Risk Insider: Terri Nichols

A Culture of Risk Management

By: | August 11, 2014

Terri Morris-Nichols is system director of risk management at PeaceHealth, a not-for-profit health care system with 10 hospitals and medical facilities in Alaska, Washington and Oregon. She is a registered nurse with a master's degree in health administration. She can be reached at [email protected]

My favorite definition of culture goes something like this: the arts and other manifestations of human intellectual achievement regarded collectively.

We think of culture as the customs, ways of thinking or behaving in a particular society or group. It can be said then that there is an art in the design, implementation, and sustainability of an organization’s risk culture, and that there are ways of thinking and behaving as it relates to how an organization understands its relationship to risk.

It’s about everyone in the organization identifying risks, participating or contributing to mitigation planning, and recognizing the thresholds the organization holds in regard to risk (for example, by risk mapping).

In a risk culture, the impact that each of our employees has as a result of their contributions to the culture cannot be underestimated. The importance of how the risk culture is nurtured and cultivated by all levels of committed leaders is paramount to setting the tone and influencing risk behaviors … behaviors that demonstrate an understanding of the inter-relationship and impacts of risks which in turn creates the culture of risk management.

In health care, think about the team member from housekeeping who sees patients every day who are at risk from some of our practices. What about the phlebotomist who must understand the risks related to restraints when they draw patient samples for testing? How much could we learn from the chaplain who hears our patient’s fears and concerns about their environment while hospitalized?

These team members contribute so much to a risk culture if we have the communication structure necessary to bring ideas and recommendations forward.

All too often, risk management is identified as the place you go when there is a claim or litigation (once related to me as a call to the principal’s office), or when you have in-the-moment crisis management needs.

However, creating an infrastructure of a successful risk culture begins early — at the job candidate interview process — and continues through the employee’s stay with the organization.

I once asked a candidate to describe their comfort with risk taking, and they described how they would take any risk — whatever the cost — to do what was right for those they would serve. Without parameters that are linked to the organization’s mission, values, and structures, this candidate would have put the organization at a level of risk we were not willing to accept.

Orientation — we use a game called “Risk Jeopardy” — is a great place to practice examples of risk taking as it relates to the organization’s policies and individual employees.

Rewarding new employees who bring a concern to risk management can also help establish the infrastructure of the culture.

As leaders are developed to be more aware of the value of risk management (through opportunities such as risk mapping), they will include risk management in strategic processes related to new programs and services, and day-to-day risk sharing opportunities and operational decision-making can become an approach to success.

Read all of Terri Nichols’ Risk Insider contributions.

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