Current conditions of risk assessment implemented in Japanese medical institutions

Introduction
Development of Risk Assessment (RA) in medical institutions will proactively protect health and safety of health care workers. We investigated the frequency of the RA currently being conducted in medical institutions, the factors hindering the adoption of RA and what would accelerate the spread of RA.

Methods
We conducted a questionnaire survey on January 2011, to total 2552 medical institutions which received the Japanese Hospital Function Evaluation (ver.5) as at September 3, 2010. The questionnaire included the current status of implementation of RA and the barriers to running RA.

Results
We received responses from 653 institutions (25% response rate). On the question for the current status of implementation of RA, institutions that answered that they evaluate the risks and decide on precautions (pre-Action group) were 9% and institutions that are currently putting the assessment results into actual preventive action (Action group) were 44%. The Action group was significantly higher in choosing person in charge, creating guidelines and conducting education and training than the pre-Action group (p<0.05). The major factor among all groups of hindering the adoption of RA was staff shortage (36%). The barriers to running RA at institutions that only do the first step of RA, to identify the hazards, was lack of knowledge of how to put it into action.

Discussion
Choosing the person in charge of RA and creating guidelines were less frequent in pre-Action group than Action group. They were considered as major causes of poor lead to RA. In Japanese medical institutions, there are not many specialists for RA, so not only securing staff resources but also training specialists in RA would be a significant promoting factor of RA. Many institutions that even don’t have activities for RA responded they have interest, so we are planning to introduce the basic concept by providing training materials or sessions.