henningsson, Stefan; Kettinger, William J.

2016-01-01

The article discusses a framework for evaluating risk of information technology (IT) integration in acquisitions. Topics include the use of the experience of serial acquirer Trelleborg AB to show the merits of the framework for managing the risk and to determine low-risk acquisitions......, the importance of managing IT integration risk, and various risk areas for acquisition IT integration....
Strategies for successful software development risk management

Directory of Open Access Journals (Sweden)

Marija Boban

2003-01-01

Full Text Available Nowadays, software is becoming a major part of enterprise business. Software development is activity connected with advanced technology and high level of knowledge. Risks on software development projects must be successfully mitigated to produce successful software systems. Lack of a defined approach to risk management is one of the common causes for project failures. To improve project chances for success, this work investigates common risk impact areas to perceive a foundation that can be used to define a common approach to software risk management. Based on typical risk impact areas on software development projects, we propose three risk management strategies suitable for a broad area of enterprises and software development projects with different amounts of connected risks. Proposed strategies define activities that should be performed for successful risk management, the one that will enable software development projects to perceive risks as soon as possible and to solve problems connected with risk materialization. We also propose a risk-based approach to software development planning and risk management as attempts to address and retire the highest impact risks as early as possible in the development process. Proposed strategies should improve risk management on software development projects and help create a successful software solution.
Value-oriented risk management of insurance companies

CERN Document Server

Kriele, Marcus

2014-01-01

Value- and risk-oriented management is a holistic method of managing businesses. In this book both actuarial methods and methods pertaining to classical internal control and classical risk management are used. Therefore the approach taken is necessarily interdisciplinary. Indeed, there is a new dynamically developing field for actuaries as a result of the emphasis now on the measurement of risk. This book provides the required basic knowledge for this subject from an actuarial perspective. It enables the reader to implement in practice a risk management system that is based on quantitative methods. With this book, the reader will additionally be able to critically appraise the applicability and the limits of the methods used in modern risk management. Value- Oriented Risk Management of Insurance Companies focuses on risk capital, capital allocation, performance measurement and value-oriented management. It also makes a connection to regulatory developments (for example, Solvency II). The reader should have...
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.
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

Applying Lean Six Sigma to improve medication management.

Science.gov (United States)

Nayar, Preethy; Ojha, Diptee; Fetrick, Ann; Nguyen, Anh T

2016-01-01

A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA's dual care policy; collect data and describe the current process for co-management of dual care veterans' medications; and draft recommendations to improve the current process for dual care medications co-management. Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. The findings of this project will be of value to VA providers and policy makers and health
Risk management study for the retired Hanford Site facilities: Risk management executive summary

International Nuclear Information System (INIS)

Coles, G.A.; Shultz, M.V.; Taylor, W.E.

1994-02-01

This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km 2 Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This document is the first in a four volume series that comprise the risk management study for the retired, surplus facilities. Volume 2 is the risk evaluation work procedure; volume 3 provides the results for the risk evaluation; and volume 4 is the risk-reduction cost comparison
Healthcare managers' construction of the manager role in relation to the medical profession.

Science.gov (United States)

von Knorring, Mia; Alexanderson, Kristina; Eliasson, Miriam A

2016-05-16

Purpose - The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations. Design/methodology/approach - In total, 18 of Sweden's 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians' sickness certification practice. A discourse analysis approach was used for data analysis. Findings - Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes "physician" or "non-physician" to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of "yes, but […]" approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers. Research limitations/implications - Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians. Practical implications - The results suggest that there is a need to address the organisational conditions for managers' role taking in healthcare organisations. Originality/value - Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.
Risk management on nuclear power plant. Application of probabilistic risk assessment

International Nuclear Information System (INIS)

Kojima, Shigeo

2003-01-01

In U.S.A., nuclear safety regulation is moving to risk-informed regulation (RIR), so necessity of a standard to provide contents of probabilistic risk assessment (PRA) constructing its roots has been discussed for a long time. In 1998, the Committee on Nuclear Risk Management (CNRM) of the American Society of Mechanical Engineers (ASME) began to investigate the standard, of which last edition was published as the Standard for Probabilistic Risk Management for Nuclear Power Plant Applications: RA-S-2002 (PRMA) on April, 2002. As in the Committee, the Nuclear Regulatory Commission (NRC), electric power companies, national institutes, PRA specialists, and so on took parts to carry out many discussions with full energies of participants on risk management in U.S.A., the standard was finished after about four years' efforts. In U.S.A., risk management having already used PRA is successfully practiced, U.S.A. is at a stage with more advancing steps of the risk management than Japan is. Here was described on the standard of PRA and a concrete method of the risk management carried out at nuclear power stations. (G.K.)
Risk management in facility transition and management decision making: Needs and opportunities

International Nuclear Information System (INIS)

Stillwell, W.; Seaver, D.; Keller, J.; Smith, D.; Weaver, D.; Sanders, T.; Thullen, P.

1993-02-01

An overall approach to risk management is described in this paper. Many of these concepts have been developed and applied as part of Hanford Mission Planning (HMP) (Hanford Mission Plan, 1992). At Hanford, HMP provides a mechanism for integrating planning across all the missions and programs of the site. This paper discusses the decision context within which EM must make and defend decisions, the types of decisions that are being and will need to be made in order to progress with the cleanup of the DOE complex, and the resulting need for risk management. Risk management, in turn, requires quality health and ecological risk information to make these decisions. Other types of information are also needed, but the risk information is typically the most important and the most difficult to obtain. The paper then describes a general technical approach to risk management, including particular methods for developing the high quality of human health and ecological risk information that will be needed to support risk management. We next turn to several special issues that make risk management more complex than many other decisions. We discuss these issues and offer some practical suggestions with respect to addressing them in the risk management framework. Finally, we conclude with some discussion of other opportunities for applying risk management
Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.

Science.gov (United States)

Gillette, Chris; Blalock, Susan J; Rao, Jaya K; Williams, Dennis; Loughlin, Ceila E; Sleath, Betsy

2014-08-01

The objectives of this study were to: (1) describe the extent to which general pediatric providers discuss risks associated with asthma control medications with families, and (2) examine factors that are associated with risk discussions. This study was a cross-sectional secondary analysis of audio taped medical visits involving 35 pediatric providers and 248 children with asthma with their caregivers. Transcripts of the visits were coded for discussions about asthma medication risks. Generalized estimating equations were used to analyze the data. Providers discussed asthma control medication risks during 23% of visits. Risks were more likely to be discussed when the visit was longer and when the provider prescribed a new asthma control medication. When providers discussed asthma control medication risks, they were most likely to ask the family general questions and make general statements. Across all of the visits, caregivers asked a total of 16 questions and made a total of 20 statements about risks associated with asthma medications; children asked a total of 3 questions and made two statements about risks associated with asthma control medications. Providers discussed risks associated with asthma control medications in less than one-quarter of medical visits. Providers should involve families in discussions about risks associated with medications during every visit to assess potential barriers to medication adherence. © 2013 Wiley Periodicals, Inc.
Managing Risks in Dry Port Operations

OpenAIRE

Ciortescu Cezar-Gabriel; Pãvãla?cu Narcis Sebastian

2012-01-01

The purpose of this paper is to have an in-depth look into the phenomenon of risk assessment and risk management strategies in managing dry port operations as an integrated part into international containerized freight trade. The fact that world crises take the form of disruptions, bankruptcies, breakdowns, macroeconomic and political changes, and disasters leads to higher risks and makes risk management more and more difficult. This paper aims to discuss the theory behind the dry port concep...
A Greater Extent of Insomnia Symptoms and Physician-Recommended Sleep Medication Use Predict Fall Risk in Community-Dwelling Older Adults.

Science.gov (United States)

Chen, Tuo-Yu; Lee, Soomi; Buxton, Orfeu M

2017-11-01

Cross-sectional studies suggest that insomnia symptoms are associated with falls in later life. This longitudinal study examines the independent and interactive effects of the extent of insomnia symptoms (i.e., multiple co-existing insomnia symptoms) and sleep medications on fall risk over a 2-year follow-up among community-dwelling older adults. Using data from the Health and Retirement Study (2006-2014, N = 6882, Mage = 74.5 years ± 6.6 years), we calculated the extent of insomnia symptoms (range = 0-4) participants reported (i.e., trouble falling asleep, waking up during the night, waking up too early, and not feeling rested). At each wave, participants reported recent sleep medications use and falls since the last wave, and were evaluated for balance and walking speed. A greater burden of insomnia symptoms and using physician-recommended sleep medications at baseline independently predicted falling after adjusting for known risk factors of falling. The effects of insomnia symptoms on fall risk differed by sleep medications use. The extent of insomnia symptoms exhibited a positive, dose-response relation with risk of falling among those not using sleep medications. Older adults using physician-recommended sleep medications exhibited a consistently higher fall risk irrespective of the extent of insomnia symptoms. The number of insomnia symptoms predicts 2-year fall risk in older adults. Taking physician-recommended sleep medications increases the risks for falling in older adults, irrespective of the presence of insomnia symptoms. Future efforts should be directed toward treating insomnia symptoms, and managing and selecting sleep medications effectively to decrease the risk of falling in older adults. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.
Managing Heavy Menstrual Bleeding in Women at Risk of Thrombosis.

Science.gov (United States)

Rivara, Andrew; James, Andra H

2018-06-01

Management of heavy menstrual bleeding (HMB) in a woman with a history of thrombosis, or who is otherwise at high risk of thrombosis, or who takes medications for anticoagulation can present a challenge to health care providers. The goal of treating HMB is to reduce menstrual blood loss. First-line therapy is typically hormonal, and hormonal therapy can be contraindicated in women with a history of thrombosis unless they are on anticoagulation. As 70% of women on anticoagulation experience HMB, successful management of HMB may involve a modification in the anticoagulation or antiplatelet regimen, hormonal therapy tailored to the patient's situation, and/or surgical therapy.
Management of radiation risk

International Nuclear Information System (INIS)

Hubert, P.

1996-01-01

The need to control the risk from ionizing radiation can be tracked back to the eve of the twentieth century. However, as knowledge improved and practices expanded, the approaches to this control have evolved. No longer is the mere respect of some forms of exposure limits or safety related standards sufficient. Rather, it is widely admitted that there is a need for managing radiation risk, both by balancing the advantages and disadvantages of enhancing protection and by setting up a proper organization that allows handling of the risk. This paper describes the multiple aspects of radiation risk management and points out the main related issues. It critically analyzes ALARA and ICRP recommendations. 74 refs, 8 figs, 5 tabs
The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

Science.gov (United States)

Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of
Proactive safety management in health care : towards a broader view of risk analysis, error recovery, and safety culture

NARCIS (Netherlands)

Habraken, M.M.P.

2010-01-01

Medical errors occur frequently. The harm and additional costs associated with those errors ask for effective safety management. According to the objective of minimal patient harm, safety management in health care should be proactive; that is, risks should be anticipated and reduced before patients
Software And Systems Engineering Risk Management

Science.gov (United States)

2010-04-01

RSKM 2004 COSO Enterprise RSKM Framework 2006 ISO/IEC 16085 Risk Management Process 2008 ISO/IEC 12207 Software Lifecycle Processes 2009 ISO/IEC...1 Software And Systems Engineering Risk Management John Walz VP Technical and Conferences Activities, IEEE Computer Society Vice-Chair Planning...Software & Systems Engineering Standards Committee, IEEE Computer Society US TAG to ISO TMB Risk Management Working Group Systems and Software
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...
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…
Using a personality inventory to identify risk of distress and burnout among early stage medical students.

