Rebalancing risk management-Part 1: The Process for Active Risk Control (PARC)

Card, Alan J.; Ward, James; Clarkson, PJ

doi:10.1002/jhrm.21155

Cited by 12 publications

(17 citation statements)

References 47 publications

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“…This study provides the first experimental evidence to support the transition from current practice, which focuses almost exclusively on risk assessment, toward a more balanced approach to risk management [38]. It also addresses a critical lack of evidence to guide risk management practice more generally [39].…”

Section: Discussionmentioning

confidence: 96%

Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options

Card¹,

Simsekler

Clark

et al. 2014

International Journal of Risk &Amp; Safety in Medicine

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BACKGROUND: Risk assessment is widely used to improve patient safety, but healthcare workers are not trained to design robust solutions to the risks they uncover. This leads to an overreliance on the weakest category of risk control recommendations: administrative controls. Increasing the proportion of non-administrative risk control options (NARCOs) generated would enable (though not ensure) the adoption of more robust solutions. OBJECTIVES: Experimentally assess a method for generating stronger risk controls: The Generating Options for Active Risk Control (GO-ARC) Technique. METHODS: Participants generated risk control options in response to two patient safety scenarios. Scenario 1 (baseline): All participants used current practice (unstructured brainstorming). Scenario 2: Control group used current practice; intervention group used the GO-ARC Technique. To control for individual differences between participants, analysis focused on the change in the proportion of NARCOs for each group. RESULTS: Control group: Proportion of NARCOs decreased from 0.18 at baseline to 0.12. Intervention group: Proportion increased from 0.10 at baseline to 0.29 using the GO-ARC Technique. Results were statistically significant. There was no decrease in the number of administrative controls generated by the intervention group. CONCLUSION: The Generating Options for Active Risk Control (GO-ARC) Technique appears to lead to more robust risk control options. A.J. Card et al. / Use of the Generating Options for Active Risk Control (GO-ARC) Techniqueof these approaches is that they are exclusively focused on problem exploration (risk assessment). They provide no direct support for the process of translating this problem-focused learning into solutionsfocused interventions (risk control) [2,9,13,14].The unexamined assumption behind this state of affairs is that successful risk assessment will necessarily lead to successful risk control. This approach may be successful in the industrial settings where these techniques were developed (the chemical process industry, for instance [15]), but recent evidence suggests that this success does not extend to the fields of healthcare [2] or occupational health and safety [16]. This may reflect that fact that the tools of operational risk assessment were created both by and for engineers, who are specifically trained to develop high-quality, robust solutions in response to identified requirements [17]. Healthcare workers are not trained in these skills [18], nor are they supported by risk management policies and procedures that provide adequate support for this function [14]. As a result, they face significant challenges in generating (and recognizing) high-quality risk controls [2,19,20].The strength of risk controls can be assessed using the three-tiered hierarchy of risk control [2]. The most effective and robust (i.e., prone to continue working over time) category is Elimination of the Hazard or the Target. The intermediate level is made up of Design Controls (aka Engineering Controls [16]), inter...

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Section: Discussionmentioning

confidence: 96%

Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options

Card¹,

Simsekler

Clark

et al. 2014

International Journal of Risk &Amp; Safety in Medicine

Self Cite

View full text Add to dashboard Cite

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“…Another issue highlighted by users was the fact that the ARC Toolkit “ shows the thought process behind the recommendations ,” which is a key way the Toolkit can support the Communication and Consultation function of the PARC …”

Section: The Pilot Study: Resultsmentioning

confidence: 99%

“…In the first installment of this 2‐part series on rebalancing risk management, we introduced the Process for Active Risk Control (PARC), a framework for designing and managing effective risk controls . In this second and final installment, we describe the Active Risk Control (ARC) Toolkit, which is designed to implement the PARC and provide the same kind of support for risk control that tools like FMEA provide for risk assessment .…”

Section: Introductionmentioning

confidence: 99%

Rebalancing risk management—Part 2: The Active Risk Control (ARC) Toolkit

Card

Ward

Clarkson

2015

J of Healthc Risk Manag

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The adoption of systems-focused risk assessment techniques has not led to measurable improvement in the rate of patient harm. Why? In part, because these tools focus solely on understanding problems and provide no direct support for designing and managing solutions (ie, risk control). This second installment of a 2-part series on rebalancing risk management describes a structured approach to bridging this gap: The Active Risk Control (ARC) Toolkit. A pilot study is presented to show how the ARC Toolkit can improve the quality of risk management practice.

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“…And efforts to improve safety and quality will often require more than one intervention targeting more than one underlying hazard. It is useful to identify all the key hazards that gave rise to an incident and ensure that each of these is either addressed or intentionally accepted 35. (See, for instance, the Options Evaluation Matrix.…”

Section: The Problem With ‘5 Whys’ In Rcamentioning

confidence: 99%

“…And like the scientific method, it must be implemented through an appropriate set of tools and techniques to produce reliable results 37. Although a handful of such tools have been introduced in recent years,35 36 67–72 they have not yet been adopted as the current standard of practice.…”

Section: Considering the Virtues Of ‘5 Whys’mentioning

confidence: 99%

The problem with ‘5 whys’

Card¹

2016

BMJ Qual Saf

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Rebalancing risk management-Part 1: The Process for Active Risk Control (PARC)

Cited by 12 publications

References 47 publications

Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options

Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options

Rebalancing risk management—Part 2: The Active Risk Control (ARC) Toolkit

The problem with ‘5 whys’

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