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Risk Management Basics
BAS Clinical TeamNovember 2, 2017
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This third session of the Incident Management series focuses on the basic principles of risk management. With the implementation of the Periodic Risk Evaluation across both BAS programs, we will discuss how the PRE informs risk management and how we can use the PRE to inform supports and services in order to mitigate risks and improve participant quality of life.
Virtual Targeted Training Description
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• Incident management is a process for assuring that when an incident happens that the response will be adequate to protect the health, safety, and rights of participants.
• Risk management is the identification, analysis, assessment, control, and avoidance, minimization, or elimination of unacceptable risks. (Businessdictionary.com)
Incident Management vs Risk Management
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Incident Management vs Risk Management
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RISK
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• Risk is the likelihood of some undesirable event or negative outcome occurring to a participant
Chapter 51.3 Definitions
What is Risk?
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• Attributes, behaviors, health conditions, features of environment, actions, events or other determinants that increase the probability of an incident or negative result for the participant
Section 51.3, Home and Community Based Regulations
• For example: depression is a risk factor in suicide, hoarding behavior and/or deplorable living conditions is risk factor for homelessness, or injury, etc.
Risk Factors
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• Risk perception is the subjective judgment that people make about the characteristics and severity of a risk.
• Don’t jump to conclusions, get all the facts.
Risk Perception
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• Each of us determines how much risk is acceptable in our own lives
• Participants and families may have different views on how much risk is acceptable to them
• Need for discussion with the team - participants and families included
Levels of Acceptable Risk
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Risk Mitigation
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• Risk mitigation is an overall approach to prevent, reduce and manage severity of risk
• Ongoing process• Teams need to regularly evaluate risk(s) and
develop strategies to meet the current needs of the participant
• Providers are part of the team and responsible for identification of risk , development of strategies, and implementation of those strategies
What is Risk Mitigation?
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Risk Mitigation Cycle
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• Imminent Risk is the likelihood that something adverse (serious injury or harm) is going to happen and soon
• Requires immediate action before moving forward with other steps of the cycle or documentation
• Typically may need to enlist immediate support of Law enforcement authorities Emergency medical care providers APS/OAPSA Incident Reporting
Imminent Risk
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Risk Mitigation Cycle
• Recognize the risks and the factors that could contribute to an adverse event.
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• The intent of the PRE is to identify risk areas and develop plans for risk mitigation.
Purpose of PRE
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• Educate and inform participants about risks• Develop proactive strategies to prevent,
reduce or eliminate potential issues• Track risks over time• Measure participant progress over time• Identify barriers to treatment, resulting in a
plan to address
Benefits of the PRE
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• Law Enforcement • Risk of Harm to Self & Others • Stressful Life Events • Unstable Living Environment• Natural Supports• Substance Abuse • Co-occurring Mental Health Diagnoses • Chronic Health Conditions
PRE Domains
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Risk Mitigation Cycle
• Imminent Risk• Non-Urgent Risk
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• In each domain where a risk/risk factor was identified, the severity or degree of concern is identified: mild concern moderate concern severe concern
Assess
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• Personal Perspectives• Cultural Perspectives• How to Gather Information
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Risk Mitigation Cycle
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Risk Mitigation Cycle
Options• Remove• Transfer• Isolate• Train/Inform
Planning • Who• What• By When
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• Remove the exposure to the risk factor• Transfer one risk factor for another less risky
option• Isolate the person from the risk factor• Train or Inform the person on how to be
more safe when exposed to the risk factor
4 Strategies to Mitigate Risk:
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• Does the participant agree to the plan?• Is there hesitation or resistance to the
plan?• Are those who are responsible for
taking action aware of their responsibilities?
• Has action on the strategies begun?
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Risk Mitigation Cycle
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• Did it reduce the level of risk?• Are there additional risk factors?• Did the person(s) responsible do
what they agreed to? • Was the strategy implemented
when agreed upon?
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Risk Mitigation Cycle
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COMMUNICATING AND DOCUMENTING RISK
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Two factors that influence response:1. Severity of potential harm2. Immediacy of potential harm occurring
Response to Risk
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• Risks identified in the PRE as well as the strategies being implemented to mitigate risks should be incorporated in to the ISP.
• The team may decide to develop a stand alone Risk Mitigation Plan to assist them in having all risks, strategies, and who is responsible in a single document.
• BAS is not requiring this document; however a template is available as a resource
Risk Mitigation Plan
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• Certain risks/risk factors may impede the participant’s quality of life or their path to an “Everyday Life”
• Consider how the various risks identified for the participant impact quality of life and how mitigation activities will assist participants to have an improved quality of life and everyday life
Quality of Life
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Every Day Lives
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“A bend in the road is not the end of the road…. Unless you fail to make
the turn”
Helen Keller
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Resources
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• Everyday Lives: Values in Action Publication (on MyODP)• Periodic Risk Evaluation Manual, version 2 (on MyODP)• PRE Service Guidance Document 1 (on MyODP)• Trainings on MyODP Adult Protective Services in Connection with Incident
Management (BAS) Core Functions of Risk Management (ODP-ID) Foundations of Incident Management/Risk Management
(ODP-ID)
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• Have you visited the ASERT website (www.paautism.org)? Did you create profiles for the participants you support? Did you sign up to receive the ASERT monthly newsletter? Do you follow ASERT on Facebook or twitter?
• Are you signed up on BAS list-servs (all providers and SC specific)? Are you receiving Admin Notices and Communications via the list-serv?
• Do you communicate with the Regional and Clinical Reps to ask questions and share participant concerns?
• Do you visit the online training platform and save all pertinent documents and watch trainings? Do you participate in live training opportunities?
If you have questions on any of the above, please contact the Provider Support Mailbox ([email protected])
How to ensure you have all the information to do your job as a provider
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