Science.gov (United States)

Bughi, Stephanie A; Lie, Desiree A; Zia, Stephanie K; Rosenthal, Jane

2017-01-01

Distress and burnout are common among medical students and negatively impact students' physical, mental, and emotional health. Personality inventories such as the Myers-Briggs Type Indicator (MBTI), used in medical education, may have a role in identifying burnout risk early. The authors conducted a cross-sectional survey study among 185 1st year medical students with the MBTI, the general well-being schedule (GWB), and Maslach Burnout Inventory-Student Survey (MBI-SS). Descriptive statistics and one-way MANOVAs were used to identify the prevalence and differences in MBTI preferences and distress/burnout risk. Response rate was 185/185 (100%). Distress (GWB) was reported by 84/185 (45.4%). High scores on exhaustion were reported by 118/182 (64.8%), cynicism by 76/182 (41.8%), and decreased professional efficacy by 38/182 (20.9%) for the three dimensions of the MBI-SS. Only 21/182 (11.5%) of respondents had high scores on all three dimensions of burnout. Students with MBTI preferences for extraversion reported greater positive well-being (P burnout are prevalent early in medical training. The significant difference between extraversion and introversion in relation to distress and burnout deserves further study. Use of a personality inventory may help identify students at risk of burnout and allow appropriate early stress management.
An antenatal prediction model for adverse birth outcomes in an urban population: The contribution of medical and non-medical risks.

Science.gov (United States)

Posthumus, A G; Birnie, E; van Veen, M J; Steegers, E A P; Bonsel, G J

2016-07-01

in the Netherlands the perinatal mortality rate is high compared to other European countries. Around eighty percent of perinatal mortality cases is preceded by being small for gestational age (SGA), preterm birth and/or having a low Apgar-score at 5 minutes after birth. Current risk detection in pregnancy focusses primarily on medical risks. However, non-medical risk factors may be relevant too. Both non-medical and medical risk factors are incorporated in the Rotterdam Reproductive Risk Reduction (R4U) scorecard. We investigated the associations between R4U risk factors and preterm birth, SGA and a low Apgar score. a prospective cohort study under routine practice conditions. six midwifery practices and two hospitals in Rotterdam, the Netherlands. 836 pregnant women. the R4U scorecard was filled out at the booking visit. after birth, the follow-up data on pregnancy outcomes were collected. Multivariate logistic regression was used to fit models for the prediction of any adverse outcome (preterm birth, SGA and/or a low Apgar score), stratified for ethnicity and socio-economic status (SES). factors predicting any adverse outcome for Western women were smoking during the first trimester and over-the-counter medication. For non-Western women risk factors were teenage pregnancy, advanced maternal age and an obstetric history of SGA. Risk factors for high SES women were low family income, no daily intake of vegetables and a history of preterm birth. For low SES women risk factors appeared to be low family income, non-Western ethnicity, smoking during the first trimester and a history of SGA. the presence of both medical and non-medical risk factors early in pregnancy predict the occurrence of adverse outcomes at birth. Furthermore the risk profiles for adverse outcomes differed according to SES and ethnicity. to optimise effective risk selection, both medical and non-medical risk factors should be taken into account in midwifery and obstetric care at the booking visit
Medication use and associated risk of falling in a geriatric outpatient population.

Science.gov (United States)

Freeland, Kathryn N; Thompson, Amy N; Zhao, Yumin; Leal, Julie E; Mauldin, Patrick D; Moran, William P

2012-09-01

Studies have shown that approximately one third of community-dwelling people aged 65 years and older will experience a fall each year. Many studies indicate that use of multiple medications may put patients at an increased risk of falling, but few studies have been conducted to correlate the number of medications with the risk of falls. To determine the medications most frequently used in patients aged 65 years or older who have experienced a fall within the past year, with particular attention to type or number of medications most commonly associated with multiple falls or a fall with injury. We conducted a chart review in an outpatient internal medicine clinic over a 13-month period. A total of 118 patients 65 years of age or older who were taking 4 or more medications and had experienced at least 1 fall in the previous 12 months were included. Data relating to sex, age, race, diagnoses, medications, and number and type of falls were obtained during the chart review. The primary end point of the study was number and type of medications most commonly used in patients experiencing a fall. A total of 116 patients were examined for trends in fall risk. A logistic regression model and receiver operating characteristic curve demonstrated significant fall risk with the addition of medications, with patients experiencing a 14% increase in fall risk with the addition of each medication beyond a 4-medication regimen (OR 1.14; 95% CI 1.02 to 1.27; p = 0.027). The addition of medications is associated with a significant increase in risk of falls in elderly patients, regardless of drug class. Further studies are needed to assess the possible increased risk of falls with increasing number of medications.
[Sleepiness, safety on the road and management of risk].

Science.gov (United States)

Garbarino, S; Traversa, F; Spigno, F

2012-01-01

Public health studies have shown that sleepiness at the wheel and other risks associated with sleep are responsible for 5% to 30% of road accidents, depending on the type of driver and/or road. In industrialized countries one-fifth of all traffic accidents can be ascribed to sleepiness behind the wheel. Sleep disorders and various common acute and chronic medical conditions together with lifestyles, extended work hours and prolonged wakefulness directly or indirectly affect the quality and quantity of one's sleep increasing the number of workers with sleep debt and staggered hours. These conditions may increase the risk of road accidents. Strategies to reduce this risk of both commercial and non-commercial drivers related to sleepiness include reliable diagnosis and treatment of sleep disorders, management of chronobiological conflicts, adequate catch-up sleep, and countermeasures against sleepiness at the wheel. Road transport safety requires the adoption of occupational health measures, including risk assessment, health education, technical-environmental prevention and health surveillance.
Update on the Management of High-Risk Penetrating Keratoplasty.

Science.gov (United States)

Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J; Djalilian, Ali R

2017-03-01

In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts.

[The development of hospital medical supplies information management system].

Science.gov (United States)

Cao, Shaoping; Gu, Hongqing; Zhang, Peng; Wang, Qiang

2010-05-01

The information management of medical materials by using high-tech computer, in order to improve the efficiency of the consumption of medical supplies, hospital supplies and develop a new technology way to manage the hospital and material support. Using C # NET, JAVA techniques to develop procedures for the establishment of hospital material management information system, set the various management modules, production of various statistical reports, standard operating procedures. The system is convenient, functional and strong, fluent statistical functions. It can always fully grasp and understand the whole hospital supplies run dynamic information, as a modern and effective tool for hospital materials management.
RISKS MANAGEMENT: NEW LITERATURE REVIEW

OpenAIRE

Ennouri Wissem

2013-01-01

The complexity of the industrial activities and the important mass of flows crossing the supply chain promotes the emergence of risks that must be considered in the decision process. For this reason, we have developed this paper to clarify the basics of risk management through a short new suggestion of literature review for risk management. Our justification of this attempt is that this area is the most discussed in our days and it is impossible to present all definition of the risk concept, ...
[Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

Science.gov (United States)

Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

2010-04-01

To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.
Cannabis Use, Medication Management and Adherence Among Persons Living with HIV.

Science.gov (United States)

Vidot, Denise C; Lerner, Brenda; Gonzalez, Raul

2017-07-01

Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.
Cognitive mapping tools: review and risk management needs.

Science.gov (United States)

Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor

2012-08-01

Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.
A Framework for Integrating Knowledge Management with Risk Management for Information Technology Projects (RiskManiT)

Science.gov (United States)

Karadsheh, Louay A.

2010-01-01

This research focused on the challenges experienced when executing risk management activities for information technology projects. The lack of adequate knowledge management support of risk management activities has caused many project failures in the past. The research objective was to propose a conceptual framework of the Knowledge-Based Risk…
Medical Data Manager an Interface between PACS and the gLite Data Management System

CERN Document Server

Montagnat, Johan; Texier, Romain; Nienartowicz, Krzysztof; Baud, Jean-Philippe

2008-01-01

The medical imaging community uses the DICOM image format and protocol to store and exchange data. The Medical Data Manager (MDM) is an interface between DICOM compliant systems such as PACS and the EGEE Data Management System. It opens hospital imaging networks to the world scale Grid while protecting sensitive medical data. It can be accessed transparently from any gLite service. It is an important milestone towards adoption of Grid technologies in the medical imaging community. Hospitals continuously produce tremendous amounts of image data that is managed by local PACS (Picture Archiving and Communication Systems). These systems are often limited to a local network access although the community experiences a growing interest for data sharing and remote processing. Indeed, patient data is often spread out different medical data acquisition centers. Furthermore, researchers in the area often need to analyze large populations whose data can be gathered through federations of PACS. Opening PACS to the outer I...
STRATEGIC PROJECT MANAGEMENT PRINCIPLES, PROGRAMS AND PORTFOLIOS OF THE MEDICAL INSTITUTION

Directory of Open Access Journals (Sweden)

Елена Борисовна ДАНЧЕНКО

2017-03-01

Full Text Available The article gives a brief overview of the latest research in the direction of the use of the project-based approach to the management of medical institutions. It is shown that medicine today is a project-oriented area, and modern scientific studies suggest the use of not only the project management approach and portfolio management. The various scientific sources proposed the classification of projects of medical institutions, mechanisms of formation of projects portfolios of such institutions. The concept of integrated management of medical institutions, which includes strategic, project, portfolio, program management approach (S3P-concept, is offered. According to this concept, the process of S3P-management of the medical institution will include four stages, which are closely interrelated. For the first time, the pair principles of S3P-management are formulated. The proposed concept and principles of S3P-management of medical institution require further development and creating of models, methods and integrated management tools, as well as the development of a system of indicators verify compliance with the organization's strategy of its projects, projects portfolios and programs. This concept and the proposed integrated management principles are universal and can be applied to any project-oriented area.
Value at Risk models for Energy Risk Management

OpenAIRE

Novák, Martin

2010-01-01

The main focus of this thesis lies on description of Risk Management in context of Energy Trading. The paper will predominantly discuss Value at Risk and its modifications as a main overall indicator of Energy Risk.
Risk management in a university environment.

Science.gov (United States)

Brewer, Ann; Walker, Ian

2011-06-01

Risk is an integral part of quality assurance in higher education in Australia. This paper describes a generic methodology for the identification and management of risk in a university or similar tertiary education environment and outlines a framework that enables the management of risk to be incorporated in the institution's governance cycle. The new approach here is that risk is embedded in the quality assurance framework and, in turn, in the strategic planning and budgeting processes. In many organisations, risk is implemented as a separate process and not considered in any meaningful way as integral to the strategic direction and performance of the university. The paper is based on work carried out by the authors and others between March 2008 and April 2009 to develop a comprehensive system for managing risk in a major Australian university, including processes whereby risk management could be integrated with, and add value to, the overall governance of the university. The case study is described in the appendix to this paper.
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
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.
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.
Medical Data Architecture (MDA) Project Status

Science.gov (United States)

Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2018-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.
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 activities...
Medical risk assessment in dentistry: use of the American Society of Anesthesiologists Physical Status Classification.

