aligned with international definitions and benchmarks, ensuring that the indicators remain reflective of best practices in the healthcare industry. Moreover, the framework improves risk management by adapting to changing standards and provides greater control over the quality of care, thereby fostering a safer and more effective healthcare environment. Regular review of CQI and SRE policies Group MAQ regularly reviews and keeps a running ledger of countries’ policies that address CQIs and prevent SREs on half-yearly basis and provide updates at quality and risk management platform. This process ensures a safer and more controlled healthcare environment through adaptation to evolving standards whereby healthcare standards, guidelines, and regulations are dynamic and subject to change. Regular policy reviews allow IHH to stay abreast of evolving standards related to clinical quality and safety and remain in compliance with regulatory requirements, reducing the risk of non-compliance issues. This proactive approach enables us to address potential issues before they escalate, minimising the impact on patient safety. Additionally, regular policy reviews also facilitate a culture of continuous improvement and alignment with best practices. IHH Clinical Risk Assurance Framework The IHH Board, AC and the RMC provided directives that there was a critical need to enhance the risk identification and management process within IHH. Group MAQ took on the task to improve the risk identification and management process for the Clinical Quality and Patient Safety as the designated risk owner for this risk category. Group MAQ currently monitor this risk through assessment of three key risk indicators on a quarterly basis. However, this is suboptimal as it falls short of addressing the broader spectrum of clinical aspects and evaluating the efficacy of our risk control measures. Beyond the imperative of auditing high clinical risk areas for compliance with standards in 2023, Group MAQ sought to be more proactive to prevent high risk incidents from occurring. To achieve this objective, we developed a new clinical risk assurance framework designed to preemptively prevent high-incidence risks by ensuring the implementation of robust risk controls, outlined as follows: • Identifying high risk scenarios in IHH through data-driven approach • Determining a risk rating (likelihood and severity/impact) • Identifying the risk control owners for each of the risk categories identified • Ensuring controls in place to prevent this risk from occurring • Tracking and monitoring of risk categories, effectiveness of risk controls • Quarterly and annual assessment of how adequately clinical risk has been controlled for reporting to IHH board and attestation Group MAQ initiated the comprehensive identification of clinical risks by leveraging a robust dataset comprising two years of historical incident data from IHH Singapore and IHH Malaysia. Through a meticulous analysis, the top 11 clinical risk categories, their sub-categories, and the corresponding risk owners were identified. It is noteworthy that effective risk controls for each category may necessitate collaboration across various departments. To establish transparent accountability lines for risk and control management, distinct roles and responsibilities have been delineated among the Board, Group, country, and hospital. This integrated approach ensures alignment between clinical risk monitoring, Clinical Quality Indicators (CQIs), incident reports, and audits, assuring effective control over clinical risk. Risk owners, for each category, assess the likelihood and potential severity of identified risks and assign a risk rating using the IHH risk matrix. This evaluation occurs at three levels – hospital, country, and group – corresponding to distinct accountability lines. Risk owners are charged with the development and implementation of appropriate risk controls, employing preventative, detective, or corrective measures based on priority. Monitoring the effectiveness of these controls is conducted through key performance indicators, key risk indicators, outcomes tracking, and periodic risk assessments. In instances where controls prove partially effective or ineffective, risk owners are tasked with establishing and monitoring action plans aimed at enhancing risk mitigation. This ensures continuous refinement and strengthening of clinical risk management practices in alignment with international best practices. In facilitating these initiatives, Group MAQ has devised a detailed timeline outlining a four-phased approach for the successful rollout of the clinical risk framework, with full implementation targeted for April 2025. Training and Education Ensuring that MAQ staff attend courses on clinical quality, patient safety, and clinical audit is pivotal for risk management and control in healthcare. Group MAQ identified training programs and certifications to provide staff with the relevant knowledge and skills, enabling them to proactively drive improvements in patient care and overall healthcare quality. By staying abreast of the latest developments in these critical areas, MAQ staff are better equipped to identify and mitigate patient safety risks effectively. The acquired knowledge fosters a culture of safety within the organisation, where staff are attuned to potential risks and are well-versed in implementing preventive measures. Control Environment In terms of the management of business units, the operating structure includes a clearly defined delegation of responsibilities. The Group’s policies clearly define and outline the limit of authority. Annual Report 2023 113
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