When do you stop – time and the art of the risk assessment…

If one calibrates an instrument, then one is behooved to calibrate the instrument used to calibrate the initial instrument. Then one is behooved to calibrate the instrument used to calibrate the instrument used to calibrate the initial instrument, and so on. Somewhere, living in the house that Jack built probably figures into the equation, but that’s probably at more decimal points than I would care to consider at the moment.

As another example, one identifies the presence of a corrosive chemical in one’s endoscopy scope processing area and decides to install an eyewash station at the usual location (in accordance with the ANSI standard, 10 seconds of unimpeded travel time). So you place the eyewash station on the soiled side of the room because that’s where the greatest likelihood of an injurious splash lives. And then you get cited because you didn’t do a risk assessment to account for the placement of the eyewash station on the soiled side of the room.

Interestingly enough, this was an actual survey finding a year or so back, and now, based on the information published in the July 2022 Perspectives, that risk assessment is not mandatory, which, as it should happen, is the case that was made during the clarification process, but to no avail. It appears that you can’t even play for a tie when it comes right down to it – the house – not your house – always wins…

When you come right down to it, there are really only a few risk assessments that are clearly mandated by code and regulation – ligature and other behavioral health environment-related stuff (don’t think it stops with ligature risks); the hazard vulnerability assessment/analysis; the NFPA 99 risk assessments for medical and utility systems equipment, etc. But what about all those standards and performance elements that talk about managing risk? Can you legitimately manage a risk without assessing it? Even doing a sort to determine what is a high-risk process versus a medium- or low-risk process – is that not an assessment in and of itself?

Clearly, there is an inescapable element of perpetuity at work here – and I don’t see any event horizon that is likely to result in the cessation of the risk assessment as a living process, so guess us risk wranglers just have to saddle up and keep on ridin’.

Hope everyone who got a chance to come to Boston for the ASHE Conference had a good time and a chance to poke around a bit to see the sights. Unfortunately, I was not able to join you all, but some day…

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.