Science.gov (United States)

Clough, S; Shehabi, Z; Morgan, C

2016-02-12

Medical risk assessment is essential to safe patient management and the delivery of appropriate dental care. The American Society of Anesthesiologists Physical Status (ASA PS) Classification is widely used within medicine and dentistry, but has received significant criticism. This is the first UK survey to assess the consistency of medical risk assessment in dentistry. (i) To determine the use and consistency of the ASA PS among dentists and anaesthetists. (ii) To consider the appropriateness of the ASA PS in relation to dental treatment planning and delivery of care. A cross-sectional online questionnaire was distributed to anaesthetists and dental practitioners in general practice, community and hospital dental services. Questions focused on professional backgrounds, use of the ASA PS, alternative approaches to risk assessment in everyday practice and scoring of eight hypothetical patients using ASA PS. There were 101 responses, 82 were complete. Anaesthetists recorded ASA PS score more frequently than dental practitioners and found it more useful. Inconsistencies were evident in the assignment of ASA PS scores both between and within professional groups. Many dental practitioners did not use or find ASA PS helpful, with significant inconsistencies in its use. An awareness of alternative assessment scales may be useful across settings. Accepting its limitations, it would be helpful for all dentists to be educated in ASA PS and its use in medical risk assessment, particularly in relation to conscious sedation.
Implementation of a pharmacist-managed heart failure medication titration clinic.

Science.gov (United States)

Martinez, Amanda S; Saef, Jerold; Paszczuk, Anna; Bhatt-Chugani, Hetal

2013-06-15

The development, implementation, and initial results of a pharmacist-managed heart failure (HF) medication titration clinic are described. In a quality-improvement initiative at a Veterans Affairs health care system, clinical pharmacists were incorporated into the hospital system's interprofessional outpatient HF clinic. In addition, a separate pharmacist-managed HF medication titration clinic was established, in which pharmacists were granted an advanced scope of practice and prescribing privileges, enabling them to initiate and adjust medication dosages under specific protocols jointly established by cardiology and pharmacy staff. Pharmacists involved in the titration clinic tracked patients' daily body weight, vital signs, and volume status using telephone-monitoring technology and via patient interviews. A retrospective chart review comparing achievement of target doses of angiotensin-converting enzyme inhibitor (ACEI), angiotensin-receptor blocker (ARB), and β-blocker therapies in a group of patients (n = 28) whose dosage titrations were carried out by nurses or physicians prior to implementation of the pharmacist-managed HF medication titration clinic and a group of patients (n = 27) enrolled in the medication titration clinic during its first six months of operation indicated that target ACEI and ARB doses were achieved in a significantly higher percentage of pharmacist-managed titration clinic enrollees (52.9% versus 31%, p = 0.007). Patients enrolled in the pharmacist-managed HF medication titration clinic also had a significantly higher rate of attainment of optimal β-blocker doses (49% versus 24.7%, p = 0.012). Implementation of a pharmacist-managed HF medication titration clinic increased the percentage of patients achieving optimal ACEI, ARB, and β-blocker dosages.
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.
Managing Risk and Opportunity

DEFF Research Database (Denmark)

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

outcomes. This topic is timely and of interest both to the academic community as well as to practicing managers, executives, and directors. The volume focuses on contemporary risk leadership issues based on recent research insights but avoids excessive technical language and mathematical formulas. The book...... is framed around the challenges imposed on executives and directors in dealing with an increasingly complex and unpredictable world. This requires a new risk leadership focus that not only avoids the downside risks but also considers ways to exploit the upside potential offered by a dynamic environment....... The underlying logic is built on the principles of financial economics where benefits derive from reducing bankruptcy costs and increasing future cash inflows. This provides a stringent framework for analyzing the effect of different risk management actions and behaviors in effective risk-taking organizations...
Tailoring Risk Management in Design

DEFF Research Database (Denmark)

Tegeltija, M.; Oehmen, J.; McMahon, C. A.

2018-01-01

While risk quantification research has grown over the last few decades, only a limited number of studies have addressed the overall process integration of these approaches in design risk management. This paper argues that the choice of risk quantification method has strong implications for several...... process aspects. We investigate current risk management maturity models and suggest an expansion to accommodate requirements originating from the choice of quantification method, and to inform the choice of quantification method, based on other process parameters, validated through 3 case companies....

76 FR 45724 - Clearing Member Risk Management

Science.gov (United States)

2011-08-01

... proposed rules address risk management for cleared trades by futures commission merchants, swap dealers... Commission has proposed extensive regulations addressing open access and risk management at the derivatives..., 2011) (Risk Management Requirements for Derivatives Clearing Organizations). These proposed regulations...
Probabilistic risk assessment methodology for risk management and regulatory applications

International Nuclear Information System (INIS)

See Meng Wong; Kelly, D.L.; Riley, J.E.

1997-01-01

This paper discusses the development and potential applications of PRA methodology for risk management and regulatory applications in the U.S. nuclear industry. The new PRA methodology centers on the development of This paper discusses the time-dependent configuration risk profile for evaluating the effectiveness of operational risk management programs at U.S. nuclear power plants. Configuration-risk profiles have been used as risk-information tools for (1) a better understanding of the impact of daily operational activities on plant safety, and (2) proactive planning of operational activities to manage risk. Trial applications of the methodology were undertaken to demonstrate that configuration-risk profiles can be developed routinely, and can be useful for various industry and regulatory applications. Lessons learned include a better understanding of the issues and characteristics of PRA models available to industry, and identifying the attributes and pitfalls in the developement of risk profiles
Seniors managing multiple medications: using mixed methods to view the home care safety lens.

Science.gov (United States)

Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

2015-12-12

Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home
Contradictions Between Risk Management and Sustainable Development

International Nuclear Information System (INIS)

Olsen, Odd Einar; Langhelle, Oluf; Engen, Ole A.

2006-01-01

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
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.
Improving medical stores management through automation and effective communication.

Science.gov (United States)

Kumar, Ashok; Cariappa, M P; Marwaha, Vishal; Sharma, Mukti; Arora, Manu

2016-01-01

Medical stores management in hospitals is a tedious and time consuming chore with limited resources tasked for the purpose and poor penetration of Information Technology. The process of automation is slow paced due to various inherent factors and is being challenged by the increasing inventory loads and escalating budgets for procurement of drugs. We carried out an indepth case study at the Medical Stores of a tertiary care health care facility. An iterative six step Quality Improvement (QI) process was implemented based on the Plan-Do-Study-Act (PDSA) cycle. The QI process was modified as per requirement to fit the medical stores management model. The results were evaluated after six months. After the implementation of QI process, 55 drugs of the medical store inventory which had expired since 2009 onwards were replaced with fresh stock by the suppliers as a result of effective communication through upgraded database management. Various pending audit objections were dropped due to the streamlined documentation and processes. Inventory management improved drastically due to automation, with disposal orders being initiated four months prior to the expiry of drugs and correct demands being generated two months prior to depletion of stocks. The monthly expense summary of drugs was now being done within ten days of the closing month. Improving communication systems within the hospital with vendor database management and reaching out to clinicians is important. Automation of inventory management requires to be simple and user-friendly, utilizing existing hardware. Physical stores monitoring is indispensable, especially due to the scattered nature of stores. Staff training and standardized documentation protocols are the other keystones for optimal medical store management.
Risk Management for Point-of-Care Testing

OpenAIRE

James, H. Nichols

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 labor...
Prospective approaches for risk analysis in modern radiotherapy: the Italian experience and the contribution of medical physicists

International Nuclear Information System (INIS)

Begnozzi, L.; Cantone, M.C.; Veronese, I.; Longobardi, B.

2014-01-01

In the last few years there has been significant development of radiation therapy (RT) equipment with advanced imaging and delivery techniques, as well as treatment planning systems. From this perspective, proactive approaches for risk assessment were identified as a powerful tool in modern radiation oncology. A multidisciplinary working group (WG) has been established in the framework of the Italian association for medical physics (AIFM) to promote the use of prospective approaches in the radiotherapy scientific community. This paper describes the main actions carried out by the WG in order to collect information about the engagement of Italian medical physicists in the risk management process, in reporting possible incidents in RT and in the procedures of collecting and analysing near misses. In particular, the main scope of the study was to evaluate the actual level of experience in use of proactive risk analysis tools in modern RT by medical physicists. Finally, the measures implemented by the WG in order to promote the use of such approaches, and consequently to contribute to enhancing safety and radiation protection culture in radiation oncology are described. (authors)
Improving post-hospital medication management in a Danish municipality

DEFF Research Database (Denmark)

Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

2018-01-01

implementation rate, which involved 31 out of the 38 patients in the target group. CONCLUSION: For patients with complex care needs, post-hospital medication management may be improved by a reconsideration of the activity-based funding of home healthcare, a recognition of the importance of organising work......AIMS AND OBJECTIVES: This study evaluates an intervention developed to improve patient safety in post-hospital medication management carried out by visiting nurses working in a municipality in Denmark. The intervention consisted of three elements: an initial inter-disciplinary home visit by nurses...... management is identified as the most challenging component of a discharge from the hospital to the home, in which discrepancies have been found in up to 94% of medication lists. DESIGN: A process evaluation inspired by the UK Medical Research Council's guidance. METHODS: The process evaluation was conducted...
Ethical challenges for medical professionals in middle manager positions: a debate article.

Science.gov (United States)

Schnoor, Joerg; Heyde, Christoph-Eckhard; Ghanem, Mohamed

2015-01-01

Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company's success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field. While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of "independence" of the medical profession and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Above all, the character of "independence" of the medical profession and its ethical values justifies medical action that is based on the patient's well-being and not exclusively on economic outcomes. In the future, medical middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become "value-added bridge-builders".
Evaluation of Medical Faculty Students's Time Management Skills

Directory of Open Access Journals (Sweden)

Umit Yavas

2012-02-01

Full Text Available SUMMARY AIM: This study was carried out in order to determine medical faculty students� time management skills. METHOD: This is a cross sectional study and was carried out between 13 -31 May 2010. The universe of the study comprised 513 medical faculty students and data collection was performed by using the Time Management Inventory (TMI from 420 students (%81,9 of the universe. For statistical analyses of data percentage, Kruskal-Wallis, One-way Anova, Mann-Whitney U, Student-t test and Pearson correlation analysis were used. RESULTS: Students� total time management points were minimum 44 and maximum 122. Total points� mean was 79,06±14,07 and also the median was 78 of Time Management Inventory. Total time management points of the fifth class students were higher than the others. There was no correlation between total time management points and ages of the students. Also there is no statistically significant difference between the males and females at the TMI points. CONCLUSION: According to the other studies the medical faculty students� total TMI mean points are low. The reason of this situation may be the pension school that someone else is planning most of students� time and inadequacy of awareness, knowledge and skills about time management. Enhancing awareness with useful knowledge and being full of resource about time management is essential. [TAF Prev Med Bull 2012; 11(1.000: 5-10
Risk management for noncombustion wastes

International Nuclear Information System (INIS)

Connor, K.K.; Rice, J.S.

