EMS World

DEC 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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14 DECEMBER 2018 | EMSWORLD.com Y ou may think of a crisis as an imme- diate threat to life safety, but any unexpected outcome that nega- tively impacts an organization, its stakeholders, or its community may cre- ate a crisis environment. Although man- aging crises effectively when they occur is essential, organizations must also strive to identify and guard against risk factors that can lead to crises. They should be able to identify, assess (i.e., prioritize), analyze, and mitigate such risks and control their envi- ronment once those factors are reduced. We are surrounded by risk. Organiza- tional risk factors can be found in services, processes, systems, workflows, policies, geographic locations, specialized equip- ment, and other activities both internal and external. In attempting to identify them, the EMS officer must look at their organization or division from a macro perspective, inter- nally and externally, with an eye toward all the threats it might face. Here are some example risk factors that could help foster a crisis: Internal • EMS service delivery (poor care provided to patients); • Lack of a capital replacement plan (may result in outdated and nonfunctioning equipment); • Reduced staffing and hours of opera- tion (not having the support to provide services); • Minimal training to internal stakehold- ers (employees not prepared to manage critical events); • Billing for services (underperforming billing process may lead to misallocated or uncollected fees). External • Safety challenges from disasters, terror- ism, etc. (resulting in injuries to respond- ers or civilians); • Market competition (loss of revenue); • Increased hospital turnaround times (limiting available transport units); • Medication shortages; • Epidemics/pandemics (inability to handle increased demand); Using an organizational risk-manage- ment framework will provide an organized approach to minimizing and eliminating risk factors. A Risk-Management Framework Risk management is an approach that's preventive, rather than reactionary. When poisoned Tylenol killed seven people in 1982, maker Johnson & Johnson handled the crisis so effectively, it became a teach- ing case: After the threat was mitigated (largely by pulling products from store shelves), the company implemented a risk- management plan that included tamper- proof caps and seals on all bottles. An organization's goal must always be to identify potential risk factors before the crisis occurs. A risk-management frame- work should encompass several aspects: a strategic risk objective or goal; identifi- cation, assessment/prioritization, analysis, and mitigation; and a method for controlling the environment once the risk is addressed. Identifying risk factors—Consider what internal and external organizational activ- ities have the greatest potential to nega- tively affect the community, employees, or organization. Many organizations can spot risk factors as they conduct quality assur- ance chart reviews. However, EMS officers must expand the search into all aspects of service delivery. Don't attempt this by yourself; establish a risk-management team and seek input from internal and external stakeholders and professionals who work with the identified risk factors every day. Assessment—Focus on identified factors that could have the greatest detriment to life safety, followed by those that imperil the organization. Ask: • Does this risk pose a threat to life? • What is the probability of this risk becoming a crisis within 24–72 hours? • What is the probability the crisis will cause life threats to internal and/or exter- nal stakeholders? • What is the probability the crisis will affect the organization and prevent it from doing business? A onetime risk-crisis assessment is not good enough—the process must be ongo- ing. No matter how busy an officer may be, risk assessment should never become a low priority. Rules of Risk Management "From the Officer's Desk" is a bimonthly column aimed at EMS leaders. What's the best approach to identify and reduce your organization's threats? By Orlando J. Dominguez, Jr., MBA, RPM FROM THE OFFICER'S DESK

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