The Analysis of Risk Management Situation in Male Medical Ward at A Tertiary Hospital

Abstract

Risk management is a critical component of patient safety and healthcare quality. This descriptive qualitative study aimed to examine the current state of risk management and propose strategies for improvement in the male medical ward at a tertiary hospital. Data were collected from relevant documents, in-depth interviews with five physicians and professional nurses from the ward’s risk management leadership team, and focus group discussions with 24 nursing personnel working in the ward, consisting of registered nurses, nursing assistants, and nurse aides. A semi-structured interview guideline was developed based on Donabedian's conceptual framework for quality assessment (structure, process, and outcome) and validated by three experts. Data were analyzed using content analysis.

The findings are as follows; Structure: Several structural factors limited work efficiency. Although the ward had a complete risk management committee in accordance with hospital policy, the implementation of the policies into practice was found insufficient. In terms of human resource management, staffing levels were inadequate. The nursing personnel demonstrated varying levels of knowledge and competence in risk management. Limitations in tools, budget, environmental conditions, and supervision further impeded implementation. Strengthening the structural dimensions of policy, human resources, and support systems is essential to enhance service quality and patient safety.

Process: Risk management was performed using the Healthcare Accreditation Institute Framework of identification, assessment, management, and evaluation. However, risk identification lacked continuity and engagement, reporting was delayed and incomplete, and management remained largely reactive. Evaluation results were not fully aligned with actual ward risks or effectively utilized for improvement. Promoting proactive risk identification, timely reporting, and systematic data use is recommended.

Outcome: The findings indicated that the indicators related to clinical and non-clinical risks, as well as patient and family satisfaction and complaints, did not meet the targets, with certain complaints showing a rising trend. Recurrent incidents and limited use of outcome data were also noted. These results highlight the need for an in-depth analysis of contributing structural and process factors. The insights can be used to support nursing administrators in designing effective risk-management structures, processes, and outcome monitoring to ensure continuous improvement.