1991-01-01

The Noncombustion Waste Risk Management Project is designed to incorporate the insights and information developed in these projects into tools that will help utilities make better noncombustion waste management decisions. Specific project goals are to synthesize information useful to utilities on noncombustion wastes, emphasize waste reduction as a priority over end-of-pipe management, develop methods to manage the costs and risks associated with noncombustion wastes (e.g., direct costs, permitting costs, liability costs, public relations costs), develop software and documentation to deliver the information and analysis methods to the industry. This project was initiated EPRI's Environment Division in late 1988. The early phases of the project involved gathering information on current noncombustion waste management practices, specific utility problems and concerns with respect to these wastes, current and potential future regulations, and current and emerging management options. Recent efforts have focused on characterizing the direct and indirect (e.g., lawsuits, remedial action) costs of managing these wastes and on developing and implementing risk management methods for a subset of wastes. The remainder of this paper describes the specific issues addressed by and the results and insights from the three completed waste-specific studies
Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies

Directory of Open Access Journals (Sweden)

Haddad PM

2014-06-01

and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive therapeutic alliance and good communication between the clinician and patient. These elements remain essential for all patients, not least for the small minority where vulnerability and risk issue dictate that compulsory treatment is necessary to ensure adherence.Keywords: adherence, nonadherence, antipsychotics, schizophrenia, long-acting injections, relapse, risk factors
Continuous Risk Management: A NASA Program Initiative

Science.gov (United States)

Hammer, Theodore F.; Rosenberg, Linda

1999-01-01

NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.
Long-term outcomes for women versus men with unstable angina/non-ST-segment elevation myocardial infarction managed medically without revascularization

DEFF Research Database (Denmark)

Clemmensen, Peter; Roe, Matthew T.; Hochman, Judith S.

2015-01-01

BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We examined sex-specific differences in long......-term ischemic and bleeding outcomes and platelet reactivity for medically managed ACS patients randomized to prasugrel versus clopidogrel plus aspirin. METHODS: Data from 9,326 patients enrolled in TRILOGY ACS were analyzed to determine differences in long-term ischemic and bleeding outcomes between women (n....... There were no sex-specific, treatment-related differences in 30-day platelet reactivity. CONCLUSIONS: Long-term ischemic and bleeding outcomes in medically managed ACS patients were similar for women versus men, as was treatment-related platelet reactivity. Women had a higher baseline risk profile and, after...
Diagnostic Medical Imaging in Pediatric Patients and Subsequent Cancer Risk.

Science.gov (United States)

Mulvihill, David J; Jhawar, Sachin; Kostis, John B; Goyal, Sharad

2017-11-01

The use of diagnostic medical imaging is becoming increasingly more commonplace in the pediatric setting. However, many medical imaging modalities expose pediatric patients to ionizing radiation, which has been shown to increase the risk of cancer development in later life. This review article provides a comprehensive overview of the available data regarding the risk of cancer development following exposure to ionizing radiation from diagnostic medical imaging. Attention is paid to modalities such as computed tomography scans and fluoroscopic procedures that can expose children to radiation doses orders of magnitude higher than standard diagnostic x-rays. Ongoing studies that seek to more precisely determine the relationship of diagnostic medical radiation in children and subsequent cancer development are discussed, as well as modern strategies to better quantify this risk. Finally, as cardiovascular imaging and intervention contribute substantially to medical radiation exposure, we discuss strategies to enhance radiation safety in these areas. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Risk Management Practices: The Ghanaian Firms' Perspective ...

African Journals Online (AJOL)

Using a quantitative approach the findings of the study are that Ghanaian firms understand risk and risk management. Additionally, operational, liquidity and credit risk are the most dominant risks experienced while risk identification and selection jointly determine risk management practices in Ghana. Based on the findings ...
RISK MANAGEMENT APPROACHES AND PRACTICES IN IT PROJECTS

Directory of Open Access Journals (Sweden)

BRANDAS Claudiu

2012-07-01

Full Text Available Risk is identified in project management literature as an important factor influencing IT projects success, and it is relevant for both academic and practitionersn#8217; communities. The paper presents the past and current approaches to risk management in IT projects. The objective of this paper is to compare the different approaches and relate them to existing practices. Project management literature and practice have brought different approaches to risk management, and as a result, many projects ended in failure. We present how risk management is considered in the literature, and we compare the main two approaches: the evaluation approach and the management approach. The contingency approach does not consider risk management to be a specific process as it is an embedded process in the other project management processes. Then, we present the main practices in risk management. The methodology applied is based on documentary study review and analysis of the concepts used by the literature. We analyzed the literature published between 1978 and 2011 from the main journals for IT project management and found out that the essence of project management is risk management. The risk management practices have a considerable influence on stakeholdersn#8217; perception of project success. But, regardless of the chosen approach, a standard method for identifying, assessing, and responding to risks should be included in any project as this influences the outcome of the project.
Scope of environmental risk management

Energy Technology Data Exchange (ETDEWEB)

O' Riordan, T

1979-01-01

Environmental risk management embraces three techniques for project appraisal: cost/benefit analysis, environmental impact analysis and risk assessment. It also explicitly relates scientific investigations to political judgments, sometimes so closely that the two cannot be separated. Indeed it is now apparent that environmental risk management encompasses procedures both to review the relative merits and priorities of policies as well as to appraise the environmental risks of particular schemes. Until recently this relationship has not been fully appreciated, so much imagination and innovation is still required to develop the most-suitable mechanisms for review.
Risk Management in the Agri-food Sector

Directory of Open Access Journals (Sweden)

Hrabrin Bachev

2013-03-01

Full Text Available This paper incorporates the interdisciplinary New Institutional Economics in a comprehensive framework for analyzing risk management in the agri-food sector. First, it specifies the diverse types of agri-food risks (natural, technical, behavioral, economic, policy, etc. and the modes of their management (market, private, public, and hybrid. Second, it defines the efficiency of risk management and identifies the factors (personal, institutional, dimensional, technological, and natural of governance choice. Next, it presents stages in the analysis of risk management and the improvement of public intervention in the governance of risk. Finally, it identifies the contemporary opportunities and challenges for risk governance in the agri-food chain.

Managing total corporate electricity/energy market risks

International Nuclear Information System (INIS)

Henney, A.; Keers, G.

1998-01-01

The banking industry has developed a tool kit of very useful value at risk techniques for hedging risk, but these techniques must be adapted to the special complexities of the electricity market. This paper starts with a short history of the use of value-at-risk (VAR) techniques in banking risk management and then examines the specific and, in many instances, complex risk management challenges faced by electric companies from the behavior of prices in electricity markets and from the character of generation and electric retailing risks. The third section describes the main methods for making VAR calculations along with an analysis of their suitability for analyzing the risks of electricity portfolios and the case for using profit at risk and downside risk as measures of risk. The final section draws the threads together and explains how to look at managing total corporate electricity market risk, which is a big step toward managing total corporate energy market risk
Managing medical equipment used by technology-dependent children: evaluation of an instructional tool for pediatric residents and medical students.

Science.gov (United States)

Jackson, Jennifer M; Radulovic, Andrea; Nageswaran, Savithri

2012-08-01

To evaluate the effectiveness of a workshop on managing medical devices used in technology-dependent children. Study participants included residents and medical students rotating in the pediatrics department at the time of the study. A workshop was conducted consisting of learning stations for common medical devices, including brief presentations and opportunities for hands-on practice with each device. Participants completed surveys before and after the workshop assessing their perceived ability to manage medical equipment before and after the workshop and their ongoing learning needs. All participants indicated a substantial need for training on how to manage medical devices used by technology-dependent patients. Scores for perceived ability to manage the devices improved significantly after workshop participation for nearly all devices taught. Medical trainees have significant learning needs for managing devices used by technology-dependent patients. Hands-on, small-group training can be an effective instructional tool for improving confidence in these skills.
Improving Operational Risk Management Using Business Performance Management Technologies

Directory of Open Access Journals (Sweden)

Bram Pieket Weeserik

2018-02-01

Full Text Available Operational Risk Management (ORM comprises the continuous management of risks resulting from: human actions, internal processes, systems, and external events. With increasing requirements, complexity and a growing volume of risks, information systems provide benefits for integrating risk management activities and optimizing performance. Business Performance Management (BPM technologies are believed to provide a solution for effective Operational Risk Management by offering several combined technologies including: work flow, data warehousing, (advanced analytics, reporting and dashboards. BPM technologies can be integrated with an organization’s Planning & Control cycle and related to strategic objectives. This manuscript aims to show how ORM can benefit from BPM technologies via the development and practical validation of a new maturity model. The B4ORM maturity model was developed following the Design Science Research approach. The maturity model relates specific maturity levels of ORM processes with BPM technologies applicable for a specific maturity stage. There appears to be a strong relationship (0.78 with ORM process maturity and supporting BPM technologies. The B4ORM maturity model as described in this manuscript provides an ideal path of BPM technologies related to six distinctive stages of ORM, leading towards technologies suitable for continuous improvement of ORM processes and organization-wide integration.
Chronic kidney disease risk reduction in a Hispanic population through pharmacist-based disease-state management.

Science.gov (United States)

Leal, Sandra; Soto, Marisa

2008-04-01

The purpose of this study was to evaluate the ability of a pharmacist-based disease-state management service to improve the care of indigent, predominately Spanish-speaking patients with diabetes mellitus and common comorbid conditions at high risk for the development of chronic kidney disease (CKD). Patients at high risk for developing CKD who have diabetes at a community health center were placed in a pharmacist-based disease state management service for CKD risk reduction. A residency-trained, bilingual, certified diabetes educator, with a PharmD served as the patient's provider using diagnostic, educational, and therapeutic management services under a medical staff approved collaborative practice agreement. Outcomes were assessed by using national standards of care for disease control and prevention screening. The impact on CKD was shown with a mean A1C decrease of 2% and improvement in the proportion of patients at target goals for blood pressure, A1C, and cholesterol levels and receiving aspirin and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. A pharmacist-based disease-state management service for CKD risk reduction, care of diabetes, and frequently associated comorbid conditions improved compliance with national standards for diabetes care in a high-risk population.
Medical waste management in Jordan: A study at the King Hussein Medical Center

International Nuclear Information System (INIS)

Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

2005-01-01

As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel
Internal audit risk management in metropolitan municipalities

Directory of Open Access Journals (Sweden)

Christo Ackermann

2016-07-01

Full Text Available Internal audit functions (IAFs of organisations are regarded as crucial components of the combined assurance model, alongside the audit committee, management and external auditors. The combined assurance model aims at having integrated and aligned assurance in organisations with the overall aim of maximising risk and governance oversight and control efficiencies. In this regard, internal audit plays a crucial role, insofar as it consists of experts in risk, governance and control consultancy who provide assurance to senior management and the audit committee. Audit committees are dependent on internal audit for information and their effectiveness revolves around a strong and well-resourced internal audit function which is able to aid audit committees to meet their oversight responsibilities. There is thus a growing demand for managing risk through the process of risk management and internal audit is in a perfect position to assist with the improvement of such processes. If internal auditors wish to continue being an important aspect of the combined assurance model, they need to address the critical area, amongst others, of risk management as part of their work. If not, it follows that the board, audit committees and other levels of management will remain uninformed on the status of these matters which, in turn, will negatively impact the ability of these stakeholders to discharge their responsibilities. This study therefore focuses on analysing the functioning of IAFs, with specific reference to their risk management mandate. The study followed a mixed method approach to describe internal audits risk management functioning in the big eight metropolitan municipalities in South Africa. The results show that internal audit provide a broad scope of risk management work which assist senior management in the discharge of their responsibilities. However, in the public eye, internal audits risk management functioning is scant
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
The process of Risk management for E-business

Directory of Open Access Journals (Sweden)

Erion Lekaj

2017-07-01

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 an 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 soft ware.
Model of Axiological Dimension Risk Management

Directory of Open Access Journals (Sweden)

Kulińska Ewa

2016-01-01

Full Text Available It was on the basis of the obtained results that identify the key prerequisites for the integration of the management of logistics processes, management of the value creation process, and risk management that the methodological basis for the construction of the axiological dimension of the risk management (ADRM model of logistics processes was determined. By taking into account the contribution of individual concepts to the new research area, its essence was defined as an integrated, structured instrumentation aimed at the identification and implementation of logistics processes supporting creation of the value added as well as the identification and elimination of risk factors disturbing the process of the value creation for internal and external customers. The base for the ADRM concept of logistics processes is the use of the potential being inherent in synergistic effects which are obtained by using prerequisites for the integration of the management of logistics processes, of value creation and risk management as the key determinants of the value creation.
78 FR 57159 - Scientific Information Request on Medication Therapy Management

Science.gov (United States)

2013-09-17

... Information Request on Medication Therapy Management AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Request for scientific information submissions. SUMMARY: The Agency for Healthcare... therapy management Scientific information is being solicited to inform our review of Medication Therapy...
Use-related risk analysis for medical devices based on improved FMEA.

