Hospital Risk Management: A Case Study of Hospital for Special Surgery (HSS)

Hospital for Special Surgery (HSS) is the largest medical center involved in musculoskeletal health in the world. The hospital is in New York City and specializes in orthopedic surgery and the treatment of rheumatologic conditions. The hospital was ranked number one nationally in orthopedics, number three in rheumatology, and number seven in geriatrics by the United States News and World Report (2015-2016). The hospital was also the first in New York City to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. Additionally, HSS has one of the lowest infection rates in the United States. Besides offering health services, the center also offers professional medical academic programs and has 327 active medical staff.

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The Hospital for Special Surgery is guided by a mission to provide the highest quality patient care, improve mobility, and enhance the quality of life for all, as well as advancing the science of orthopedic surgery, rheumatology, and related disciplines through research and education. All this is done regardless of race, ethnic origin, color, religion, or sexual orientation. The vision is to lead the world as the most innovative source of medical care, the premier research institution, and the most trusted educator in the fields of rheumatology, orthopedics, and related disciplines. The hospital is anchored on values such as excellence, integrity, teamwork, creativity, and passion. This paper will be analyzing the possible key risks of the organization and discuss the impact they may have on the hospital or other exposed individuals.

There are various risks that the Hospital for Special Surgery is exposed to when running its operations. One of the major risks includes patients' morbidity and mortality when undergoing surgery and treatment. This has been identified especially for patients who undergo surgery for knee replacement in both legs at the same time. The morbidity and mortality rate is higher for patients with a history of significant health problems such as congestive heart failure or pulmonary hypertension. These patients are more likely to develop complications after undergoing surgery. Second is the risk of having patient falls in the hospitals which could result in injuries. This is more so with patients who have undergone total hip replacement than for those who have undergone other orthopedic procedures. These falls could slow down recovery for these patients or cause them to develop new complications such as fractures, dislocations, intra-cranial bleeding, or the need for an operation or transfer to a higher level of care.

A third risk is the exposure to hazardous materials such as medications or other hospital equipment. This is mostly for the staff such as the nurses and doctors working in the hospital. Exposure to hazardous drugs such as antivirals or hormonal therapy, as well as those used for the treatment of cancer has been found to cause acute and chronic health effects such as rashes, infertility, and possibly cancer. Fourth is the risk of possibly developing musculoskeletal injuries for the hospital staff. Nurses in such a hospital perform dozens of activities daily which can lead to acute or chronic musculoskeletal injuries. Studies show that 52% of nurses sustain chronic back pain due to on-the-job injuries. Poor postures such as repetitive bending when treating patients can strain the muscles in the neck, shoulders, and the back. Also, lifting patients as well as moving heavy equipment can result in injuries. Five, there is a risk of needlesticks and sharps injuries. Reports from the Occupational Safety and Health Administration (OSHA) show that hospital-based healthcare personnel sustains an average of 384,000 needlestick and other sharps-related injuries each year. An estimated 5.6 million healthcare workers risk exposure to bloodborne pathogens related to contact with needlesticks and other sharps.

Six, there is the risk of a shortage of specialists and staff in the hospital. HSS is a hospital that deals with specialized treatment for musculoskeletal health problems. The demand for specialists may exceed the supply since there are other hospitals that need these services. Shortage of service providers means that patients are staying for long before receiving treatment. These delays are likely to escalate their health problems or even complicate them. Seven, there is the risk of shortages in resources required for service delivery such as equipment and medical supplies. As such, the hospital is unable to accommodate as many patients as would want to be admitted to this hospital. An eighth risk is alarm fatigue. Due to a large number of patients in the hospital, the number of alarm beeps on the hospital devices is overwhelming and this can make the hospital staff turn them off. This means that they will not be able to respond to emergencies and the patients as they should. The consequences of alarm fatigue can be devastating especially if there is a patient who is in a critical condition or there is fire or any other danger in any part of the hospital.

The ninth risk is the potential breakout of violence in any part of the hospital. Such incidences expose not only the patients to risk, but also medical professionals who are often targets for harassment, intimidations, and attacks. Incidences of assault, rape, and homicide are also possible and have been reported in some hospitals. The tenth risk is on preparedness for pandemics. Such health pandemics could be contagious and, therefore, will affect both the patients and the staff. Eleventh is the risk of environmental pollution which is likely to affect the hospital in different capacities. For instance, noise and air pollution will affect the facility differently. Twelfth is the risk of emergency preparedness. This is a risk which can have disastrous outcomes if not mitigated. Thirteen is the risk of failure in healthcare reform integration. This risk exposes the hospital to medical mistakes which can cause deformities to patients. Fourteen is the risk of disruptive staff behavior which makes them and others distracted and unable to concentrate on their duties. Finally, there is the risk of staff strikes which are very disastrous since the patients are left without minimal or no care.

Of the fifteen potential risks, there are four which can be considered critical. These are patients' morbidity and mortality when undergoing surgery and treatment, patient falls in the hospitals, developing musculoskeletal injuries for the hospital staff, and alarm fatigue. These are considered critical since they directly affect the patients and the medics and they directly impact on the health of these individuals. These risks can be mitigated through proper policies that address each of them, as well as following the regulations and guidelines formulated for use in hospitals such those of OSHA. The hospital also should have control mechanisms in times of emergency. For instance, alarm fatigue should be addressed seriously and all alarms left on in case of emergencies.