TY - JOUR T1 - Risk register: an integrated governance approach JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care SP - 271 LP - 272 DO - 10.1136/bmjspcare-2011-000105.205 VL - 1 IS - 2 AU - Chris Haywood AU - Alison Coackley Y1 - 2011/09/01 UR - http://spcare.bmj.com/content/1/2/271.3.abstract N2 - Introduction While risk management is an integral component of high quality care it can be difficult to demonstrate effectiveness. A key aim of the Hospice Business Plan was to devise and develop a Risk Register that could incorporate Fundraising and Clinical activities as part of an Integrated Governance Framework. Aims ▶ To produce a Risk Register to identify areas and work practices most at risk▶ To implement a Risk Register to minimise risks that could affect the running of the Hospice▶ To use a Risk Register to monitor effectiveness of actions/initiatives.Aims Methods ▶ Literature review▶ Risk Matrix▶ Risk scoring process▶ Audit cycle.Methods Example Risk Date Governance Area Description of Risk concern (x,y,z) Potential Impact including current controls Risk Score (Pre) Risk control processes to reduce or transfer risk Date for completion Risk Score (Post) Likelihood rating Impact rating RISK. Clinical effectiveness Administration of bisphosphonate infusions without adequate checks causing harm Patient condition compromised Develop hospice policy on bisphosphonate infusions with flow chart Training and education for nursing and medical staff Distribution of new regional audit guidelines Audit to check on process Results▶ Organisational risks were identified and scored using likelihood and impact ratings▶ Risks were categorised into seven key themes▶ Potential impact including current controls were described▶ Risk control processes to reduce/transfer risk were shown for each individual risk▶ Following intervention 86% of high risks were significantly reduced within a 7 month period. Conclusions▶ Use of a Risk Register clearly demonstrates effectiveness▶ Heightened awareness; risk is everyone's business▶ Audit has shown improvements in identifying risks▶ Strengthened communication across fundraising and clinical services. Recommendations▶ Understanding of Risk Register to be part of induction training▶ Use of Register needs to be an ongoing process and should be regularly monitored and updated. ER -