Science.gov (United States)

Liu, Long; Shuai, Ma; Wang, Zhu; Li, Ping

2012-01-01

In order to effectively analyze and control use-related risk of medical devices, quantitative methodologies must be applied. Failure Mode and Effects Analysis (FMEA) is a proactive technique for error detection and risk reduction. In this article, an improved FMEA based on Fuzzy Mathematics and Grey Relational Theory is developed to better carry out user-related risk analysis for medical devices. As an example, the analysis process using this improved FMEA method for a certain medical device (C-arm X-ray machine) is described.
SPD-based Logistics Management Model of Medical Consumables in Hospitals

Science.gov (United States)

LIU, Tongzhu; SHEN, Aizong; HU, Xiaojian; TONG, Guixian; GU, Wei; YANG, Shanlin

2016-01-01

Background: With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. Methods: We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. Results: We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. Conclusion: The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China. PMID:27957435
SPD-based Logistics Management Model of Medical Consumables in Hospitals.

Science.gov (United States)

Liu, Tongzhu; Shen, Aizong; Hu, Xiaojian; Tong, Guixian; Gu, Wei; Yang, Shanlin

2016-10-01

With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China.
Information risk management a practitioner's guide

CERN Document Server

Sutton, David

2014-01-01

Information risk management (IRM) is about identifying, assessing and prioritising risks to keep information secure and available. This accessible book provides practical guidance to the principles and development of a strategic approach to an IRM programme. The only textbook for the BCS Practitioner Certificate in Information Risk Management.
CEA - Assessment of risk management 2013

International Nuclear Information System (INIS)

Bigot, Bernard; Bonnevie, Edwige; Maillot, Bernard

2014-06-01

After some introducing texts by CEA managers, this report proposes a rather detailed overview and presentation of CEA activities, objectives and obtained results in different fields: protection and control of the environment, installation safety, health, safety and radiation protection, transports of hazardous materials, waste management, protection of sites, installations and heritage, management of emergency situations, management of legal risks, internal controls and audits, activity of the risk management department, CEA activities from research to industry
Management information system of medical equipment using mobile devices

Science.gov (United States)

Núñez, C.; Castro, D.

2011-09-01

The large numbers of technologies currently incorporated into mobile devices transform them into excellent tools for capture and to manage the information, because of the increasing computing power and storage that allow to add many miscellaneous applications. In order to obtain benefits of these technologies, in the biomedical engineering field, it was developed a mobile information system for medical equipment management. The central platform for the system it's a mobile phone, which by a connection with a web server, it's capable to send and receive information relative to any medical equipment. Decoding a type of barcodes, known as QR-Codes, the management process is simplified and improved. These barcodes identified the medical equipments in a database, when these codes are photographed and decoded with the mobile device, you can access to relevant information about the medical equipment in question. This Project in it's actual state is a basic support tool for the maintenance of medical equipment. It is also a modern alternative, competitive and economic in the actual market.
Medication management policy, practice and research in Australian residential aged care: Current and future directions.

Science.gov (United States)

Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon

2017-02-01

Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting. Copyright © 2016 Elsevier Ltd. All rights reserved.
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.
Methods of assessment and management of enterprise risks

Directory of Open Access Journals (Sweden)

I. A. Kiseleva

2017-01-01

Full Text Available The article is devoted to the actual topic of our time – the management of business risks. An integral part of professional risk management is to identify the nature of the object of management in the sphere of economy. Since the domestic theory of risk management is under development, the problem of a clear comprehensive definition of risk becomes now of particular relevance. The article discusses the basic concepts of risk management; studied its components in the business activities; reflected system and risk management principles; The basic types of risks in business. A organizational and economic mechanism of enterprise risk assessment. Practical advice on risk management. Entrepreneurship without risk does not exist. With the development of market economy the specific entrepreneur determines the methods that will work, and they all lead to entrepreneurial risks. The level of threats on the market today, above the level of potential profits. It is concluded that it is impossible to increase revenue without increasing the risk or reduce risk without reducing income. The lower range of the probability distribution of expected returns relative to its mean value, the lower the risk associated with this operation. Avoid risk in business is almost impossible, but you can reduce this risk. And it depends on how professionally and correctly operates the entrepreneur, what kind of strategy he will choose to reduce the appearance of risk.
Managing Risk to the Patient: Recoding Quality Risk Management for the Pharmaceutical and Biopharmaceutical Industries

OpenAIRE

Waldron, Kelly

2017-01-01

This thesis explores the application of quality risk management (QRM) in pharmaceutical and biopharmaceutical companies and its effectiveness at managing risk to the patient. The objective of the research described in this thesis was to characterize a maturity state of QRM implementation in which the patient is adequately protected from the risks associated with medicinal products of inadequate quality. The research was conducted over three phases: first, to determine whether patients are bet...

A SURVEY OF INTERNATIONAL FINANCIAL RISK MANAGEMENT SYSTEM

Directory of Open Access Journals (Sweden)

SETHI Narayan

2013-12-01

Full Text Available Rising global competition, increasing deregulation, and introduction of innovative products have pushed financial risk management to the forefront of today's financial landscape. Identification of different types of risks and effective management of these risks in the international financial system would help to alleviate crisis, financial losses and also helpful to the long term success of all the financial institutions. The present study aims to analyze different types of risk management strategies and throws some light on challenges and opportunities regarding implementation of Basel-II in international financial system. The present paper also attempts to discuss the different methods and techniques used to measure financial risk management. There are three types of risk faced by all financial institutions: market risk, credit risk and operational risk. In commercial banking, credit risk is the biggest risk; in investment banking, its market risk; and in asset management, it’s operational risk.
The application of holistic risk management in the banking industry

Directory of Open Access Journals (Sweden)

J. Chibayambuya

2007-12-01

Full Text Available Purpose: The application of holistic risk management is fast becoming a standard measure of good governance in the business arena. What role can holistic risk management play in the management of risk in the financial services industry? The aim of this paper is to propose a holistic risk management framework for the management of risk. Design/Methodology/Approach: A comprehensive framework that covers the holistic view risk management is proposed/developed out of an extensive literature review. Findings: Given the deliberations of various frameworks, a holistic risk management is proposed. The proposed framework ensures that all components of risk management are taken into account when strategizing for risk management in general and holistic risk management in particular; thereby improving the management of risk in the banking industry. Implications: The article proposes a holistic approach to risk management which takes into account all the facets of risk management, e.g. analyzing, planning, strategy, communication, implementation, motivation, systems review and plan modification. This holistic approach, when implemented in the banking industry, can have a significant impact on the improved management of risk. Originality/Value: The new proposed holistic risk management framework offers a fresh perspective of strategizing for risk management in terms of risk analysis, risk planning, risk strategy, risk communication, risk implementation, risk motivation, risk review and risk plan modification.
THEORETICAL BASIS FOR MANAGEMENT OF PERSONNEL RISKS

OpenAIRE

Haliashova, Katsiaryna

2017-01-01

Necessity of personnel risks management is based on research results. The authors' approaches to the determination of personnel risks and to their management have been explored. The author's definition of the concept of "personnel risks" is proposed. A classification of personnel risks is developed depending on the stage of origin and the tasks of the personnel policy, as well as the methods of management personnel risks in the organization. The article presents a methodical approach to perso...
Baseline Antihypertensive Drug Count and Patient Response to Hypertension Medication Management.

Science.gov (United States)

Crowley, Matthew J; Olsen, Maren K; Woolson, Sandra L; King, Heather A; Oddone, Eugene Z; Bosworth, Hayden B

2016-04-01

Telemedicine-based medication management improves hypertension control, but has been evaluated primarily in patients with low antihypertensive drug counts. Its impact on patients taking three or more antihypertensive agents is not well-established. To address this evidence gap, the authors conducted an exploratory analysis of an 18-month, 591-patient trial of telemedicine-based hypertension medication management. Using general linear models, the effect of medication management on blood pressure for patients taking two or fewer antihypertensive agents at study baseline vs those taking three or more was compared. While patients taking two or fewer antihypertensive agents had a significant reduction in systolic blood pressure with medication management, those taking three or more had no such response. The between-subgroup effect difference was statistically significant at 6 months (-6.4 mm Hg [95% confidence interval, -12.2 to -0.6]) and near significant at 18 months (-6.0 mm Hg [95% confidence interval, -12.2 to 0.2]). These findings suggest that baseline antihypertensive drug count may impact how patients respond to hypertension medication management and emphasize the need to study management strategies specifically in patients taking three or more antihypertensive medications. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

Science.gov (United States)

Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

2015-01-01

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting
Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

Science.gov (United States)

Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

2018-05-01

Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with
Economic Exposure and Integrated Risk Management

OpenAIRE

Miller, Kent D.

1994-01-01

Most corporate risk management research focuses on particular risk exposures to the exclusion of other interrelated exposures. By contrast, this study models corporate risk exposures using a multivariate approach integrating the distinct exposures of interest to finance and strategy researchers. The paper addresses the implications of multivariate modeling for corporate risk management, some key methodological issues arising in empirical estimation of corporate economic exposrues, and direc...
Risks versus benefits of medication use during pregnancy : What do women perceive?

NARCIS (Netherlands)

Mulder, Bianca; Schuiling-Veninga, Nynke C.M.; Morssink, Leonard P.; Bijlsma, Maarten J.; Van Puijenbroek, Eugene; Aarnoudse, Jan G.; Hak, Eelko; De Vries, Tjalling W.

2014-01-01

Background: Understanding risk perception is essential in designing good risk communication strategies. It has been reported that women overestimate the teratogenic risk of medication use, but these studies didn't include perceived benefits and major concerns of pregnant women regarding medication
Managing power risk

International Nuclear Information System (INIS)

Rudd, D.C.

1999-01-01

Issues regarding the management of financial risks in the electric power market were discussed. The nature of the risk was defined for electricity producers, local utilities, traders/dealers, and brokers, each of which are exposed to different types of risks with the exception of credit risk, which is common to all. The main features of options, swaps, CFDs, bilateral financial contracts, futures contracts and the terms of the NYMEX electricity contract were outlined. Basic derivative strategies, the role of the broker, the elements of emissions trading, and trading strategies for consumers were also explained. 3 fig
Accommodating the Challenges of Climate Change Adaptation and Governance in Conventional Risk Management: Adaptive Collaborative Risk Management (ACRM)

OpenAIRE

Bradley May; Ryan Plummer

2011-01-01

Risk management is a well established tool for climate change adaptation. It is facing new challenges with the end of climate stationarity and the need to meaningfully engage people in governance issues. The ways in which conventional approaches to risk management can respond to these challenges are explored. Conventional approaches to risk management are summarized, the manner in which they are being advanced as a tool for climate change adaptation is described, and emerging themes in risk m...
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
Clinical pharmacy cardiac risk service for managing patients with coronary artery disease in a health maintenance organization.

