Since 7/2007 when long term care insurance for the aged started, the number of elderly care facilities has been rapidly increasing so that the significance of risk management has emerged as a tool to prevent and manage various risks in elderly care facilities. Because the risk prevention is achieved through sufficient education and training, the in-depth and systemic study on the risk management should be conducted; however, a case study for the risk management conducted through education and training for the staff has not existed so far.
Therefore, this study is the single organized case presenting the outcomes of the risk management by establishing and applying the risk management system in a elderly care facility for the fist time in Korea to suggest the coping strategies and prevent various risks in elderly care facilities. The object of the single case study is S elderly care facility situated in Busan Metropolitan City and the study was conducted during one year and seven months from 4/2014 to 10/2014.
The major study contents were as follows; As a first step, SQI team perfomances were conducted to establish the risk management system mainly by TF team through 7 months from 4/2013 to 10/2013. As a second step, the risk management system established through the first step was applied so that concrete action plan was implemented to achieve objectives and goals which were set up. As a third step, the outputs and outcomes of the risk management system were analyzed and evaluated.
The significance of the case study is that it was conducted mainly by TF team that consisted of professionals in each area and the entire employee in the facility participated through Bottom-Up methode. In addition, the new reference for the establishment and risk management system application in elderly care facilities is suggested by presenting implications and suggestions based on outputs and outcomes of the application of the risk management system.
The result of this study could be summarized as follows;
Above all, there is the risk management system establishment procedure for the elderly care facility. First, the four steps of the risk management establised and applied in this study turned out to be effective and useful procedure for the establishment of the risk management system. Second, in this study, as education and training in order for the staff to understand various utilization techniques, risk factors were found and the degree of exposure to risks was analyzed. In addition, the coping strategies for the prevention from risks were set up by utilizing 4M4E Model technique, SHELL Model technique and Characteristics Factors technique. Third, 21 concrete goals were set up to achieve 4 objectives. Fourth, the entire employees'' participation and interest are very important factors to establish successfully the risk management system through the entire staff''s recognition of the significance and necessity for the risk management. Specially, SQI team performance mainly by TF team takes very important position in system establishment.
Next, there is the risk management system application procedure. First, the role of the risk management manager as a control tower of the risk management should be strengthened. Second, the risk management committee should consist of professionals in care and medical service and be practically working. Third, the staff should possess the sensibility for the risk management to detect beforehand and prevent risks. The sensibility for the risk management should be taught and obtained through practical service procedures rather than theoretical logic. Forth, the performance for the re-evaluation and the recurrence prevention should be conducted in order to modify and update the coping strategies by evaluating the results of strategies for the risk management. Fifth, the regular staff education and training should be conducted in order to strengthen the recognition for the risk management and effectively operate the risk management system.
Finally, the incident finding and reporting is the important utilization technique. First, the range of risks should be enlarged in order to manage and prevent various risks. Second, new risks should be found based on incident and accident reports. Third, more attention should be paid to the facility management and bedsore care. Fifth, the risk management system should be introduced and applied in order to increase satisfaction of family members. Sixth, the staff education and training should be continually provided in order for the staff to utilize various techniques and specially to find out incidents effectively. Seventh, the burden due to work load of the risk management should try to be decreased.
Based on these results of the study, suggestions for the risk management establishment and operation are as follows; Above all, various techniques for the risk management system establishment and application should be utilized and the staff education and training should continually be conducted. Second, concept for risks in the elderly care facility should be redefined and techniques for measuring the risk exposure should be developed. Third, the reality of risks in the elderly care facility should be concretely explored. Fourth, reports for incidents and accidents should be actively utilized. Fifth, the full staff participation in the risk management performance should be motivated. Sixth, the risk management committee consisting of professionals who can suggest the coping strategies to practically prevent risks should be organized. Seventh, writing and reporting accidents should be made mandatory. Eighth, the risk management system establishment and application should be institutionalized as a management technique for setting up the coping strategy and risk prevention. Ninth, the staff arragement standards should be strengthened to cope rapidly with and prevent risks.
This study suggests that setting up the risk prevention and coping strategies in the elderly care facility is not optional anymore but necessary. However, the studies of the risk management in the elderly facility is insufficient.
Therefore, in order to prevent risks and establish the coping strategies more scientifically and effectively, further studies should be conducted on risks in real settings of the elderly care facility.
This study is considered to be expected to contribute to the future studies on the risk management by concretely presenting risks found in the real settings and occurrences of incidents in the elderly care facility.