What is the Managing Risk Toolkit?
The ELDAC Managing Risk Toolkit is designed for health professionals and care staff providing palliative care and advance care planning for older Australians living in residential care with advanced life limiting illnesses, their families and carers. It provides information and guidance on managing risk at end of life for people living in residential aged care and for their families.
The Managing Risk Toolkit is available online, user-friendly, and has been developed and reviewed by aged care experts.
It comprises a series of resources commissioned by ELDAC which aim to build understanding and capability to improve the end of life1 experiences for aged care residents. Related resources cover the topics of Nutrition and Hydration, Medication Management and Transfers of residents between care settings and towards the end of life. This series is designed to be read in conjunction with ELDAC’s broader collection of evidence informed materials.
This resource has been informed by a review of contemporary Australian and international literature including authoritative sources on the Australian policy, legal and practice environment. Additionally, three focus groups of nurses working in a variety of aged care settings were held and content was reviewed by experts in the ELDAC network.
Common Risk Management Principles
Effective governance and risk management is a critical part of safe, effective, appropriate and quality aged care. It starts at the top, with the organisation’s board responsible for setting the tone and culture on risk management, and clearly communicating this throughout the organisation.
Aged care providers are expected to identify, manage and continuously review risks to aged care consumers and others. This includes maintaining a risk management system to:
- identify and assess risks – including to detect possible issues, their likelihood and potential impact, and determine tolerances for such issues
- respond to risks – including by accepting risks or putting strategies in place to mitigate or reduce identified risks (or their impact)
- monitor risks – regularly reviewing risks to determine whether they are ongoing and whether the response is still appropriate (or needs to be escalated or deescalated)
- record and report on risks – to ensure risks are communicated to those who need to know about them and data can be used to make improvements (to service delivery and the risk management system).
Working in residential aged care means understanding and using your organisation’s risk management system and ensuring the system guides your practice. This creates a connected, inclusive and holistic approach to risk management across the organisation. While the risks to residents at the end of life may change in the palliative care context, the systems and governance to support risk management will not. For example, some common risk management principles that will inform and support your practice include:
Principles
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Description
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| Consumer-centred |
Your approach to risk management will focus on the health, safety and wellbeing of consumers. You must manage risks in a way that is respectful of, and responsive to, each consumer’s needs, goals and preferences, while reducing the likelihood of risks being realised and minimising potential harm to consumers. |
| Leadership and accountability |
The organisation’s governing body is ultimately responsible for effectively managing risks. This includes ensuring that everyone (management, health professionals, care staff, consumers and others) understand their role and responsibilities in identifying, mitigating and responding to risks when they are identified. |
| Quality and safety culture |
The governing body promotes a culture where the quality and safety of care and services is at the forefront of all decisions and interactions. A blame free culture with a focus on understanding, learning and improving will enable you identify and manage risks effectively. It will also encourage workers to report risks and issues without fear of reprimand and learn from the experience. |
| Communication and collaboration |
Risk identification, assessment and response involves all impacted parties, including consumers, their families and carers, workers and others involved in a consumer’s care. This enables you to collaboratively develop risk mitigation strategies that meet the needs of consumers and ensures everyone understands their risk management responsibilities. |
| Continuous improvement |
Your risk management system will enable you to identify trends, issues and areas for improvement. This will enable you to continuously improve the quality of care and services you provide and your ability to identify, assessment and manage risks. |
More information is available in three focus areas to support members of your organisation to manage risks specific to residents at the end of life - nutrition and hydration, medication management and transfers. This information supports health professionals and care staff to identify and manage some common areas of risk when providing end of life care.
Within the three sections of the Toolkit you will find fact sheets, practical tips, links to forms and detailed information. Key features of the Managing Risk Toolkit include:
- key risks associated with nutrition and hydration, medication management and transfers and considerations to manage these risks
- pamphlets that are downloadable and printable to hand out and review with residents and their families.