Joana Siqueira de Souza

ERM for Health Care Organizations: An Economic Enterprise Risk Management Innovation Program (E2RMhealth care)

BACKGROUND In recent years, health care organizations have looked to enterprise risk management (ERM) for novel systems to obtain more accurate data on which to base risk strategies. OBJECTIVE This study proposes a conceptual ERM framework specifically designed for health care organizations. METHODS We explore how hospitals in the United States and Brazil are structuring and implementing ERM processes within their management structure. This study incorporates interviews with 15 chief risk officers (8 from the United States and 7 from Brazil) with qualitative data analysis using NVivo (QSR International software). RESULTS The interviews confirm that adopting ERM for health care organizations has gained momentum and become a priority, and that the demand for risk economic assessment orientation is common among health care risk managers. CONCLUSION We propose an ERM model for health care (Economic Enterprise Risk Management in Health Care) divided into four maturity levels and complemented by an implementation timeline. The model is accompanied by guidelines to orient the gradual implementation of ERM, including orientation to perform risk economic assessment.

A proposed enterprise risk management model for health organizations

Abstract Health care organizations are environments with high management complexity and subject to a constant exposure to risks. Enterprise risk management (ERM) has been studied and applied in different economic environments with the aim of improving organizational performance. However, the health sector still suffers from a lack of attention in this context, in particular with regard to the need for a high degree of financial transparency and for the establishment of process-orientated management, and this provides the motivation for the study described in this paper. An ERM model for health organizations is proposed, based on a systematic literature review and on seven case studies in Brazilian hospitals. An approach to economic risk assessment using indicators such as the cash flow at risk and the variability of costs and receipts from the proposed model is suggested. The health organizations involved in the case studies all interpret ERM as a source of information contributing to corporate governance, and the indicators listed provide constructive data for improvement-driven decision-making. Given the interest expressed by the organizations involved, further application and validation of the proposed model in subsequent studies is suggested.

Análise comparativa de ferramentas de gestão de portfólio: um estudo de caso na indústria alimentícia

Portfolio Management is the centralized management of one or more portfolios, which includes identifying, prioritizing, authorizing, managing and controlling projects, programs and related work to achieve specific strategic business objectives. There are different methods and tools in the literature that can be applied to portfolio management. The objective in this paper is to analyze the same portfolio using the DEIN and PAMP methods for comparison purposes. One of the tools is based on scoring models, while the other is based on economic-financial models. The case study was performed in a small food company where the feasibility of the two methods was evaluated. The results indicated that the methods can be applied complementarily and, although they present different basis, they resulted in a comparable product portfolio.

Development of an enterprise risk inventory for healthcare

BackgroundThe first phase of an enterprise risk management (ERM) program is the identification of risks. Accurate identification is essential to a proactive and effective ERM function. The authors identified a lack of such risk identification in the literature and in practical cases when interviewing the chief risk officers from healthcare organizations. A risk inventory specific to healthcare organizations that includes detailed risk scenarios and risk impacts currently does not exist. Thus, the objective of this research is to develop an enterprise risk inventory for healthcare organizations to create a common understanding of how each type of risk impacts a healthcare organization.MethodERM guidelines and data from 15 interviews with chief risk officers were analyzed to create the risk inventory. The identified risks were confirmed through a survey of risk managers from a range of global healthcare organizations during the ASHRM conference in 2017. Descriptive statistics were developed and cluster analysis was performed using the survey results.ResultsThe risk inventory includes 28 risks and their specific risk scenarios. Cyberattack was ranked as the principal risk by the participants, followed by sentinel events and risks associated with human capital management (organizational culture, use of electronic medical records and physician wellness). The data analysis showed that the specific characteristics of the survey participants, such as the length of time working in risk management, the size of the organization, and the presence of a school of medicine, do not impact an individual’s opinion of the importance of the risks identified. A personal background in risk management (clinical or enterprise) was a characteristic that showed a small difference in the perceived importance of the risks from the proposed risk inventory.ConclusionsIn addition to defining specific risk scenarios, the enterprise risk inventory presented in this research can contribute to guiding the risk identification phase of an ERM program and thereby support the development of a risk culture. Patient data security in hospitals that operate with high levels of technology is fundamental to delivering high quality and safe care to patients. At the top of the risk ranking, the identification of cyberattacks reflects the importance that healthcare risk managers place on this risk by allocating time and other resources. Exploring opportunities to improve cyber risk management and evaluating the benefits of using the risk inventory at the beginning of the risk identification phase in an ERM program are suggestions for future studies.

Risk management for companies focused on innovation processes

Risk is inherent to the activities of technology and innovation companies and to manage them represent an opportunity to improve the company capability to achieve its goals. The use of ERM models has been studied since the Committee of Sponsoring Organizations of the Treadway Commission guides. This article adapted the MIGGRI model for the context of an innovation company from a TSP in Brazil. Using a case study and a review from previous ERM literature, the article show that is possible to measure the risks that an innovation company faces, and that they may be managed with a view to supporting a company’s strategy. Were applied an economic analysis based on a MCS and an indicator of CFaR were applied to measure innovation risks. A strategic performance model for innovation companies are proposed and the benefit to implement Risk Management practices in innovation organizations was validated.