Science.gov (United States)

Sandhoff, Brian G; Nies, Leslie K; Olson, Kari L; Nash, James D; Rasmussen, Jon R; Merenich, John A

2007-01-01

A clinical pharmacy service for managing the treatment of coronary artery disease in a health maintenance organization is described. Despite the proven benefits of aggressive risk factor modification for patients with coronary artery disease (CAD), there remains a treatment gap between consensus- and evidence-based recommendations and their application in patient care. In 1998, Kaiser Permanente of Colorado developed the Clinical Pharmacy Cardiac Risk Service (CPCRS) to focus on the long-term management of patients with CAD to improve clinical outcomes. The primary goals of the CPCRS are to increase the number of CAD patients on lipid-lowering therapy, manage medications shown to decrease the risk of future CAD-related events, assist in the monitoring and control of other diseases that increase cardiovascular risk, provide patient education and recommendations for nonpharmacologic therapy, and act as a CAD information resource for physicians and other health care providers. Using an electronic medical record and tracking database, the service works in close collaboration with primary care physicians, cardiologists, cardiac rehabilitation nurses, and other health care providers to reduce cardiac risk in the CAD population. Particular attention is given to dyslipidemia, blood pressure, diabetes mellitus, and tobacco cessation. Treatment with evidence-based regimens is initiated and adjusted as necessary. Over 11,000 patients are currently being followed by the CPCRS. A clinical pharmacy service in a large health maintenance organization provides cardiac risk reduction for patients with CAD and helps close treatment gaps that may exist for these patients.
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".
Risk Management in Logystics Chains

OpenAIRE

Butrin, Andrey; Vikulov, Vladimir

2013-01-01

Article is devoted to risk management of supply chain. The authors considered indicators of supply chain risks, including risks caused by supplier. Authors formed a method of optimizing the level of supply chain risk in the integration with suppliers and customers.
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.
Risk management at GPU Nuclear

International Nuclear Information System (INIS)

Long, R.L.

1991-01-01

This paper reports on GPU Nuclear. Among other goals, it established the independence of key safety functions as highlighted by the lessons learned from the accident. In particular, an independent Nuclear Assurance Division was established which include Quality Assurance, Training and Education, Emergency Preparedness, and Nuclear Safety Assessment. The latter consisted of corporate and site independent-safety-review groups. As the GPU Nuclear organization matured, a mid-1987 reorganization created an even more focused Planning and Nuclear Safety Division bringing together Nuclear Safety Assessment with Licensing and Regulatory Affairs and Risk Management. The Risk Management Group (RMG), which began its work in fall 1987, was formed to develop a framework for proactive identification, evaluation, and cost-effective reduction and management of risks of all types. The RMG set out to learn as much as possible about risks and their management in nuclear and other high-technology industries. This began with a thorough literature search. It progressed to interviews with individuals and organizations which have demonstrated innovative ideas, experience, and reputations for safe and reliable operation
Risk Management and Uncertainty in Infrastructure Projects

DEFF Research Database (Denmark)

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

2014-01-01

The assumption that large complex projects should be managed in order to reduce uncertainty and increase predictability is not new. What is relatively new, however, is that uncertainty reduction can and should be obtained through formal risk management approaches. We question both assumptions...... 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...
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....
Rethinking 'risk' and self-management for chronic illness.

Science.gov (United States)

Morden, Andrew; Jinks, Clare; Ong, Bie Nio

2012-02-01

Self-management for chronic illness is a current high profile UK healthcare policy. Policy and clinical recommendations relating to chronic illnesses are framed within a language of lifestyle risk management. This article argues the enactment of risk within current UK self-management policy is intimately related to neo-liberal ideology and is geared towards population governance. The approach that dominates policy perspectives to 'risk' management is critiqued for positioning people as rational subjects who calculate risk probabilities and act upon them. Furthermore this perspective fails to understand the lay person's construction and enactment of risk, their agenda and contextual needs when living with chronic illness. Of everyday relevance to lay people is the management of risk and uncertainty relating to social roles and obligations, the emotions involved when encountering the risk and uncertainty in chronic illness, and the challenges posed by social structural factors and social environments that have to be managed. Thus, clinical enactments of self-management policy would benefit from taking a more holistic view to patient need and seek to avoid solely communicating lifestyle risk factors to be self-managed.
The role of risk perception for risk management

International Nuclear Information System (INIS)

Renn, Ortwin

1998-01-01

Are risks social constructions of different societal actors that can be checked at best against standards of consistency, cohesion and internal conventions of deduction, but cannot claim any validity outside of the actor's logical framework? Or are technical estimates of risk representations of real hazards that can and will affect people as predicted by the statistical values, regardless of the beliefs or convictions of those who conduct the assessments? Which of the two sides one takes determines the legitimate function of risk perception for management purposes. The paper argues that both extremes, the constructivist and the realist perspective, miss the point, as risks are always mental representations of threats that are capable of claiming real losses. Over the last two decades, risk analysts have dealt with both sides of risk in an additive fashion. In times in which risk management has been under serious pressure to demonstrate effectiveness and cost-efficiency, the parallel approach of pleasing the technical elite and the public alike has lost legitimacy. In order to integrate risk assessment and perception, the paper analyses the strengths and weaknesses of each approach to risk analysis and highlights the potential contributions that the technical sciences and the social sciences can offer to risk management. Technical assessments provide the best estimate for judging the average probability of an adverse effect linked to an object or activity. First, public perception should govern the selection of criteria on which acceptability or tolerability are to be judged. Second, public input is needed to determine the trade-offs between criteria. Third, public preferences are needed to design resilient strategies for coping with remaining uncertainties. A public participation model is introduced that promises an integration of analytic knowledge and deliberative process involving those who will be affected by the respective risk

A risk communication case study: the Nevada risk assessment/management program

International Nuclear Information System (INIS)

Hechanova, A.E.

2000-01-01

The Nevada Risk Assessment/Management Program (NRAMP) is part of a national effort by the U.S. Department of Energy (DOE) to develop new sources of information and approaches to risk assessment, risk management, risk communication and public outreach as these objectives relate to the ecological and human health effects of radioactive and hazardous material management and site remediation activities. This paper reviews the innovation behind the NRAMP project and presents a synopsis of the NRAMP effort which occurred from 1995 to 2000. The primary goals of the DOE in awarding the cooperative agreement establishing NRAMP were to (I) use a risk-based approach to evaluate the consequences of alternative actions in DOE's Environmental Remediation Programs at sites in Nevada and (2) use a neutral and credible institution outside the DOE to perform the risk assessments and contribute to public education about environmental management issues at the Nevada Test Site. (author)
Contextualising risk within enterprise risk management through the application of systems thinking

CSIR Research Space (South Africa)

Haywood, Lorren K

2017-06-01

Full Text Available New and emerging risks create growing uncertainty and unpredictability within enterprise risk management. While ISO 31000:2009 is a progressive risk management framework, it is limited in its guidance on how to contextualise complex risks...
Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

Directory of Open Access Journals (Sweden)

Shah M

2013-09-01

Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.
Perspectives on management education: an exploratory study of UK and Portuguese medical students.

Science.gov (United States)

Martins, Henrique M G; Detmer, Don E; Rubery, Eileen

2005-09-01

Healthcare management is becoming extremely important and large health organizations face increasing demands for leadership and system change. The role of doctors is pivotal but their relationship with management issues and practice has been a matter of long-lasting debate. The aim of this research was to establish opinions of medical students and other medical educational stakeholders on the value and structure of a management and leadership course in medical school. A survey of undergraduate medical students from two medical schools (n = 268) was carried out, and quantitative and qualitative data were analysed and compared with opinions collected from interviews with hospital managers and clinical professors. Portuguese medical students attributed higher relevance to leadership/management education than their UK counterparts. For both groups, such a course would be best: (1) situated in the clinical years, (2) optional and (3) one term/semester long. Main topics desired were 'Managing people/team management'; 'National Health Service'; 'Doctors and Leadership', 'Costs/prices and resource management'. In conclusion, leadership/management education is perceived as relevant but its inclusion in the medical curriculum as well as its content needs careful consideration. Education in informatics and knowledge management would also provide a positive contribution to professional development but is scarcely appreciated at present.
Time management tips, tricks, and exercises for busy medical practice employees.

Science.gov (United States)

Hills, Laura

2012-01-01

Working in a busy medical practice requires excellent time management skills and an ability to handle those unanticipated emergencies, urgencies, and monkey-wrenches that can and often do throw a well-planned day out of whack. This article offers busy medical practice employees 50 time management tips to help them manage their time well. It focuses specifically on eliminating time wasters, working more efficiently, and developing personal goals and habits that can increase productivity, reduce stress, and make working in the practice more enjoyable. This article also offers several hands-on time management exercises, including a time management self-assessment quiz, a multitasking exercise, and a time drain exercise. These can be completed individually or collaboratively with other members of the medical practice team. Finally, this article explores 12 popular time management myths and how a medical practice employee can increase his or her productivity by identifying and harnessing his or her productivity "happy hour(s)".
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.
Management Ownership and Risk-Shifting Investment

OpenAIRE

Nobuyuki Teshima

2012-01-01

This study analyzes the relationship between management ownership and its risk-shifting incentive. We first present a simple model showing that the risk-shifting incentive of management of financially distressed firms increases as the management ownership of the firm increases. Empirically, we test the hypothesis that under the former Japanese Corporate Reorganization Law, firms with higher management ownership are more likely to use legal rather than private reorganization. Since the reorgan...
Radiation exposure and management of medical employes

Energy Technology Data Exchange (ETDEWEB)

Yamamoto, C [Nagoya Univ. (Japan)

1981-11-01

Medical employes handling medical radiation are increasing in recent years. In connection with the radiation exposure management, it was surveyed how much their cumulative exposure doses are and how many employes distribute in respective exposure levels. The medical employes surveyed are physicians, radiation technicians and nurses, working in the hospitals of educational institutions. The period of survey is every three years, from 1962 to 1977. For X-ray and ..gamma..-ray, respectively, the yearly cumulative exposure doses were measured by film badges, stepwise starting from below 500 mrem upward to over 5000 mrem; for the respective groups of employes, the percentage in each dose level was shown. The percentage in the level below 500 mrem was the largest in all groups, and in both X-ray and ..gamma..-ray, the percentages in higher levels decreased sharply to less than 7%. The exposure management has been improved in recent years.
Characterizing the High-Risk Homebound Patients in Need of Nurse Practitioner Co-Management

Science.gov (United States)

Jones, Masha G.; Ornstein, Katherine A.; Skovran, David M.; Soriano, Theresa A.; DeCherrie, Linda V.

