Propose actions
Proposing ways to address the risks that are too high
Generating ideas for actions
At this point, it is important to produce some Ideas of actions that could reduce the risks. This is particularly important for those risks that were identified as requiring action in the Assess phase (typically coloured Red or Orange). For each risk it is helpful to look back and examine the underlying problem, impact and likelihood. Understanding where the risk came from can help to determine how to reduce it.
The chance of finding suitable actions can also be increased by considering a range of risk reduction methods. Examples of these are described later on this page, grouped into five categories. Each of the categories should be worked through in turn, choosing at least one method from each category to identify possible actions. At this stage, the quality of the ideas is not especially important, as even poor quality ideas may stimulate others that are better.
After generating some ideas for possible actions, it can be useful to go back through them, reviewing and modifying them as necessary. The ideas can also be combined to create stronger, more effective solutions.
Putting ‘Generating ideas for actions’ into practice |
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Categorising risk reduction methods
It is necessary to consider a range of risk reduction methods in order to generate a strong pool of options to choose from. Five categories of methods are listed below, with additional details and examples presented further down this page. This is not an exhaustive list, but represents some of the different perspectives. Not all of the methods will apply to every situation, but they are helpful in thinking through a range of possibilities. They are listed in order of likely preference, with the (typically) most effective methods placed first:
- Removing high-risk processes may involve replacing a high-risk process with a lower-risk one, transferring the risk to another group or organisation, or simply not using the existing process or materials;
- Implementing design controls may involve careful design of equipment or buildings, for example, using physical barriers to limit access to risky areas or making important equipment easier to use and correspondingly harder to misuse;
- Defining administrative measures may involve creating procedures, training or signs, to encourage people to take the correct actions;
- Monitoring for problems may involve observation or the use of alarms to detect when something is going wrong or is likely to do so, in time to reduce its impact or prevent it altogether;
- Preparing for foreseeable risks may involve having a plan, effective training and appropriate resources available to reduce the impact of the risks when they occur.
In addition, when choosing a method, it is important to take account of the nature of the risks present in the system.
More help in identifying and analysing different kinds of methods for addressing risk is provided in The Active Risk Control (ARC) Toolkit, available in the Resources section of this website. Whilst the ARC Toolkit represents a ‘gold standard’, and may be suitable for some SSAs, much of the content has been reproduced in a simplified form in the following sections.
1: Removing high-risk processes
One method of reducing risk is to remove the risky process or materials. This can be achieved in various ways by:
Putting ‘1: Removing high-risk processes’ into practice |
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2: Implementing design controls
Another method of reducing risk is to design the equipment or buildings carefully to make it harder for people to make a mistake or to complete a high-risk action. This can be achieved in various ways by:
Putting ‘2: Implementing design controls’ into practice |
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3: Defining administrative measures
A third method of reducing risk is to use administrative measures. In fact, these tend to be by far the most frequently used methods to reduce risk in healthcare. Policies, procedures, training, signs and other measures can be used to help people take correct actions, but ultimately safety will still depend on people doing the right things. A variety of administrative measures can be used, such as:
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4: Monitoring for problems
Another method of reducing risk is to use monitoring to detect when something is going wrong, or is likely to go wrong, in time to reduce its impact or prevent it altogether. This can be achieved in various ways, by:
Putting ‘4: Detection of issues’ into practice |
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5: Preparing for foreseeable risks
A fifth method of reducing risk is to be prepared for predictable risks, so that when they do happen they have less of an impact. It means having a plan, as well as effective training and appropriate resources available to implement that plan. This can be achieved in various ways, by:
Putting ‘5: Preparing for foreseeable risks’ into practice |
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