Suckling R, Ferris M, Price C
Sheffield West Primary Care Trust, West Court, Langsett Road, Sheffield S6 2LR.
J Public Health Med. 2003 Jun;25(2):138-43. doi: 10.1093/pubmed/fdg029.
The continuing identification, assessment and management of risks are key themes for clinical governance. These themes are being integrated into both primary and secondary care practice; however, integration into public health practice appears much slower. This paper describes the recent approach that we have taken in Sheffield, and proposes a model for public health departments to identify, assess and manage risks, which complements other risk management processes and is transferable to other settings. It assumes that public health practice is not a risk-free activity and holds that the process of identifying, assessing and managing risks is a key component to raising standards.
A number of risk 'management' models were reviewed and a primary care approach was applied to public health practice. A list of potential risks was identified using a number of methods including reflective practice, information from complaints and/or critical incidents. Risks were assessed by likelihood and impact, and were captured in a risk framework.
By March 2002, 21 risks had been identified and characterized, and progress had been made to manage 11 of these risks.
This process, and the development of a risk framework, was useful in identifying a prioritized work programme to improve standards of public health practice in this department. This model can also be used not only for planning risk management activities, continual identification and assessment of risks but also to provide inspiration for other clinical governance activities including public health audit.
持续识别、评估和管理风险是临床治理的关键主题。这些主题正被融入初级和二级医疗实践；然而，融入公共卫生实践的进程似乎要慢得多。本文描述了我们在谢菲尔德近期采取的方法，并提出了一个公共卫生部门识别、评估和管理风险的模型，该模型补充了其他风险管理流程，并且可应用于其他环境。本文假定公共卫生实践并非无风险活动，并认为识别、评估和管理风险的过程是提高标准的关键组成部分。
对一些风险“管理”模型进行了审查，并将初级医疗方法应用于公共卫生实践。通过多种方法确定了一系列潜在风险，包括反思性实践、投诉和/或重大事件提供的信息。根据可能性和影响对风险进行评估，并记录在一个风险框架中。
到2002年3月，已识别并描述了21种风险，其中11种风险的管理取得了进展。
这一过程以及风险框架的制定，有助于确定优先工作方案，以提高该部门公共卫生实践的标准。该模型不仅可用于规划风险管理活动、持续识别和评估风险，还可为包括公共卫生审计在内的其他临床治理活动提供启发。
