1. ORGANISATION AND INDIVIDUAL'S INFORMATION INDIVIDUAL'S ROLE 1. What is your job title?   2. Please describe the nature of the institution: public hospital general gractice private hospital dental practice Other, please specify  Where is the institution located?Ireland UK 3. How long have you been in the institution/organisation? yrs  mths 4. How long have you been employed in your current role? yrs  mths 5. Do you have sole responsibility for the risk management process? yes  no 6. If not, how many other individuals/groups have responsibility over the risk management process?  7. Please state their job title/s (e.g. CEO, member of audit committee etc.)   8. Please describe the nature of your responsibility/tasks in relation to risk management: (tick as necessary) I am involved in the formulation of policy and strategy in the organisation I am involved in the carrying out of internal audits I am involved in the reporting of adverse incidents I am involved in organising a risk register I am involved in organising a risk action plan I am involved in training staff in medico-legal and risk management matters I am involved in matters of health and safety I am involved with patient complaints and grievances I act as a liaison between management and clinical staff I am involved in making decisions in relation to investment   other, please specify  9. Please describe the organisations over which you have responsibility: 1 hospital 2-5 hospitals 6-15 hospitals general practice dental practice other, please specify  10. Do you have a qualification in risk management? yes  no If yes, from where did you obtain it?  11. How essential is this qualification for your employment? This was a mandatory requirement It was not mandatory but desirable It was not important, I wanted to further my knowledge of risk management 12. Is there an individual(s) specifically appointed for responsibility over matters of health & safety? (e.g. a health & safety officer) yes  no 13. If yes, does this individual have interaction with the appointed Risk Manager(s) (where there is one or more) as follows? the interaction is regular the interaction is not regular the interaction only takes place on the occurrence of an adverse incident there is no interaction Other, please specify  EMPLOYEE DETAILS 14. How many employees are there in total in the institution/organisation?  15. How many clinical personnel are employed in the institution/organisation?  2. RISK MANAGEMENT AT INSTITUTIONAL /ORGANISATIONAL LEVEL RISK MANAGEMENT POLICY (THE 'POLICY') 16. Is there a specific 'policy' (i.e. a statement of objectives/risk management mission statement/risk management statement, agreed rules and regulations governing procedures on risk management) on risk management in your institution/organisation? yes  no THE RISK MANAGEMENT PROCESS ('THE PROCESS') 17. If yes, in what form does this policy exist? (tick as necessary) a written mission and/statement that is visually displayed available as part of a written training/induction pack distributed as part of employment contract or employee handbook available on institution/organisation internal website communicated as part of an overall communication strategy (i.e posters, leaflets or      newsletters) discussed at board level discussed at management level discussed at staff departmental level discussed at training courses/lectures Other, please specify  18. Is there a defined or established risk management process in your organisation? yes  no 19. Which of the following is included in your risk management process? (tick as necessary) internal audits external audits self-assessment a system of accreditation defined responsibility of roles competence assurance patient complaints procedure accountability for risk management early warning systems for adverse incident (adverse events and near misses) reporting an annual/regular assurance statement on the risk management process signed by the      CEO/Board of management/manager of the organisation Other, please specify  20. Who is/was involved in establishing/drawing up the process? (e.g. CEO, member of audit committee etc.)  21. In which year was the idea of developing the process first introduced?  22. In which year was the actual process introduced?  23. Please rank the following factors in order of the importance to your institution/organisation, (please rank from 1-7 where 1 is the most important, 7 being of lesser importance) 1 2 3 4 5 6 7  quality of patient care  1 2 3 4 5 6 7  the number of cases/lawsuits taken by patients against your institution/organisation  1 2 3 4 5 6 7  indemnity and insurance premiums  1 2 3 4 5 6 7  public liability insurance premiums  1 2 3 4 5 6 7  staff morale  1 2 3 4 5 6 7  professional reputation  1 2 3 4 5 6 7  increase of costs, please specify   24. How was the process evaluated? the process was not evaluated an external consultant was used a user panel was used meets the standard of an accreditation body, please indicate which body       meets the guidelines of a government department evaluation took place internally only Other, please specify  25. Is there a specific budget in place to deal with matters of risk management? yes  no If yes, what percentage of the total annual budget is allocated to risk management? % 26. Over the last three years, has this budget allocation for risk management increased in your institution/organisation? yes  no If yes, please indicate by what percentage % 27. Is there an official costing procedure for the process?yes  no 28. What is the responsibility of management to this risk management process? (tick as necessary) management formulate future policy as a result of lessons learnt from the process management will vary budgets/investment depending on the requirements and priorities      that result from the process management will define responsibilities of various members of staff management communicate the process to all staff management ensure the commitment of all staff to the process 29. Is management accountable for this process? yes  no  not sure 30. If no to 29, then who is accountable for this process?  