Question

Please give examples for each risk domain in any healthcare organization.

Domain	Description
Operational	The business of healthcare is the delivery of care that is safe, timely, effective, efficient, and patientcentered within diverse populations. Operational risks relate to those risks resulting from inadequate or failed internal processes, people, or systems that affect business operations. Included are risks related to: adverse event management, credentialing and staffing, documentation, chain of command, and deviation from practice.
Clinical / Patient Safety	Risks associated with the delivery of care to residents, patients and other healthcare customers. Clinical risks include: failure to follow evidence based practice, mediation errors, hospital acquired conditions (HAC), serious safety events (SSE), and others.
Strategic	Risks associated with the focus and direction of the organization. Because the rapid pace of change can create unpredictability, risks included within the strategic domain are associated with brand, reputation, competition, failure to adapt to changing times, health reform or customer priorities. Managed care relationships/partnerships, conflict of interest, marketing and sales, media relations, mergers, acquisitions, divestitures, joint ventures, affiliations and other business arrangements, contract administration, and advertising are other areas generally considered as potential strategic risks.
Financial	Decisions that affect the financial sustainability of the organization, access to capital or external financial ratings through business relationships or the timing and recognition of revenue and expenses make up this domain. Risks might include: costs associated with malpractice, litigation, and insurance, capital structure, credit and interest rate fluctuations, foreign exchange, growth in programs and facilities, capital equipment, corporate compliance (fraud and abuse), accounts receivable, days of cash on hand, capitation contracts, billing and collection.
Human Capital	This domain refers to the organization’s workforce. This is an important issue in today’s tight labor and economic markets. Included are risks associated with employee selection, retention, turnover, staffing, absenteeism, on-the-job work-related injuries (workers’ compensation), work schedules and fatigue, productivity and compensation. Human capital associated risks may cover recruitment, retention, and termination of members of the medical- and allied-health staff.
Legal / Regulatory	Risk within this domain incorporates the failure to identify, manage and monitor legal, regulatory, and statutory mandates on a local, state and federal level. Such risks are generally associated with fraud and abuse, licensure, accreditation, product liability, management liability, Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (CoPs) and Conditions for Coverage (CfC), as well as issues related to intellectual property.
Technology	This domain covers machines, hardware, equipment, devices and tools, but can also include techniques, systems and methods of organization. Healthcare has seen an explosion in the use of technology for clinical diagnosis and treatment, training and education, information storage and retrieval, and asset preservation. Examples also include Risk Management Information Systems (RMIS), Electronic Health Records (EHR) and Meaningful Use, social networking and cyber liability.
Hazard	This ERM domain covers assets and their value. Traditionally, insurable hazard risk has related to natural exposure and business interruption. Specific risks can also include risk related to: facility management, plant age, parking (lighting, location, and security), valuables, construction/renovation, earthquakes, windstorms, tornadoes, floods, fires.

Answer 1

Domain	Risk Example
Operational	Hygiene problem faced in hospital or staff
Clinical / Patient Safety	Absence of adequate oxygen cylinder or absence of clear plan of fire exit process
Strategic	No clear strategy on which specialty service in medical field organization wants to serve may lead to improper equipment or skilled doctors and staff
Financial	Mismanaged working capital of hospital may lead to stop of operation
Human Capital	Recruitment of unskilled doctors or staff may lead to operational or legal issue
Legal / Regulatory	Use of banned medicine by law in the hospital may lead to legal action
Technology	Medical equipment giving wrong reading which may create chaos in treatment
Hazard	Risk of exposure of radioactive materials used in healthcare