2016-01-01

By providing more frequent provider visits, prompt responses to acute issues, and care coordination, nurse practitioner (NP) co-management has been beneficial for the care of chronically ill older adults. This paper describes the homebound patients with high symptom burden and healthcare utilization who were referred to an NP co-management intervention and outlines key features of the intervention. We compared demographic, clinical, and healthcare utilization data of patients referred for NP co-management within a large home-based primary care (HBPC) program (n=87) to patients in the HBPC program not referred for co-management (n=1027). A physician survey found recurrent hospitalizations to be the top reason for co-management referral and a focus group with nurses and social workers noted that co-management patients are typically those with active medical issues more so than psychosocial needs. Co-management patients are younger than non-co-management patients (72.31 vs. 80.30 years old, P<0.001), with a higher mean Charlson comorbidity score (3.53 vs. 2.47, P=0.0001). They have higher baseline annual hospitalization rates (2.27 vs. 0.61, P=0.0005) and total annual home visit rates (13.1 vs. 6.60, P=0.0001). NP co-management can be utilized in HBPC to provide intensive medical management to high-risk homebound patients. PMID:27876403
Marine and Hydrokinetic Technology Development Risk Management Framework

Energy Technology Data Exchange (ETDEWEB)

Snowberg, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Weber, Jochem [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-09-01

Over the past decade, the global marine and hydrokinetic (MHK) industry has suffered a number of serious technological and commercial setbacks. To help reduce the risks of industry failures and advance the development of new technologies, the U.S. Department of Energy (DOE) and the National Renewable Energy Laboratory (NREL) developed an MHK Risk Management Framework. By addressing uncertainties, the MHK Risk Management Framework increases the likelihood of successful development of an MHK technology. It covers projects of any technical readiness level (TRL) or technical performance level (TPL) and all risk types (e.g. technological risk, regulatory risk, commercial risk) over the development cycle. This framework is intended for the development and deployment of a single MHK technology—not for multiple device deployments within a plant. This risk framework is intended to meet DOE’s risk management expectations for the MHK technology research and development efforts of the Water Power Program (see Appendix A). It also provides an overview of other relevant risk management tools and documentation.1 This framework emphasizes design and risk reviews as formal gates to ensure risks are managed throughout the technology development cycle. Section 1 presents the recommended technology development cycle, Sections 2 and 3 present tools to assess the TRL and TPL of the project, respectively. Section 4 presents a risk management process with design and risk reviews for actively managing risk within the project, and Section 5 presents a detailed description of a risk registry to collect the risk management information into one living document. Section 6 presents recommendations for collecting and using lessons learned throughout the development process.
Strategic Risk Management and Corporate Value Creation

DEFF Research Database (Denmark)

Andersen, Torben Juul; Roggi, Oliviero

Major corporate failures, periodic recessions, regional debt crises and volatile markets have intensified the focus on corporate risk management as the means to deal better with turbulent business conditions. Hence, the ability to respond effectively to the often dramatic environmental changes...... 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...... of risk management effectiveness and the relationship to corporate performance based on panel data for more than 3,400 firms accounting for over 33,500 annual observations during the turbulent period 1991-2010. Determining effective risk management as the ability to reduce earnings and cash flow...
A Systematic Review of Stress-Management Programs for Medical Students

Science.gov (United States)

Shiralkar, Malan T.; Harris, Toi B.; Eddins-Folensbee, Florence F.; Coverdale, John H.

2013-01-01

Objective: Because medical students experience a considerable amount of stress during training, academic leaders have recognized the importance of developing stress-management programs for medical students. The authors set out to identify all controlled trials of stress-management interventions and determine the efficacy of those interventions.…
Medication management in North Carolina elementary schools: Are pharmacists involved?

Science.gov (United States)

Stegall-Zanation, Jennifer; Scolaro, Kelly L

2010-01-01

To determine the extent of pharmacist use in medication management, roles of school nurses, and use of other health care providers at elementary schools in North Carolina. Prospective survey of 153 (130 public and 23 private) elementary schools in four counties of North Carolina. A 21-question survey was e-mailed to the head administrator of each school (e.g., principal, headmaster) containing a Qualtrics survey link. Questions were designed to elicit information on school policies and procedures for medication management and use of health care providers, including pharmacists, in the schools. Responses were collected during a 2-month period. Representatives from 29 schools participated in the survey (19% response rate). All 29 schools reported having a school policy regarding medication administration during school hours. Of those, 27 schools reported consulting with nurses on their policies. Only 1 of 27 respondents reported consulting with pharmacists on medication management policies. The majority of the respondents (93.1%) stated that administrative staff was responsible for medication administration at the schools. Use of pharmacists in creating and reviewing policies for schools and actual medication management at schools was extremely low. The findings in this study reinforce the findings in previous studies that pharmacists are not being used and are not a major presence in elementary school health.
Medication Therapy Management and Preconception Care: Opportunities for Pharmacist Intervention

Directory of Open Access Journals (Sweden)

Natalie A. DiPietro

2014-01-01

Full Text Available As medication therapy management (MTM continues to grow in the profession of pharmacy, careful consideration as to areas for positive patient impact is warranted. Given the current gaps in preconception care in the United States, and the accessibility and expertise of the pharmacist, MTM interventions related to preconception care may be valuable. This paper describes potential for pharmacist intervention in several different areas of preconception care. Notably, targeted medication reviews may be appropriate for interventions such as folic acid recommendations, teratogenic/category X medication management, immunizations, and disease state management. Comprehensive medication reviews may be warranted for selected disease states due to complexity of interventions, such the management of diabetes. Comprehensive medication reviews may also be warranted if several targeted interventions are necessary, or if there are a several medications or disease states requiring intervention. Pharmacists also have important roles in screening, support, and referrals needed for preconception care in the context of MTM. Patients may benefit substantially from pharmacist-directed MTM services related to preconception care. In addition, depending on clinical pharmacy service contracts and billing opportunities, pharmacists may be reimbursed for providing these services, generating sustainable revenue while fulfilling an important public health need. Type: Idea Paper
Developing Risk Management as a Competitive Capability

OpenAIRE

Silva, E.; Wu, Y.; Ojiako, U.

2013-01-01

At the level of the firm, three major parameters are found to influence the ability of SMEs to develop risk management competencies; these are enterprise risk management, internal control, and risk culture.
Social Risk and the Management of MNCs

DEFF Research Database (Denmark)

Taarup Esbensen, Jacob

2015-01-01

Multinational companies (MNCs) are increasing being exposed to risk that originate from local communities in the business environment where they operate. The response has been to implement systems for stakeholder engagement by including social issues into their risk management systems. However......” systems, which are based on the capability to identify frames and sensemaking processes. This paper show how social risk management can be conventionalised using distinct theoretical domains taking its outset in a sociological perspective on risk, linking International Business (IB) risk management...
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.
Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.

Science.gov (United States)

Scobie, Andrea

2011-04-01

To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. None. A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill. A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department. Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.
Risk management of precious metals

NARCIS (Netherlands)

S.M. Hammoudeh (Shawkat); F. Malik (Farooq); M.J. McAleer (Michael)

2010-01-01

textabstractThis paper examines volatility and correlation dynamics in price returns of gold, silver, platinum and palladium, and explores the corresponding risk management implications for market risk and hedging. Value-at-Risk (VaR) is used to analyze the downside market risk associated with
Risk management, derivatives and shariah compliance

Science.gov (United States)

Bacha, Obiyathulla Ismath

2013-04-01

Despite the impressive growth of Islamic Banking and Finance (IBF), a number of weaknesses remain. The most important of this is perhaps the lack of shariah compliant risk management tools. While the risk sharing philosophy of Islamic Finance requires the acceptance of risk to justify returns, the shariah also requires adherents to avoid unnecessary risk-maysir. The requirement to avoid maysir is in essence a call for the prudent management of risk. Contemporary risk management revolves around financial engineering, the building blocks of which are financial derivatives. Despite the proven efficacy of derivatives in the management of risk in the conventional space, shariah scholars appear to be suspicious and uneasy with their use in IBF. Some have imposed outright prohibition of their use. This paper re-examines the issue of contemporary derivative instruments and shariah compliance. The shariah compatibility of derivatives is shown in a number of ways. First, by way of qualitative evaluation of whether derivatives can be made to comply with the key prohibitions of the sharia. Second, by way of comparing the payoff profiles of derivatives with risk sharing finance and Bai Salam contracts. Finally, the equivalence between shariah compliant derivatives like the IPRS and Islamic FX Currency Forwards with conventional ones is presented.

The total theory about risk management

International Nuclear Information System (INIS)

Furuya, Shunsuke

2003-01-01

A general working procedure of risk management, some example of other countries, topics and problems in the future are described. A definition of risk, risk assessment, risk management process, setting of aim and definite policy are explained. As a fundamental way of thinking, risk is controlled by ALARP (As Low As Reasonably Practicable). The upper and lower limit of risk level is called as Quantitative Safety Goal and Target Level of Safety, respectively. These limits in the atomic power and airplane are decided. Evaluation of risk, countermeasure and practice are explained. For example, a permissible range of risk and practical use in England, U.S.A, Holland and Japan are stated. Recently, accountability risk, missing demand risk and control risk are important. (S.Y.)
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.
Risk management at Lawrence Livermore National Laboratory

International Nuclear Information System (INIS)

Cummings, G.E.; Strait, R.S.

1993-10-01

Managing risks at a large national laboratory presents a unique set of challenges. These challenges include the management of a broad diversity of activities, the need to balance research flexibility against management control, and a plethora of requirements flowing from regulatory and oversight bodies. This paper will present the experiences of Lawrence Livermore National Laboratory (LLNL) in risk management and in dealing with these challenges. While general risk management has been practiced successfully by all levels of Laboratory management, this paper will focus on the Laboratory's use of probabilistic safety assessment and prioritization techniques and the integration of these techniques into Laboratory operations
BEHAVIOURAL INSIGHTS INTO SUPPLY CHAIN RISK MANAGEMENT

OpenAIRE

Alexandra-Codruta Popescu (Bîzoi); Cristian-Gabriel Bîzoi

2015-01-01

Literature has focused largely on the field of supply chain risk management. Numerous risks occur within supply chain management. Until lately, behavioural risks (implying large amount of losses) have been neglected and considered not relevant. In this paper we provide an analysis of the importance of including behavioural research in logistics and supply chain risk management, what has been written so far and potential future research directions. Until now, literature on logistics and supply...
Risk management in Swedish hedge funds

OpenAIRE

Fri, Samuel; Nilsson, Joakim

2011-01-01

Background: Risk management has always been a complex topic, especially when it comes to hedge funds. Since hedge funds are able to utilize many kinds of financial instruments it is difficult to find a risk management strategy that goes well with them. Not much research regarding the Swedish hedge fund industry and its risk management has been done; hence we find it an interesting topic to focus this thesis on. Purpose: The purpose of this thesis is to increase the knowledge of how Swedish he...
Is ALARP applicable to the management of terrorist risks?

International Nuclear Information System (INIS)

Guikema, S.D.; Aven, T.

