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This study aims to analyze the major risk categories that could be encountered in hospitals and other medical facilities and attempts to determine which are more important from the patients’ perspective for the purpose of improving to the hospital–patient relationship improvement. For this, five main risk categories are identified along with an overall perceived risk.

To extract the patients’ opinion over the considered types of risks in terms of importance and exposure to these risks when using the medical services, a questionnaire has been created and validated using AMOS 22.0.0. Due to the validation process, a series of variables have been excluded, while the selected ones have been used for calculating the overall perceived risk. Having the values of this risk for the entire set of respondents (N = 304), the grey incidence analysis has been applied to determine whether there is a correlation between the overall perceived risk and the frequency of medical services usage, the disease gravity, the hospitalisation period or the healing degree.

The human resources and the hospital conditions risk has been mentioned as the main risk category encountered by the respondents when accessing the medical services both in term of importance and exposure, shortly followed by the technological and hospital conditions risk. The overall perceived risk has a moderate to high average value on the entire set of respondents and it is mostly related to the frequency to which the respondents are utilising the medical services.

In this paper, the hospital’s risks are analysed from the patients’ point of view to see both their perception over these risks and the importance they are giving to these risks. More, an overall perceived risk has been determined, with a moderate to high value on the Likert scale (on this data set), which can be useful if extended to each hospital (and not calculated as a general indicator), as it can provide a landmark for patients when choosing a hospital.

The identification of the main risk triggers is essential for the hospital’s survival and performance with direct effects on its patients’ health and well-being. For this reason, in this paper some of the most important risk categories have been determined. While in a previous research a qualitative analysis has been done for determining which are the most important risks felt by the patient that are believed to affect their health through the usage of a questionnaire and through conducting a confirmatory factor analysis, the purpose of this paper is to analyze the quantitative side of these risks’ presence in a hospital.

On this purpose, four main categories of risks have been considered (the same as in the qualitative research) and they have been analyzed from the hospital’s point of view – through the usage of the hospital financial and internal documents. Therefore, a series of indicators have been determined for each risk category. After that, a representative indicator has been selected and the grey incidence analysis has been conducted.

By comparing the results gathered form this study with the qualitative analysis conducted among the patients (Delcea et al., 2016) it can be said that there can be seen a difference among the way a hospital and a patient perceive the risks within a medical activity. While for the hospital, the most affecting risk is the technological and hospital conditions risk, for the patients the most affecting risk seems to be the human resources and clinical risk. The mismanagement risk and inability to treat patients is the second in intensity for both the hospital and patients, with a smaller value in the patients’ case.

From here, the research can be extended for capturing the risks that are considered to be important for the medical stuff, which will permit us to have a global image over the healthcare risks. After that, a comparative analysis among the hospitals with different financial performance can be conducted in order to see how these risks are affecting their performance and to determine which can be the decisions that can fostering the reduction of these risks.

The present paper offers a quantitative analysis from the hospital’s point of view using the advantages offered by the grey systems theory. Combining this analysis with a qualitative one conducted on the patients, the managers of the hospital can a have a more adequate view over the risks that they are facing with. In this context, grey systems theory offers the needed methods for dealing with such situations.

Globally, several studies have shown that hospital building is charged with multiple inherent risks because a large number of users are vulnerable in tragic events. Thus, the need for the fire safety management plan (FSMP) has been proved as an instrument to mitigate fire and related risks in healthcare facilities. In Malaysia, FSMP regarding public healthcare building is yet to be explored in-depth. Therefore, this paper explores the information necessary to develop the FSMP framework for public hospital buildings.

The paper’s objectives were accomplished via a combination of five face-to-face interviews and observations of five selected public hospitals in Pulau Pinang, Malaysia. The five key participants were across the five public hospitals and collated data analysed through thematic analysis with the assistance of MAXQDA 2018.

Findings show that fire safety stakeholders practice system, fire safety action plan and fire risk management were the three main variables that promote fire safety programme and will improve FSMP for Malaysia’s public hospital buildings.

This paper’s data collection is limited to Penang, Malaysia, and a qualitative research approach was used, but this does not deteriorate the strength of the findings. Future studies are needed to consider validating findings from this paper via a quantitative approach.

The suggested framework can be employed by Malaysia’s public hospital authorities as a guideline to mitigate fire hazards in the country’s healthcare facilities.

This paper is encouraging hospital operators and other key stakeholders to improve on their FSMP for healthcare buildings across Malaysia as part of the study implications.

