A critical view of severity classification in risk assessment methods

Pasquini, Alberto; Pozzi, Simone; Save, Luca

doi:10.1016/j.ress.2010.06.029

Cited by 17 publications

(8 citation statements)

References 6 publications

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“…For instance, “ the worst case scenario ” might lead to an overconsideration of the most extreme cases; “ the most likely scenario ” might ignore the extreme cases; “ the reasonably foreseeable worst case scenario ” might lead to most of the risk scores being assigned to intermediate colored bands; and “ the highest risk score scenario ” might require the measurement of risk scores for all possibilities, which might be considered to be time consuming. Although there is always a possibility of bias in following such strategies, it is advised in the literature to consider “ the worst credible case scenario ” as referring to “ the reasonably foreseeable worst case scenario ” (Air Force Safety Agency [AFSC], ; Manuele, ; ORR, ; Pasquini, Pozzi, & Save, ).…”

Section: Discussionmentioning

confidence: 99%

A Review of Risk Matrices Used in Acute Hospitals in England

2018

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In healthcare, patient safety has received substantial attention and, in turn, a number of approaches to managing safety have been adopted from other high-risk industries. One of these has been risk assessment, predominantly through the use of risk matrices. However, while other industries have criticized the design and use of these risk matrices, the applicability of such criticism has not been investigated formally in healthcare. This study examines risk matrices as used in acute hospitals in England and the guidance provided for their use. It investigates the applicability of criticisms of risk matrices from outside healthcare through a document analysis of the risk assessment policies, procedures, and strategies used in English hospitals. The findings reveal that there is a large variety of risk matrices used, where the design of some might increase the chance of risk misprioritization. Additionally, findings show that hospitals may provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms of risk matrices. Consequently, this is likely to lead to variation in the quality of risk assessment and in the subsequent deployment of resources to manage the assessed risk. Finally, the article outlines ways in which hospitals could use risk matrices more effectively.

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Section: Discussionmentioning

confidence: 99%

A Review of Risk Matrices Used in Acute Hospitals in England

2018

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“…the likelihood that the patient suffers a permanent lifechanging incapacity as the result of the medication overdose. Deciding on the likelihood and severity parameters was a challenging task 40,41 . For example, for the Hazard Instance 'prescribing a medication to which the patient is allergic ', it is likely that there will be relatively little harm (e.g.…”

Section: Risk Analysismentioning

confidence: 99%

Development and piloting of a software tool to facilitate proactive hazard and risk analysis of Health Information Technology

Habli¹,

Jia

White

et al. 2019

Health Informatics J

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Health Information Technology (HIT) is now widely promoted as a means for improving patient safety. The technology could also, under certain conditions, pose hazards to patient safety. However, current definitions of hazards are generic and hard to interpret, particularly for large HIT in complex socio-technical settings, i.e. involving interacting clinical, organisational and technological factors. In this paper, we develop a new conceptualisation for the notion of hazards and implement this conceptualisation in a tool-supported methodology called the Safety Modelling, Assurance and Reporting Toolset (SMART). SMART aims to support clinicians and engineers in performing hazard identification and risk analysis and producing a safety case for HIT. Through a pilot study, we used and examined SMART for developing a safety case for electronic prescribing in three acute hospitals. Our results demonstrate the ability of SMART to ensure that the safety evidence is generated based on explicit traceability between the clinical models and HIT functionality. They also highlight challenges concerning identifying hazards in a consistent way, with clear impact on patient safety in order to facilitate clinically-meaningful risk analysis.

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“…Numerous calls to propagate innovative ideas on safety risk analysis (Leveson 2004;Mohaghegh, 2007;Kyriakidis et al, 2012) have produced frameworks that expand our understanding of risk (e.g., Mohaghegh and Mosleh, 2009;Stroeve et al, 2009). However, the complexity and multi-disciplinary nature of safety issues has created a lag between theoretical advancements and the development of methods and techniques with which to implement these (Pasquini et al, 2011). Consequently, three major challenges have impeded progression from first to second generation safety risk models:…”

Section: Challenges Of Moving Toward a Second-generation Modelmentioning

confidence: 99%

Modeling tunnel construction risk dynamics: Addressing the production versus protection problem

et al. 2016

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Accidents remain a pervasive problem in tunnel construction. A major contributor to these accidents is the construction contractor's inability to determine an appropriate trade-off between production and protection goals. Building upon previous research, a conceptual framework of the relationships between competing organizational goals and various technical risks is proposed. This framework forms the basis for a systemic 'multiple methods' model of the interactions between the contractor's organizational and technical systems as a first step towards mitigating risks posed. Multiple methods are utilized given the complexity of risk factors that influence a system's safety. Specifically, the model integrates System Dynamics (SD), Bayesian Belief Networks (BBN) and smooth Relevance Vector Machines (sRVM) (referred to as 'Organizational Risk Dynamics Observer' (ORDO)). The final model developed is demonstrated on an urban metro tunnel project that was constructed in Wuhan, China. Organizational factors that influence the performance of a safe system of work and the shifting focus of management between production and protection goals are also examined. Findings suggest that when attention focuses upon production, the propensity for minor accidents to occur increased, which triggered management to focus on protection. Moreover, an increasing emphasis on protection may mute the safe systems of working as incidents go unreported thus inhibiting the motivation for safety awareness. When coupled with an increase in production pressure, the tunneling project becomes prone to experiencing a major accident. Therefore, the whole organization must continue to foster a sound safety culture to resist production pressure at the expense of compromising safety.

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A critical view of severity classification in risk assessment methods

Cited by 17 publications

References 6 publications

A Review of Risk Matrices Used in Acute Hospitals in England

A Review of Risk Matrices Used in Acute Hospitals in England

Development and piloting of a software tool to facilitate proactive hazard and risk analysis of Health Information Technology

Modeling tunnel construction risk dynamics: Addressing the production versus protection problem

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