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

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

doi:10.1002/jhrm.21160

Cited by 11 publications

(20 citation statements)

References 32 publications

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“…Seven of these (58%) were non-administrative risk controls. The resulting action plan included all seven non-administrative control options, along with four of the five administrative controls [23]. The experimental study presented here is a significant step forward for the evidence base on the use of this method, and strongly suggests that current practice can be improved upon.…”

Section: Discussionmentioning

confidence: 90%

Section: Aj Card Et Al / Use Of the Generating Options For Active mentioning

confidence: 99%

“…It is a structured brainstorming method designed to increase the proportion of non-administrative risk control options considered after a risk assessment. The GO-ARC Technique was developed for use as part of the broader Active Risk Control (ARC) Toolkit [22,23], which includes additional tools for assessing the risk control options that result.The technique could also be used on a stand-alone basis, or in combination with other approaches to assessing and selecting risk control options -e.g., the Commercial Aviation Safety Team-based approach [19] or the Lovebug Diagram [24]. Unlike the ARC Toolkit, neither of these alternate approaches currently includes a component for generating high-quality risk control options in the first place.…”

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confidence: 99%

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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: 90%

Section: Aj Card Et Al / Use Of the Generating Options For Active mentioning

confidence: 99%

mentioning

confidence: 99%

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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

show abstract

“…(See, for instance, the Options Evaluation Matrix. )36 But the use of ‘5 whys’ makes this impossible.…”

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%