The purpose of this paper is to extend the body of knowledge on healthcare facilities management (FM) by investigating the risks associated with outsourcing of FM services in hospitals.

The paper relied on two strands of methodology common with pragmatic research. Questionnaire survey (QS) used data from 208 respondents representing ten hospitals while three out of the ten hospitals involved in the QS were selected based on their willingness to enter the case study (CS) interview. Data collected were analysed using descriptive and inferential statistics for QS and using narrative techniques by discussing themes, sub-themes for the CS.

Findings established 24 out of the 35 risk factors as critical, four factors as somehow critical, and five factors as not critical. Besides, nine risk factors were found to be significantly loaded on the five risk categories. The rank analysis also revealed that the top five critical risk factors are: inexperience and lack of requisite skills; possibility of fraud by vendor; financial failure of chosen vendor; vendor opportunism; and fall in morale of employees.

The study provides an unambiguous contribution to exiting body of knowledge on outsourcing risks as it relates to healthcare FM. It reinforces the theory that risks exist in any form of relationship but developed a distinct body of factors associated with outsourcing of FM services particularly from the context of Nigeria’s public healthcare sector.

Healthcare failure mode and effect analysis (HFMEA) identifies potential risks and defines preventive actions to reduce the effects of risks. In addition, a discrete event simulation (DES) could evaluate the effects of every improvement scenario. Consequently, a proposed integrated HFMEA-DES model is presented for quality improvement in a general hospital.

In the proposed model, HFMEA is implemented first. As any risk in the hospital is important and that there are many departments and different related risks, all defined risk factors are evaluated using the risk priority number (RPN) for which related corrective actions are defined based on experts' knowledge. Then, a DES model is designed to determine the effects of selected actions before implementation.

Results show that the proposed model not only supports different steps of HFMEA but also is highly in accordance with the determination of real priorities of the risk factors. It predicts the effects of corrective actions before implementation and helps hospital managers to improve performances.

This research is based on a case study in a well-known general hospital in Iran.

This study takes the advantages of an integrated HFMEA-DES model in supporting the limitation of HFMEA in a general hospital with a large number of beds and patients. The case study proves the effectiveness of the proposed approach for improving the performances of the hospital resources.

The purpose of this paper is to identify and analyse the readmission risk prediction tools reported in the literature and their benefits when it comes to healthcare organisations and management.

Readmission risk prediction is a growing topic of interest with the aim of identifying patients in particular those suffering from chronic diseases such as congestive heart failure, chronic obstructive pulmonary disease and diabetes, who are at risk of readmission. Several models have been developed with different levels of predictive ability. A structured and extensive literature search of several databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis strategy, and this yielded a total of 48,984 records.

Forty-three articles were selected for full-text and extensive review after following the screening process and according to the eligibility criteria. About 34 unique readmission risk prediction models were identified, in which their predictive ability ranged from poor to good (c statistic 0.5–0.86). Readmission rates ranged between 3.1 and 74.1% depending on the risk category. This review shows that readmission risk prediction is a complex process and is still relatively new as a concept and poorly understood. It confirms that readmission prediction models hold significant accuracy at identifying patients at higher risk for such an event within specific context.

Since most prediction models were developed for specific populations, conditions or hospital settings, the generalisability and transferability of the predictions across wider or other contexts may be difficult to achieve. Therefore, the value of prediction models remains limited to hospital management. Future research is indicated in this regard.

This review is the first to cover readmission risk prediction tools that have been published in the literature since 2011, thereby providing an assessment of the relevance of this crucial KPI to health organisations and managers.

The UK Government has now adopted Private Finance Initiative (PFI) as a major vehicle for the delivery of additional resources to the health sector in order to achieve a greater investment in healthcare facilities. The purpose of this paper is to examine the trends and risk assessment of the PFI in the healthcare sector.

The paper employed secondary data and interviews of key participants in two hospital PFI projects to highlight developments in healthcare PFI and the risk management of hospital projects.

The results show that the use of PFI in the provision of healthcare is increasing in terms of number, capital value and size of projects. What emerged in the healthcare PFI project was a usage of a plethora of risk management techniques, albeit to varying degrees. Experience appeared to be the prime risk assessment technique employed, while risk avoidance was first explored before pricing and allocating any residual risks. “Risk prompts”, such as using checklists and risk registers were also useful in the identification of risks. Among all participants, insurance cover and sub‐contracting appear to be the most prominent strategies employed for managing out the risks.

