A framework to support risk assessment in hospitals.

Quality problem or issue: A number of challenges have been identified with current risk assessment practice in hospitals, including: a lack of consultation with a sufficiently wide group of stakeholders; a lack of consistency and transparency; and insufficient risk assessment guidance. Consequently, risk assessment may not be fully effective as a means to ensure safety.

Initial assessment: We used a V system developmental model, in conjunction with mixed methods, including interviews and document analysis to identify user needs and requirements.

Choice of solution: One way to address current challenges is through providing good guidance on the fundamental aspects of risk assessment. We designed a risk assessment framework, comprising: a risk assessment model that depicts the main risk assessment steps; risk assessment explanation cards that provide prompts to help apply each step; and a risk assessment form that helps to systematize the risk assessment and document the findings.

Implementation: We conducted multiple group discussions to pilot the framework through the use of a representative scenario and used our findings for the user evaluation.

Evaluation: User evaluation was conducted with 10 participants through interviews and showed promising results.

Lessons learned: While the framework was recommended for use in practice, it was also proposed that it be adopted as a training tool. With its use in risk assessment, we anticipate that risk assessments would lead to more effective decisions being made and more appropriate actions being taken to minimize risks. Consequently, the quality and safety of care delivered could be improved.