Risk Preparedness Program – ROJoson’s Paper – 2008

Risk Preparedness Program – ROJoson’s Paper – 2008

Manila Doctors Hospital


 Risk Preparedness Program


A Concept Paper on Design and Development


Reynaldo O. Joson, MD

V- January 9, 2008




2008 Annual Planning Conference

            Resolution to study “risk management”

            President Sobrepeña asked Dr. Reynaldo Joson to make a concept paper on design


Existing program and activities:

            Disaster Preparedness Committee – activated in 2005 – fully functional

            Customer Relations Service and Business Development Division – procedures in   handling complaints and possible medicolegal suits

            Human Resource Division – procedures in handling legal suits arising from staff

            Medical Services Division – procedures in handling complaints and possible medicolegal suits (presence of Medical Audit Committee)

            Nursing Services Division – procedures in handling complaints and possible medicolegal suits (presence of Nursing Audit Committee)

            Hospital lawyers – handling complaints and possible suits

            Administrative Director and Hospital Director – procedures in handling complaints and possible legal suits


            NOTE: Need to review, refine, coordinate, and integrate


Approach in the development of design and development by Dr. Rey Joson


            Systemic perspective – hospital wide

            Hospital-wide framework


            Use of euphenismic and non-alarming terms

            Emphasis on prevention

            Emphasis on preparedness




Title or name of program:


Possible titles:

Risk Management Program

Risk Preparedness Program

Crisis Management Program
Crisis Preparedness Program

Disaster Management Program

Disaster Preparedness Program



Recommendation: Risk Preparedness Program

            Basis:   Use euphenism / Non-alarming terms (risk best compared to crisis and disaster)

                        Encompassing (risk for all types – natural, man-made, medicolegal, non-medicolegal suits)

                        Preparedness concept – risk preferred over crisis as risk precedes crisis

                        Preparedness preferred over management as latter connotes response; preparedness connotes prevention and being ready and includes response.


            Thus, Risk Preparedness Program



Concepts and Definition of Terms:


Risk is the possibility of an adverse deviation from a desired outcome.  It is the probability and consequences of exposure to a hazard.  Examples of consequences: death, injury, damage to infrastructure, loss of property, loss of income, contamination of environment, breakdown in essential services, breakdown in security, etc.


Risk preparedness process / program is a planned and systematic process / program to reduce and/or eliminate the probability of a “risk” that usually results in injuries, losses, and legal suits. It consists of three distinct, yet interrelated areas: 1) risk identification and loss prevention; 2) loss reduction; and 3) risk financing.

Hazard is any potential threat to health, safety, and property.  Examples: natural hazards, technological hazards, biological hazards, societal hazards.


Vulnerabilities refers to the infrastructure, system, and people within the organization less able to cope with the impact of the hazards


Capacity refers to the capacity of the infrastructure, system, and people within the organization to respond to and recover from the emergencies (crisis and actual disaster).


Risk is directly proportional to hazards and vulnerabilities and inversely proportional to readiness for response.


Preparedness is a measure to build capacities to respond to and recover from emergencies. Elements of preparedness: policies, procedures, guidelines, plans, resources, authority, knowledge, skills, awareness.


Risk preparedness / management processes refer to risk assessment and analysis – risk communication – risk reduction – risk monitoring


Risk assessment processes refer to the following: 

            Prepares hazard profile.

            Maps the distribution of hazards.

            Identify elements / people exposed to hazards.

            Predict consequences of hazards.


Risk reduction – protecting health, safety, and property by

                        Hazard reduction plan (reduce exposure)

                        Vulnerability reduction plan (reduce consequences)

                        Emergency preparedness plan (increase capacity for response and recovery)

Emergency is any actual threat to health, safety and property.


Disaster is an emergency in which the institution CANNOT cope.



Risk Identification


Types / Categories of Risks in the Manila Doctors Hospital

1.      Risk for natural disasters (earthquake, flood, tsunamis, fire, etc.)

2.      Risk for man-made disasters (fire, felony, bomb threat, terrorism, etc.)

3.      Risk for medico-legal suits (arising from patient care)

4.      Risk for non-medico-legal suits (not arising from patient care)


Situation in MDH:


            Needs data on risk frequency / incidence / prevalence from 2005 to 2007

            What were the consequences?

            Status of all activities on risk preparedness and management




            Risk Preparedness Program

                        Risk Preparedness and Response Plans

                                    Risk identification and assessment

                                    Risk reduction

                                    Risk financing

            Operational needs assessment

                        Policies and Procedures


                        Delegate authority

            Training needs assessment

                        Upgrade knowledge

                        Upgrade skills

                        Upgrade attitude

            Resource needs assessment



Expected outcomes and impact of Risk Preparedness Program


            Risks reduced to a minimum possible.

                        Reduced financial losses.

                        Reduced infrastructure losses.

            Improved quality and safety services.

            Improved customer satisfaction.

            Improved reputation.

            Improved business development.




Planning on Risk Preparedness Program


Risk Intervention Responsible body Resources needed Time Indicators
Natural disasters Preparedness Program


Disaster Preparedness Committee Committee works and activities

Risk financing

March, 2008 No fire
Man-made disasters Preparedness Program Disaster Preparedness Committee Committee works and activities

Risk financing

March, 2008 Incidents near zero
Medico-legal suits Preparedness Program Medico-Nursing Safety Committee Committee works and activities

Risk financing

March, 2008 Potential medico-legal suits ≤ 10 / year


No medico-legal suit

Non-medico-legal suits Preparedness Program Occupational Safety Committee Committee works and activities

Risk financing

March, 2008 Potential non medico-legal suits ≤ 3 / year


No non-medicco-legal suit

Recommendations on Committee and Membership:


Risk Preparedness Committee (mother committee – coordinating body)


                        Disaster Preparedness Committee

                        Medico-Nursing Safety Committee

                        Occupational Safety Committee



  Head Members Members
Risk Preparedness Committee Hospital Director Division Heads Lawyer

Finance Person

Disaster Preparedness Committee Dr. Robbie Ruiz FMD


Linen and Housekeeping




Finance Person

Medico-Nursing Safety Committee Dr. Roehl Salvador MSD



Finance Person

Occupational Safety Committee Mr. Benhur Bernardo HRD




Finance Person


Today, September 12, 2012, I looked back at what I wrote in 2008.

Today, I will use the terms “Hospital Risk Management Program” instead of “Risk Preparedness Program.”  Risk Preparedness Program is subsumed in Risk Management Program.

I will use Hospital Risk Management Program to mean the program is in a hospital setting.

I will use Hospital Risk Management Program to include the concepts of business continuity management program.

I will use Hospital Risk Management Program to include all types of emergencies-disasters-crises that can occur in a hospital setting that has to be prevented, mitigated, prepared, responded to with the end-goals of maintaining business continuity and hospital sustainability.  

All types of emergencies-disasters-crises will include both natural and man-related ones.  Man-related emergencies-disasters-crises will include legal and medicolegal suits and accounts receivables among other things.

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