The negotiations that precede the signing of a healthcare PFI project contract had an impact on the final choice of facilities or their specifications. The two contracting parties sought a balance between an optimal allocation of risks, choice of facilities and project price. Although the risk management techniques being used are generic in nature, there is still no evidence at the moment to show that these are appropriate for PFI projects. It is important that further investigation is undertaken to assess the level of current skills in risk management techniques to deal with PFI projects and the extent to which these techniques are appropriate to tackle complex healthcare PFI projects.

Risk management in the healthcare sector is a highly relevant sub-domain and a crucial research area from the humanitarian perspective. The purpose of this paper is to focus on the managerial/supply chain risk factors experienced by the government hospitals in an Indian state. The present paper analyzes the inter-relationships among the significant risk factors and ranks those risk factors based on their criticality.

The current research focuses on 125 public hospitals in an Indian state. Questionnaire-based survey and personal interviews were conducted in the healthcare sector among the inpatients and hospital staff to identify the significant risk factors. An integrated DEMATEL–ISM–PROMETHEE method is adopted to analyze the impact potential and dependence behavior of the risk factors.

The analysis asserts the absence of critical risk factors that have a direct impact on patient safety in the present healthcare system under investigation. However, the results illustrate the remarkable impact potential attributed to the risk factor, namely, staff shortage in inducing other risk factors such as employee attitudinal issues, employee health issues and absenteeism altogether resulting in community mistrust/misbeliefs. Maintenance mismanagement, monsoon time epidemics, physical infrastructure limitations are also found to be significant risk factors that compromise patient satisfaction levels.

Multiple options are illustrated to mitigate significant risk factors and operational constraints experienced by public hospitals in the state. The study warrants urgent attention from government officials to fill staff vacancies and to improve the infrastructural facilities to match with the increasing demand from the society. Furthermore, this research recommends the hospital authorities to start conducting induction and training programs for the hospital employees to instill the fundamental code of conduct while working in hectic, challenging and even in conditions with limited resources.

Only limited papers are visible that address the identification and mitigation of risk factors associated with hospitals. The present paper proposes a novel DEMATEL–ISM–PROMETHEE integrated approach to map the inter-relationships among the significant risk factors and to rank those risk factors based on their criticality. Furthermore, the present study discloses the unique setting of the public healthcare system in a developing nation.

The complexity and criticality of healthcare services highlight the importance of maintenance management function in healthcare facilities. The purpose of this paper is to review the literature on maintenance management of healthcare facilities and hospital buildings to provide an organized literature review and identify gaps from the perspective of research and practice.

The paper categorizes the literature and adopts a review hierarchy according to maintenance management functions in hospital buildings. It explores the impact of those functions on the performance of maintenance activities in hospitals. Furthermore, it examines the role of information technology and automated decision support systems in facilitating hospital maintenance management functions and performance.

Literature on maintenance management in healthcare facilities and hospital buildings has so far been very limited. Recently published literature focusing on healthcare facilities management and its maintenance management functions is classified into various areas and sub-areas. The paper highlights gaps in the literature and suggests avenues for future research and improvements.

The paper contains a comprehensive listing of publications and their classifications according to various attributes. It will be useful for researchers, maintenance managers, practitioners and stakeholders concerned with facility management of hospital buildings.

There is significant literature to demonstrate that people with intellectual disabilities are at higher risk of premature death, however there is relatively little evidence of research carried out on risk assessment in hospital for this patient group. This paper aims to share the outcomes from a patient safety project conducted in an acute hospital by the Trust's intellectual disabilities team.

A project structure was used, supported by the Trust patient safety team through association with the National Institute for Innovation and Improvement: leading improvement in patient safety (LIPS) programme. The aim of the project was to bring together the current evidence, to understand the risk issues for this group and develop a robust risk assessment tool that could be embedded into the care processes in acute hospitals.

A six month pilot concluded that a short assessment in a familiar format was more likely to be used by nurses. Risk assessment on its own does not deliver better and safer care. It must be accompanied by a series of clear, evidence based actions that used together ensure the patients' total safety and care needs are met. This tool is used throughout the Trust and in a number of other hospitals across the eastern region. Its use has contributed to reducing length of stay and improving health outcomes.

The paper shows the need for further research and data gathering.

This study demonstrates that risk for patients with intellectual disabilities in hospital is complex. Education is essential to underpin new assessment tools for clinical practice.