Lecture:  Objective Risk Analysis

 

Assigned Reading

  1. Objective security risk analysis  Read►
  2. Privacy and confidentiality analysis Read►

Presentations

  1. Security risk analysis  Slides►   Listen►
  2. Privacy risk assessment  Slides► 

Narrated slides and videos require Flash.  Download►

What do you know?

Advanced learners like you, often need different ways of understanding a topic. Reading is just one way of understanding. Another way is through writing about what you have read.  The following questions get you to think more about the concepts taught in this session.

  1. Are the methods of conducting risk analysis different depending on whether the analysis is applied to hospital safety, terrorism or patient privacy?
  2. Can daily probability of rare events (e.g. operating room fire) be calculated despite the fact that these events are quite rare?
  3. How does objective risk analysis differ from comprehensive risk analysis?
  4. Is it practical to conduct probabilistic risk analysis?
  5. Does probabilistic risk analysis protect us from events that have never occurred before?
  6. What is the daily probability of an event that has occurred 6 years ago?

Do One:  Risk Analysis 

  1. Conduct a personal security risk analysis or use the opportunity to analyze the risks faced within an organization where an incidence database exists.  Here are the steps you need to follow:
    • Create an incidence database, listing at least 3 different types of security incidences (or near incidences) that have occurred to you over the years.  List at least 10 incidences and their dates.
    • Calculate the daily probability of various security risks
    • Prepare a presentation.  Include the following minimum 4 slides in your presentation:
      • Introductory slide (do not include your name or any identifiable information)
      • Provide incidences and date of occurrences of each incidence
      • Report daily probability of each type of incidence
      • Provide introspection about the utility of conducting risk analysis
    • Narrate your slides
    • Post your slides to the web
    • Forward the URL of your presentation to the instructor.
    See other students response to this assignment:  Bryant►  Tina►  Joe►  Mary►  Megan► Nicole►
  2. Using the procedures described in this section, analyze the following data on incidences of medication omission and describe the causes of medication omission at this organization:

    CASE ID DATE Days Until CAUSE PRESENTED EXPLANATION LOC ATTRIBUTED ADMIT DATE ADMIT TIME
    07-1899 11/22/07 9 2, 9 preop med ordered but pt sent to OR without it being given; given in PACU OR 3S 11/22/2007 1316
    07-1929 12/1/07 1 1, 2, 6, 9 no documentation on EMAR that med was given 6 days after order; some documentation by RT, unsure who was giving. ICU ICU 11/19/2007 2155
    07-1941 12/2/07 1 1, 8 name sticker covered order on copy sent to pharmacy 3W 3W 11/27/2007 1453
    07-2000 12/3/07 14 2, 4, 7 pt unable to provide non -formulary med from home; delay ordering in pharmacy 3S Pharmacy 12/3/2007 0253
    07-2134 12/17/07 10 6, 10 order for methadone q 8 hrs, usually prn, computer defaulted to PRN, not changed by pharmacist entering (OE) 2W 2W, Pharmacy 12/13/2007 2124
    07-2096 12/27/07 0 1, 3 order sheet folded between 2 blank order sheets 3S 3S 12/26/2007 1608
    07-2097 12/27/07 7 1, 10 order not taken off and not sent to pharmacy 3S 3S 12/26/2007 2244
    13
    08-74 1/16/08 5 4, 5 IV med not opened to infuse when hung, discovered next day 3S 3S 1/15/2008 1937
    08-108 1/21/08 6 4, 6 IV med not opened to infuse when hung, discovered next dose; RN orientee 3W 3W 1/21/2008 1428
    08-122 1/27/08 18 1, 8 missed dose, no reason given OB OB 1/25/2008 0810
    18
    08-201 2/14/08 3 3, 7 order entered 2/13, not sent until 2/14, eye gtt not on formulary and had to order; pharmacist should have made substitution to alleviate delay 2W Pharmacy 2/10/2008 0640
    08-227 2/17/08 5 2, 3, 5, 6 order for 4 times/day entered as PRN, not caught on chart check; Pharmacist did not look further in the order for changes since Vicondin already on EMAR 2W 2W, Pharmacy 2/13/2008 1455
    08-245 2/22/08 0 5, 6 order not entered by pharmacy, pharmacist missed part of order 3S 3S, Pharmacy 2/17/2008 1713
    08-246 2/22/08 6 6 med & instructions for f/u labs sent to unit, but med not given 2 days later; unknown reason 3S 3S 12/3/2007 0253
    08-304 2/28/08 24 2, 5, 6, 8 incomplete home med list sent to pharm, med list completed by MD next day, but not re-faxed to pharmacy; pt without home meds x5 days 3S 3S 2/28/2008 0350
    08-401 3/23/08 15 Order for colon prep written 3/21. Sheet folded over. RN did not see. 3S 3S, ICU, Pharmacy 3/19/2008 1647
    08-460 4/7/08 11 pharmacy order entry, wrong date for lovenox start date. RN also checked it off for wrong date. 3W 3W, Pharmacy 4/7/2008 1125
    08-514 4/18/08 order written at 1520 for pre-MRI valium. Pt to MRI w/o. RN unaware there was an order. 3S 3S 4/18/2008 241

In Fiscal Year 2008, the average daily census was 65.5 admissions.  The above data shows the following code for cause of medication omission:

  1. Order not taken off chart 

  2. Failure to Reconcile Physician order 

  3. Misplaced Medication Order

  4. Incorrect Administration of IV

  5. Order Not Written

  6. Computer related errors

  7. Pharmacy order delayed

  8. Pharmacist did not see the order

  9. Pharmacy order written incorrectly

  10. Prescription is Incorrect

  11. Patient Off the Unit

  12. Patient in Boarding Unit

  13. Patient NPO Option not Addressed

  14. Medication Held for Procedure

  15. RT Treatment Omitted

  16. Ambiguous Dose/Numbers  

More

For additional information(not part of the required reading), please see the following links:

  1. Legal and ethical issues related to EHR   Slides►
  2. Federal regulations governing health information security.   Accession Number: 00000703-199811000-00023   Library Link►
  3. Standards for privacy of individually identifiable health information Read►

This page is part of the course on Information Systems.   This page was edited 05/16/2013 by Farrokh Alemi, Ph.D.  ©Copyright protected.