31. Are all clinical staff made aware of this process? yes  no  not sure 32. If yes, how were they made aware of this process? through documentation (letters, memos etc) through staff/departmental meetings through training and lectures given internally/given by internal staff through training and lectures given by a third party/external organisation by means of the organisation's website Other, please specify  33. Do you believe that the risk management process is satisfactory in your institution/organisation? yes  no 3. EDUCATION AND TRAINING 34. Is there a mandatory system of continuing education in place for appointed risk managers? yes  no 35. If yes to 34 above, does this system consist of the following? (tick as necessary) lectures relating to medico-legal matters (good record keeping, patient consent, etc.) lectures relating to clinical governance, controls assurance and risk management practical workshops by way of interactive training tools other training Other, please specify  36. How often do risk managers receive training, as outlined in question 35? every month every four months annually bi-annually Other, please specify  37. Is there a mandatory system of continuing education in place for clinical personnel? yes  no 38. If yes to 37 above, does this system consist of the following? (tick as necessary) lectures relating to medico-legal matters (good record keeping, patient consent, etc.) lectures relating to clinical governance, controls assurance and risk management practical workshops by way of interactive training tools other training Other, please specify  39. How often do clinical personnel receive the above? every month every four months annually bi-annually Other, please specify  40. If the above is not mandatory, do voluntary systems exist? yes  no If yes, please describe  41. If clinical audits are carried out, are the results fed to clinical staff through training and education? yes  no 42. Do clinical staff receive the following educational tools? medico-legal/risk management training manual any interactive training tools (CD-ROM or Web-based) Other, please specify  4. SPECIFICS RELATING TO MEDICO-LEGAL ASPECTS FOR MANAGEMENT OF CLINICAL RISKS AND NON-CLINICAL RISKS 43. Is training given in your institution/organisation in relation to the following? the working of legal systems medical ethics patient consent record keeping and data protection clinical negligence law and practice living wills ethics and law in relation to terminally ill patient ethics and law in relation to the dying patient doctor/patient communication inter-professional communication clinical trials and clinical research health and safety legislation and procedures 44. If this training is given, is it given by any of the following methods? documentation lectures/training seminars communicated by an ethics committees by way of interactive training tools Other, please specify  45. Do established/defined procedures/protocols exist in your institution/organisation in relation to the following health and safety matters? yes  no If yes, please tick and describe: sharps injuries (e.g. needle stick injuries) chemical & biological agents manual handling of loads (e.g. the lifting of patients) sterilisation of equipment minimisation of slips and falls waste management stress management violence at work security in the workplace infection control policy emergency plans in cases of fire Other, please specify  46. Does your institution/organisation have a health and safety statement? yes  no 47. If yes, is every employee (clinical and non-clinical) given the health and safety statement? yes  no 48. If your Institution/organisation has a health and safety statement, how often is it reviewed? annually bi-annually when considered necessary Other, please specify  49. Do (clinical and non-clinical) personnel receive training in health and safety? yes  no If yes, do they receive the following types of training? (tick as necessary) lecture training workshops by way of interactive training tools Other, please specify  If this training is received, is it mandatory? yes  no 50. Does the National Agency with responsibility over Health and Safety in your country visit your institution/organisation? yes  no If yes, how often? every two years annually bi-annually every four months every month Other, please specify  51. Within the last three years, has your institution/organisation or medical personnel experienced: Please choose from the options below an increase in clinical negligence litigation (i.e. new cases taken against your institution/organisation)? a decrease in clinical negligence litigation? no change in the rate of clinical negligence litigation 52. What percentage of your total annual budget is utilised for such litigation? % 53. Has the institution/organisation incorporated the findings of court decisions to improve the risk management process? yes  no 5. BENEFITS/OUTCOMES/FUTURE OUTCOMES/IMPACT 54. Since the introduction of a risk management process have cases of litigation against your institution/organisation been reduced?      yes  no  difficult to say have patient complaints reduced in number?      yes  no  difficult to say do you believe that staff morale increased?      yes  no  difficult to say is there a measured and definite improvement in the quality of patient care?      yes  no  difficult to say 55. Has there been a reduction in medical indemnity costs?      yes  no  difficult to say 56. Has there been a reduction in public liability insurance costs?      yes  no  difficult to say 57. Has there been a reduction in other costs?yes  no Other, please specify  58. Will the improvement of the risk management process directly reduce costs relating to litigation? yes  no  not sure 59. If these litigation costs are reduced, will the reduction further enable the institution/organisation to improve the delivery of healthcare? yes  no 60. What impact has risk management had on patient care in your institution/organisation? no impact very little impact some impact considerable impact it is difficult to say what impact it has had Other, please specify  6. OTHER CONCERNS AND YOUR OPINIONS - LOOKING TO THE FUTURE 61. Do you feel that the Government should have a role in the regulation of the risk management process? (1 being the most important and 3 being of lesser importance) yes  no  not sure 62. Please rank in order of importance, the role you think a court of law should play in clinical negligence. (1 being the most important and 3 being of lesser importance) 1 2 3 setting standards of care in the healthcare professions 1 2 3 compensating for loss for injured patients 1 2 3 providing a medium for a fair hearing 63. Do you feel that clinical negligence/litigation should be either: removed from the court system maintained within the court system and improved 64. If you feel that clinical negligence/litigation can be improved within the court system then please rank in order of importance (1 being the most important and 3 being of lesser importance) the following: 1 2 3 the manner in which damages are paid 1 2 3 speed up the processing of cases 1 2 3 introduce specialised medical courts that will only deal with cases of clinical negligence 65. Do you feel that Alternative Dispute Resolution (ADR) systems could be utilised in relation to matters of clinical negligence? yes  no 66. If yes to the above, please rank in order of importance (1 being the most important and 5 being of lesser importance) the following ADR systems: 1 2 3 4 5 arbitration 1 2 3 4 5 mediation 1 2 3 4 5 patient complaints system provided by healthcare provider 1 2 3 4 5 no-fault liability scheme 1 2 3 4 5 medical injuries compensation boards 67. Please describe any concerns you have in relation to the future of clinical governance/risk management. If you wish to be considered as a 'best practice' organisation for a video interview and a case study, please include your name, organisation, address and contact details in the box provided so that we may contact you. Name : Organisation : Address: Telephone : Email : The form may take up to two minutes to submit. Please press the 'send' button only once.