The Safety Net

Risk Assessment

No discussion of Risk Management would be complete without a review of Risk Assessment processes. In order to have a thorough Risk Management program fully operational, one of the early tasks needed is to develop a process for assessing the risk status for individuals served by the program. Some individuals may be at no more risk than John Q. Citizen but others may be high risk because of medical problems, mobility difficulties, behavioral issues, or a lowered awareness of safety.  Remember: Prevention is the number one priority

Purpose:
The purpose of a Risk Assessment process is first, to identify who is at risk for what and second to develop appropriate interventions to minimize potential harm and injury. 

Definitions:
A Risk is defined as any potential for serious harm or injury. (John has the potential to get lost if he gets into large crowds such as fairgrounds or arenas.)

A Significant Risk is defined as any potential for serious health problems, injuries or emotional or psychological effects of abuse. (John will lose his eyesight if he bangs his forehead many more times.)

An Assessment may be a formal or an informal review of observations, history and caregiver insights to establish facts.  It is best done by a full team of those who work with and know the individual. Example: (John has the potential to get lost if he gets into large crowds such as at fairgrounds or arenas; at his last physician visit, Dr. Abercrombie reported that if he bangs his forehead many more times or does so with severe force, there is a high probability that he will lose his eyesight; staff report that if he feels stressed-like when he is lost- he will bang his forehead).  

An Intervention is a strategy that caregivers use to anticipate a potential problem that might come up.  (Staff will maintain a 1:1 contact with John at all crowded events and will ensure that he takes a mini-talkie on these trips and that he wear his bright colored jacket with an Info -Card in his pocket with information about who to notify if he is lost and found.    Over the next four weeks staff will teach John to use the mini talkie so that, if he is lost, he will contact staff and not panic).  

Process:
Individual Program Plan teams may want to adopt an assessment tool such as a document that has been developed by them or obtained from another source and have it available if a team decides there are risks that should be documented. Teams can use it to follow as a  guide for their discussions to incorporate in the staffing report or the team can use it to document risks. It is not necessary to complete a formal risk assessment for each individual, however the team should discuss any potential risks to the individual at the time of the Individual Program Plan (IPP) meeting.  If risks are evident, the document would then be completed and appropriate proactive interventions put in place with the intent of minimizing these risks.  

Some indicators that teams should consider when deciding if a person is at significant risk include:

• History of Incidents Reports that have resulted in injury or threat of injury
• Involvement in consumer to consumer altercations
• Significant changes in the overall status of the individual
• Health conditions, for example things like;
  -Diabetes
  -High Blood Pressure
  -COPD
•  Behavior Plans targeting high risk behaviors or using interventions with risk potential
• Nutrition Status, for example things like;
  -Needs an altered textured diet 
  -History of aspirations
• Environmental factors, such as;
  -Proximity to medical facilities
  -Neighborhood Safety,
  -Air Quality
• Mobility Status  
• Mental Health Status
• Sexuality Issues

This is not intended to be a complete list or a complete explanation of Risk Assessment. It is a starting place to begin thinking about Risk Management, Assessment and Mitigation.  It is the coming together of all three concepts that will lead to increased safety and well being for individual consumers.  Watch this web site for new information every month.