Risk management is the systematic approach to identifying, assessing, and reducing risks that could impact the safety, quality, and effectiveness of healthcare services. The primary goals are to protect patients and staff, ensure compliance with regulations, and maintain organisational sustainability.
Accreditation processes, such as general practice accreditation and hospital accreditation, are integral to this as they require the implementation of systems and protocols that address potential risks. Accreditation helps healthcare organisations not only comply with established standards but also to continuously improve by integrating best practices into their daily operations.
A key aspect of accreditation is that it provides a structured way to manage risks by enforcing standards that are designed to reduce errors, improve patient safety, and enhance the quality of care. It also fosters a culture of safety and quality among healthcare providers.
The Nature of Risk in Different Healthcare Settings
Risk in healthcare is a broad concept that can include clinical, operational, legal, and reputational risks. The nature of risk management may differ between a general practice clinic and a hospital due to various factors such as the scale of operation, the complexity of services provided, and the patient population served.
Here are some fundamental differences:
- General practice clinics typically have smaller staff and focus on outpatient services, including primary and preventive care.
- Hospitals provide a wide range of specialised, acute, and inpatient services, often dealing with more complex and high-risk procedures involving advanced technologies and larger, multidisciplinary teams.
Risk Management in General Practice
The most prominent risks faced by general practices may include: the risks of not upholding the quality of preventive care, including screening or immunisation programs; the risks of failure to make medical records complete or accurate; and the risks of improper management of patients’ personal information. Examples include:
1. Cold Chain Management
Failure to provide appropriate storage temperature conditions for vaccines or medicines that are sensitive to heat or cold may result in a risk to the health of the patient and community members. This can be caused by a lack of calibration of refrigeration equipment, inadequate recording or staff training. The accreditation standards specify requirements for temperature control policies and procedures for storage areas, including temperature checks, data logging and reporting, alarm systems, data storage and corrective and contingency plans.
2. Privacy and Confidentiality
The digital health age has increased the risk of breaches or unauthorised access to patients’ personal information and medical records. Accreditation requirements regarding privacy and confidentiality address the obligation to comply with relevant privacy legislation, to use secure and robust IT systems and provide staff with relevant training. These requirements apply to all organisations that hold patient information, including general practices.
3. Infection Prevention and Control in Outpatient Care
The risk of hospital-acquired infection (HAI) in the general practice setting is significantly lower than in acute care hospitals; however, risks still include ineffective management of an outbreak of an infectious respiratory illness, or a high-risk procedure such as oxygen cleaning not being undertaken as per the recommended standard in a high-traffic reception area. The infection prevention and control (IPC) standards of accreditation require organisations to have documented evidence of regular cleaning schedules and hand hygiene procedures, including availability of hand sanitiser, and staff immunisations.
4. Clinical Governance, Record Keeping and Documentation
In general practice, medical records are the evidence on which continuity of care and clinical decision-making are based. Errors or omissions in records can be potentially risky for patient safety and for the legal defensibility of practice decisions. The accreditation standard in relation to clinical governance, record keeping and documentation will provide an organisation with the assurance that medical records meet a consistent standard of completeness, accuracy and accessibility.
Risk Management in Hospitals
Risks are more extensive and complex in hospitals. The following areas are key priorities:
1. Medication Safety
Medication errors can occur at any stage from prescribing to administration, leading to significant patient harm. Hospitals need systems to double-check drug orders, use standardised dosing protocols, and implement electronic medication management systems. Accreditation Standards require tracking of adverse drug events, staff training, and continuous process improvements.
2. Infection Prevention and Control
HAIs are a substantial risk in hospital settings. Hospitals must have strict infection control programs, antimicrobial stewardship, isolation procedures, and compliance monitoring. Accreditation Standards include requirements for comprehensive infection prevention and control plans, supported by audit and feedback mechanisms.
3. Surgical and Procedural Safety
The inherent risks of surgeries and invasive procedures in hospitals demand additional protocols for surgical safety and patient identification to prevent wrong-site/wrong-patient errors. This includes adherence to safety checklists (e.g., WHO Surgical Safety Checklist) and protocols to verify patient identity, procedure site, and informed consent. Accreditation ensures hospitals have systems and processes for these verifications.
4. Emergency Preparedness
Hospitals need to be ready for mass casualty events, natural disasters, or outbreaks of infectious diseases. Accreditation Standards mandate documented emergency preparedness plans, regular training drills, and coordination across departments.
Comparison of Accreditation’s Role in Risk Mitigation
Overall, the concept is similar but applied differently, depending on the risks.
General Practice Accreditation:
Standards guide clinics in having systems for safe vaccine storage and handling, secure patient data management, and ongoing quality improvement. They also encourage proactive rather than reactive problem-solving, which is challenging for small teams with limited resources trying to provide quality, safe care.
Hospital Accreditation:
The accreditation framework addresses the complexity of multidisciplinary care teams, high patient volumes, and specialised treatments. Risk management needs to be built into the hospital’s governance structures, operational protocols, and day-to-day practice. This includes mandated audits, staff credentialing, and incident reporting systems that can support organisational learning.
Shared Benefits Across Settings
Despite their differences, both general practice and hospital settings gain similar benefits from accreditation-driven risk management:
- Consistency in Standards: Clear, standardised expectations reduce variability in care delivery.
- Continuous Improvement: Accreditation fosters a cycle of assessment, action, and review.
- Staff Engagement: Involving teams in accreditation processes builds ownership of safety practices.
- Public Confidence: Accreditation reassures patients that services meet recognised safety and quality benchmarks.
Effective risk management is not optional—it is integral to safe, high-quality care. While general practices and hospitals face different risks, both rely on accreditation to create structured, reliable systems for identifying hazards, implementing safeguards, and monitoring performance.
By aligning risk management strategies with current safety and quality standards in healthcare, such as general practice accreditation and hospital accreditation standards, healthcare organisations can reduce harm, improve patient outcomes, and build a culture where safety is embedded into every decision and action. In doing so, they not only meet regulatory requirements but also strengthen trust with the communities they serve.
