Risk Management in the Healthcare Sector: What and Where are the Agents of Opportunity and Why? Department of Defense TATRC Lewis R. Goldfrank, MD Professor and Chair, Emergency Medicine Director, Emergency Medicine Bellevue Hospital/NYU Hospitals/VA Medical Center New York University School of Medicine Medical Director, New York City Poison Center

5 AO Examples

YOUR HELP Human Subjects Research Request for Nominations –AO Survey Yourselves, Research Coordinators, Investigators, 15 minutes/agent –One-on-One Interviews – Material Tracking Yourselves, Logistical Managers, Purchasing Decision-makers Up to 30 minutes –Threat/Mitigation Scenario Workshop Yourselves, SOM and Hospital Departmental Leadership Up to 90 minutes

Common Operating Picture PI AO SELECTION Survey Tool Key Informants THREAT SCENARIOS Haddon Matrix Mitigation Strategies MATERIALS MGT TRACING IT Interoperability RISK MANAGEMENT FRAMEWORK (Cost Benefit Analysis)

Mapping Manufacturer Or Exporter Truck or Rail Carrier Shipping and Receiving Securing the Supply Line Covered under existing U.S. Customs and Transportation Security Screening and Regulations Research Laboratory Purchasing Clinical Engineering Pharmacy and Satellites Diagnostic/Patholog y Laboratories Building Services Patient Units Public Areas Environment of Care Committee, Security, Infection Control Supply Chain Management, Risk Management Finance, Information Technology, DataBase Management Central Supply Environmental Services Logistics Managers Facilities Management Clinics Physician Offices

1 st Year Deliverables An Improved Healthcare Risk Management Framework Identify, track and control the risk of AOs Use existing enterprise information technology New mitigation strategies: Safety >> Security Reduce military and civilian health risk GIS Tool: Create a geographic information system (GIS) tool (location intelligence software) Inform military/ emergency responder interventions during AMC-based terrorist attacks Inform future architectural design of healthcare facilities

Time Line Funding: Sometime soon Project Year: x/07 through y/08 Participant Recruitment: Month 1 Interviews: Month 2 AO Survey: Month 3 Workshops: Month 7

Years 2 & 3 Deliverables IT Interoperability –AO Tracking –Location Intelligence Algorithms Risk Management Framework –Revise Hazard Vulnerability Analysis GIS-AO Device –Commercial Partner

Project Summary Statements/ VideoConsent Form Asymmetrical Employer-Employee Context Voluntary Participation Confidentiality De-Identify Public Information