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The Group’s Risk Register, dated May 2016, identified some 25 risks linked with HIQA’s National Standards for Safer Better Healthcare and three had the top risk rating of 25. The highest point in the risk matrix is measured in terms of likelihood (almost certain) by impact (extreme). Six risks had the second-highest risk rating.
One of the top-ranked risks was described as “insufficient capacity to manage the demand for inpatient beds, leading to overcrowding in the emergency departments” across the Group, with the “potential for adverse patient outcomes”.
The impact was described as increased incidence of patient harm, such as prolonged length of stay, infection, and increased morbidity and mortality. The risk also applied nationally, according to the register.
The second of the top-ranked risks was lack of standardisation across all sites in the Group. This was in the context of HIQA’s standard that leaders promote and strengthen a culture of quality and safety. Lack of standardisation resulted in “variation and reduced reliability”, increasing the risk in provision of safe patient care. The establishment of a Group Quality and Safety Directorate was noted as being among the measures used to control the risk.
The final risk, with a score of 25, indicated concern over the extent of use of early warning scores and auditing of same.
A spokesperson for the RCSI Hospitals Group did not provide a detailed explanation of the above risk, in response to queries from the Medical Independent. The spokesperson said there was consistent audit in place in the Group’s hospitals. Nursing and Midwifery Quality Care Metrics “audit whether patient observations have been carried out and their escalation”.
The Group’s review of quality and safety structures will be carried out by Health Care Informed. It was identified as the preferred supplier following a tender process. “The cost was under the threshold for competitive tendering but the amount is commercially sensitive information. The report is in draft currently,” said the Group’s spokesperson.