2010-01-01

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.
Cardiovascular risk behavior among students of a Medical College in Delhi

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N Rustagi

2011-01-01

Full Text Available Background: Life style related behavioural risk factors are mainly implicated for increased burden of cardio- vascular diseases. Research related to these risk behaviours especially among medical students is essential, considering their role as future physicians and role models in public health intervention programmes. Objective: To evaluate the burden of cardiovascular risk behaviours among students of a medical college of Delhi, India. Materials and Methods: A cross sectional study was carried out among undergraduate medical students of a medical college in Delhi. Self administered questionnaire was used to collect information on identification data and risk behaviours in relation to cardiovascular diseases. Binary logistic regression analysis was done to calculate adjusted odds ratio to assess association between risk behaviours and covariates. Results: The minimum recommendation of taking at least five servings per day of fruits and vegetables was complied only by 12% of students. Consumption of carbonated soft drinks either once or more on daily basis was present in 23.7% students and 32.0% reported frequent consumption of fast foods in past week. Consumption of alcohol was present in 28.8% students but only small proportion of students (7% was current tobacco users. Large proportions of students (42.6% were either not carrying out or were involved in only occasional physical activity in past week. Conclusions: Unhealthy behavioural practises are present and may progress as student advance through medical college. Developing strategies targeting at these risk behaviours and determining factors is necessary to promote healthy life style among medical students.
Enhanced Capabilities for Subcritical Experiments (ECSE) Risk Management Plan

Energy Technology Data Exchange (ETDEWEB)

Urban, Mary Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Process Modeling and Analysis Group

2016-05-02

Risk is a factor, element, constraint, or course of action that introduces an uncertainty of outcome that could impact project objectives. Risk is an inherent part of all activities, whether the activity is simple and small, or large and complex. Risk management is a process that identifies, evaluates, handles, and monitors risks that have the potential to affect project success. The risk management process spans the entire project, from its initiation to its successful completion and closeout, including both technical and programmatic (non-technical) risks. This Risk Management Plan (RMP) defines the process to be used for identifying, evaluating, handling, and monitoring risks as part of the overall management of the Enhanced Capabilities for Subcritical Experiments (ECSE) ‘Project’. Given the changing nature of the project environment, risk management is essentially an ongoing and iterative process, which applies the best efforts of a knowledgeable project staff to a suite of focused and prioritized concerns. The risk management process itself must be continually applied throughout the project life cycle. This document was prepared in accordance with DOE O 413.3B, Program and Project Management for the Acquisition of Capital Assets, its associated guide for risk management DOE G 413.3-7, Risk Management Guide, and LANL ADPM AP-350-204, Risk and Opportunity Management.
Assessing and managing multiple risks in a changing world ...

Science.gov (United States)

Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological c
Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China

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Zhu LL

2014-03-01

Full Text Available Ling-ling Zhu,1 Wei Li,2 Ping Song,3 Quan Zhou3 1Geriatric VIP Ward, Division of Nursing, 2Division of Medical Administration, 3Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China Abstract: The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People's Republic of China. Injection device-related near misses and adverse events comprised the following: 1 improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2 complications associated with vascular access; 3 incidents induced by absence of efficient electronic pump management and infusion tube management; and 4 liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. Keywords
Medical negligence--prevention and management.

Science.gov (United States)

Chao, T C

1987-04-01

The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.
Assurance of Medical Device Quality with Quality Management System: An Analysis of Good Manufacturing Practice Implementation in Taiwan

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Tzu-Wei Li

2015-01-01

Full Text Available The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development.
The medical management of high risk individuals. Experiences with persons exposed to chronic internal irradiation; Ueber den aerztlichen Umgang mit Hochrisikopersonen. Erfahrungen bei Personen mit chronischer interner Strahlenexposition

Energy Technology Data Exchange (ETDEWEB)

Kaick, G. van; Delorme, S. [Deutsches Krebsforschungszentrum, E010 - Radiologie, Heidelberg (Germany)

2011-12-15

The medical management and counseling of persons at high risk due to exposure to chemicals or radiation or due to personal disposition, present an additional challenge for physicians and especially radiologists involved. This article is based on own experiences with patients who had been exposed to Thorotrast. They had been injected with the contrast medium Thorotrast, which was in use world-wide until around 1950. Thorotrast caused a chronic alpha irradiation mainly of the liver (up to 0.4 Gy/a), spleen (1.2 Gy/a) and bone marrow (0.1 Gy/a). For the Thorotrast patients and their physicians the most worrying problem was the risk of primary malignant liver tumors which occurred in more than 20% of the exposed persons, i.e. 100 times more frequently than in a non-exposed control group. The medical and especially radiological experiences with the management of these patients summarize a general aspect of the problem and can be referred to when managing other high risk groups. (orig.) [German] Die aerztliche Fuehrung von Personen, die noch nicht erkrankt sind, aber ein deutlich hoeheres Risiko fuer bestimmte Tumorerkrankungen aufgrund exogener oder endogener Ursachen haben, stellt den Arzt und speziell den diagnostischen Radiologen vor neue Herausforderungen. Dem Beitrag zugrunde liegen die Erfahrungen bei der Betreuung und Beratung so genannter Thorotrastpatienten, d. h. Personen, die nach lange zurueckliegender (vor 1950) intravasaler Injektion eines weltweit eingesetzten Roentgenkontrastmittels zeitlebens einer Alphastrahlung v. a. der Leber (bis 0,4 Gy/a), der Milz (1,2 Gy/a) und des Knochenmarks (0,1 Gy/a) ausgesetzt waren. Fuer die Thorotrastpatienten und die Aerzte stand im Vordergrund die Sorge der Entstehung primaerer, maligner Lebertumoren, die bei mehr als 20% der Betroffenen und damit im Vergleich zu einer Kontrollgruppe 100-fach haeufiger auftraten. Die allgemeinen aerztlichen und speziell radiologischen Erfahrungen sind grundsaetzlicher Art und lassen
Health software: a new CEI Guide for software management in medical environment.

Science.gov (United States)

Giacomozzi, Claudia; Martelli, Francesco

2016-01-01

The increasing spread of software components in the healthcare context renders explanatory guides relevant and mandatory to interpret laws and standards, and to support safe management of software products in healthcare. In 2012 a working group has been settled for the above purposes at Italian Electrotechnical Committee (CEI), made of experts from Italian National Institute of Health (ISS), representatives of industry, and representatives of the healthcare organizations. As a first outcome of the group activity, Guide CEI 62-237 was published in February 2015. The Guide incorporates an innovative approach based on the proper contextualization of software products, either medical devices or not, to the specific healthcare scenario, and addresses the risk management of IT systems. The Guide provides operators and manufacturers with an interpretative support with many detailed examples to facilitate the proper contextualization and management of health software, in compliance with related European and international regulations and standards.
Risikomanagement für medizinische Netzwerke in der Intensiv- und Notfallmedizin. Gemeinsames Positionspapier zur Norm IEC 80001-1 [Risk management for medical networks in intensive care and emergency medicine – a joint position paper on IEC 80001-1

Directory of Open Access Journals (Sweden)

Imhoff, Michael

2013-02-01

Full Text Available [english] IEC 80001-1 is an international standard and offers recommendations for a risk management process for medical information technology networks (MITs. MITs are defined as IT networks incorporating at least one medical device. The goal is to build and maintain reliable and secure MITs for hospitals of all kids. To achieve it, the standard suggests applying risk management and defines the roles involved as well as their responsibilities. A central role is the medical IT-network risk manager, assigned by the top management of organizations. He communicates with and mediates between clinical, medical device and IT divisions and compiles risk relevant facts usually distributed among them. All identified risks are analyzed, evaluated and documented in the risk management file along with counter measures and a final assessment of acceptability.We acknowledge that implementing the suggested process will create an overhead cost in documentation and – partly by extension – in personnel. However we believe that the investment at the start of projects is worthwhile, because it helps to prevent or solve problems in later stages. Especially consecutive projects can profit from the investment, reducing required effort and costs. Furthermore, a reliable and secure MIT forms the basis for frictionless routine operations and innovations for connected medical devices. Hence the investment is justified. Applying risk management to the whole cooperation all at once is unrealistic. Focusing on parts of the network, which are crucial to a new project is more recommendable. With a smaller scope, risk management remains feasible and can later be expanded to other parts of the network.IEC 80001-1 demands communication among involved employees from different specialties and divisions. This offers a chance for cooperation to find better decisions and solutions regarding an organization’s medical IT network.[german] Die IEC 80001-1 ist eine Norm, die
Dairy farmer use of price risk management tools.

Science.gov (United States)

Wolf, C A

2012-07-01

Volatility in milk and feed prices can adversely affect dairy farm profitability. Many risk management tools are available for use by US dairy farmers. This research uses surveys of Michigan dairy farmers to examine the extent to which price risk management tools have been used, the farm and operator characteristics that explain the use of these tools, and reasons farmers have not used these tools. A 1999 survey was used to benchmark the degree to which dairy producers had used milk and feed price risk management instruments to compare with 2011 use rates. The surveys collected information about the farm characteristics such as herd size, farmland operated, business organization, and solvency position. Farm operator characteristics collected include age, education, and experience. Dairy farmer use of both milk and feed price risk management tools increased between 1999 and 2011. In 2011, herd size was positively related to the use of milk price risk management tools, whereas farms organized as a sole proprietorship were less likely to use them. Also in 2011, herd size and land operated were positively related to feed price risk management tools, whereas operator age was negatively related. Reasons why farmers had not used price risk management tools included basis risk, cost, lack of management time, cooperative membership, and lack of understanding. Conclusions include the need for educational programming on price risk management tools and a broader exploration of dairy farm risk management programs. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
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...
Effects of Medicaid disease management programs on medical expenditures: Evidence from a natural experiment in Georgia.

Science.gov (United States)

Kranker, Keith

2016-03-01

In recent decades, most states' Medicaid programs have introduced disease management programs for chronically ill beneficiaries. Interventions assist beneficiaries and their health care providers to appropriately manage chronic health condition(s) according to established clinical guidelines. Cost containment has been a key justification for the creation of these programs despite mixed evidence they actually save money. This study evaluates the effects of a disease management program in Georgia by exploiting a natural experiment that delayed the introduction of high-intensity services for several thousand beneficiaries. Expenditures for medical claims decreased an average of $89 per person per month for the high- and moderate-risk groups, but those savings were not large enough to offset the total costs of the program. Impacts varied by the intensity of interventions, over time, and across disease groups. Heterogeneous treatment effect analysis indicates that decreases in medical expenditures were largest at the most expensive tail of the distribution. Copyright © 2016 Elsevier B.V. All rights reserved.
WAYS TO IMPROVE RISK MANAGEMENT IN COMPLEX PROJECTS

Directory of Open Access Journals (Sweden)

Emilia IORDACHE

2012-01-01

Full Text Available Risk is present in all human activities; it can be associated with health, security, economy or environment. The goal of risk management is to control, prevent or decrease potential damages. Technically speaking, risk management means all the activities coordinated so as to orient and monitor an organization from the risk perspective. Risk management helps formulate the most adequate decisions by taking account of uncertainties and their effects upon the accomplishment of proposed goals, and argues the need to lay down and implement coercive, preventive actions typical of the management of a company. The benefits of good risk management and also the consequences of bad management shall undoubtedly be felt by an organization’s board, employees, shareholders, customers as well as by all other entities concerned with organizational performance. Projects generally include a number of risks in common with those in business as well as certain typical ones. In complex projects, it is this very feature – complexity – which generates the need to implement risk management for the purpose to diminish, remove, and monitor the risks which can influence the development of a project.
Risk Management in Information Technology Project: An Empirical Study

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Kornelius Irfandhi

2016-09-01

Full Text Available The companies are facing some risks due to changes in a dynamic environment. If risks are not managed properly, it will have some negative impacts on the companies at the present and the future. One important function of the Information Technology (IT governance is risk management. Risk management in IT project aims to provide a safe environment for IT projects undertaken. Risk management becomes an important process for the success of IT projects. This article discussed the risk of IT project and whether there was a relationship between risk management and the success of the project. The method used was performing a literature review of several scientific articles which published between 2010 and 2014. The results of this study are the presence of risk management and risk manager influence the success of the project. Risk analysis and risk monitoring and control also have a relationship with the subjective performance of IT projects. If risk management is applied properly, the chance of the success of the projects undertaken can be increased.

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