A framework to support risk assessment in hospitals

Kaya, Gulsum Kubra; Ward, James; Clarkson, PJ

doi:10.1093/intqhc/mzy194

Cited by 36 publications

(24 citation statements)

References 40 publications

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“…Actually, even if quantitative values were used to estimate risk ratings, the assessors’ strength of knowledge of the event, its consequences, and probability would impact on the judgments made to estimate the risk ratings (Aven, ; Aven & Renn, ; Flage & Aven, ). In addition, the tolerability of a risk might require consideration of multiple other factors in addition to likelihood and consequence (Kaya, Ward, & Clarkson, ). Indeed, when evaluating risks, there are additional factors to determine, including detectability of a risk, the rapidity with which the risk will manifest itself, and potentially additional legal requirements (Aven, ; Curtis & Carey, ; Office of Rail Regulation [ORR], ; Suddle, ).…”

Section: Discussionmentioning

confidence: 99%

A Review of Risk Matrices Used in Acute Hospitals in England

2018

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In healthcare, patient safety has received substantial attention and, in turn, a number of approaches to managing safety have been adopted from other high-risk industries. One of these has been risk assessment, predominantly through the use of risk matrices. However, while other industries have criticized the design and use of these risk matrices, the applicability of such criticism has not been investigated formally in healthcare. This study examines risk matrices as used in acute hospitals in England and the guidance provided for their use. It investigates the applicability of criticisms of risk matrices from outside healthcare through a document analysis of the risk assessment policies, procedures, and strategies used in English hospitals. The findings reveal that there is a large variety of risk matrices used, where the design of some might increase the chance of risk misprioritization. Additionally, findings show that hospitals may provide insufficient guidance on how to use risk matrices as well as what to do in response to the existing criticisms of risk matrices. Consequently, this is likely to lead to variation in the quality of risk assessment and in the subsequent deployment of resources to manage the assessed risk. Finally, the article outlines ways in which hospitals could use risk matrices more effectively.

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Section: Discussionmentioning

confidence: 99%

A Review of Risk Matrices Used in Acute Hospitals in England

2018

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“…Therefore as an approach to summarising and ranking risk to human health, a semiquantitative method (Section S.1.8) adapted from World Health Organization (2012), Hunter et al (2003, Kaya et al (2018) and Burns et al (2019), was undertaken to indicate and rank the relative harm caused by different activities. As suggested by Kaya et al (2018) it should be noted that this method is not intended to quantify risk associated with the identified hazard-pathway-receptor combinations or inform decisions directly. Rather it is intended to support decision-making and indicate where efforts for intervention or further research might be directed.…”

Section: Risk Based Approachmentioning

confidence: 99%

Plastic waste reprocessing for circular economy: A systematic review of risks to occupational and public health from legacy substances and extrusion

Cook¹,

Velis²,

Derks³

2020

Preprint

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Increasing aspirations to develop a circular economy for waste plastics will result in an expansion of the global plastics reprocessing sector over the coming decades. Here we focus on two critical challenges within the value chain that as a result of such increased circularity may exacerbate existing issues for occupational and public health (1): Legacy contamination in secondary plastics, addressing the risk of materials and substances being inherited from the previous use and carried through into new products when the material enters its subsequent use phase; and challenge (2): Extrusion of secondary plastics in reprocessing, an end process of conventional mechanical recycling of plastics, involving heating secondary plastics under pressure until they melt and can be formed into new products. Via a systematic review (PRISMA guidelines, adapted), we considered over 4,000 sources of information, refined and consolidated into 20 relevant sources, which were critically assessed. We also derive prevalent risk scenarios of hazard-pathway-receptor combinations, subsequently being ranked. Our critical analysis highlights that despite stringent regulation, industrial diligence and enforcement, occasionally small amounts of potentially hazardous substances are able to pass through these safeguards and re-enter in the new product cycle. Although many are present at concentrations unlikely to pose a serious and imminent threat, their existence may be an indication of a wider or possibly increasing challenge of pollution dispersion, as the plastics reprocessing sector proliferates. But, in the Global South context, such controls may not be in place. Several studies showed emission control by passive ventilation, through open doors and windows followed by dilution and dispersion in the atmosphere, resulting in increased occupational exposure. It is recommended that further investigations are undertaken to establish the scale and magnitude of such phenomena, especially given the limited evidence base, with results informing improved future risk management protocols of a circular economy for plastics.

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“…To assist with comparisons and ranking of the relative risk of each hazard-pathway-receptor combination, a risk-based approach reported by Cook et al 22 , adapted from Hunter et al 28 , Kaya et al 29 , World Health Organization 30 and Burns et al 31…”

Section: Risk Based Approachmentioning

confidence: 99%

Mismanagement of plastic waste through open burning with emphasis in the Global South: A systematic review of risks to occupational and public health

Velis¹,

Cook²

2020

Preprint

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Large quantities of mismanaged plastic waste threaten the health and wellbeing of billions worldwide, particularly in low- and middle-income countries where waste management capacity is being outstripped by increasing levels of consumption and plastic waste generation. One of the main self-management strategies adopted by 2 billion people who have no waste collection service, is to burn their discarded plastic in open, uncontrolled fires. While this strategy provides many benefits, including mass and volume reduction, it also results in the release of chemical substances and particles that may pose serious risks to public health and the environment. We followed PRISMA guidelines to select and review 20 publications that provide evidence on potential harm to human health from open burning plastic waste, arranging evidence into eight groups of substance emissions: brominated flame retardants; phthalates; potentially toxic elements; dioxins and related compounds; bisphenol A; particulate matter; and polycyclic aromatic hydrocarbons. We semi-quantitatively assessed 18 hazard-pathway-receptor combination scenarios to provide an indication of the relative harm of these emissions so that they could be ranked, compared and considered in future research agenda. This assessment overwhelmingly indicated high risk of harm to waste pickers, a large group of 11 million informal entrepreneurs who work closely with waste, delivering a circular economy but often without protective equipment or many structured, safe system of work. Though the risk to human health from open burning emissions is high, this remains a substantially under-researched topic.

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A framework to support risk assessment in hospitals

Cited by 36 publications

References 40 publications

A Review of Risk Matrices Used in Acute Hospitals in England

A Review of Risk Matrices Used in Acute Hospitals in England

Plastic waste reprocessing for circular economy: A systematic review of risks to occupational and public health from legacy substances and extrusion

Mismanagement of plastic waste through open burning with emphasis in the Global South: A systematic review of risks to occupational and public health

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