The decision process explained: risk management in practice

Today I give you a practical example of how you can apply risk management in your own environment. I am using an existing process here: the GDD's (Dutch regional healt centres) Corona vaccination "streets". I will briefly describe the process, then name a risk that actually occurs, and then explain the decision-making process that you can also apply in your organization.

The process is (from the outside) very simple, there are five steps. 1: You will be checked for symptoms, etc. (through a questionnaire that you must complete in advance). 2: Your identity will be verified and your vaccination will be recorded on a bright colored paper (different colours per supplier). 3: You get the vaccination. 4: You have to wait 15 minutes for any immediate side effects to be able to catch and treat immediately. 5: Optionally have your travel vaccination booklet filled.

Behind the scenes, some more "checks and balances" have probably been set up, not to mention the administrative processing of all those vaccinations. Yet often enough something can go wrong (read: there are risks in the process), such as a second shot with a different vaccine than the first shot (step 3), or a wrong registration in the GGD system (step 2) or in your travel vaccination booklet (step 5). I recently understood from an acquaintance that there are people who go to the GGD halls and have their vaccination registered, only to run away and not be vaccinated. So this happens between steps 2 and 3. Now I believe that everyone should decide for themselves whether they take the vaccination or not and I want to leave that discussion here, I am focussing purely on the process and managing the risks within it.

If you see an incorrect vaccination registration as an operational risk and you want to do something about it, in this case the solution could be quite simple: reverse the order of the steps. First vaccination (was step 3, now step 2), then registration (was step 2, now step 3). This way you prevent incorrect registrations and disruptions in the process. Currently it is the other way around, with the described (yet rare) reaction as a result. You could possibly perform step 2 and 3 at the same time, so that the person recording the vaccination in the system/on your brightly colored paper actually sees the vaccination taking place.

Now there may (probably?) be a good reason why the order that is now being followed has been chosen, registration and after that, vaccination. I do not know those reasons, it could be a deliberate choice to prevent incorrect registrations (type of vaccine, for example) or missing registrations (then the Corona check app will not work for the person concerned either). Or maybe it could not be organised otherwise, technically or organisationally.

The decision-making process that the process owner has to go through in this case, and in every other case, is quite simple and therefore universally applicable. 1: map out your process (what is the end goal and which steps are necessary to get there?), 2: map out the risks of that process and rank them relative to each other. See also my article on this subject. 3: organize your process in the most logical way, taking into account the risks and the effectiveness of your process. 4: Assess whether the chosen process entails the lowest overall risk.

The latter is probably the most difficult step. To stick to the example: when you have set up your process, you estimate whether the risk of an incorrect registration is greater with the original setup, or that the risk of an incorrect and/or missing registration in the alternative setup is greater. In other words, when do you run the least risk in total, knowing that no single process design will be able to control every risk completely.

The choice is yours. However, I always recommend that if a risk occurs more often than previously estimated and/or a new risk arises, you review the process and perhaps make some adjustments. Incidentally, the "run away" risk can also be controlled in a different way here: you can close off the walking area with high walls instead of low barriers. Also try to think outside the box to come up with creative solutions. In addition, there may be other risks, but for the purpose of this blog I will limit myself to the three mentioned.

Finally, sometimes the costs of control (such as renting high walls) are more expensive than the costs of resolving the risk, should it arise. So always keep an eye on the efficiency of your choices.