Managing the climate change risk

We interview Mrs Leona Karnali, CEO of Primaya Hospital on hospital risk management in the Indonesian context.

Mrs Leona Karnali is the CEO of Primaya Hospital, a group that operates ten hospitals located in several major cities of Indonesia. She is also Head, International Relations of Indonesian Private Hospital Association. Hospital Management Asia speaks with her on her views relating to risk management and its importance in hospitals.

Q: What would you say is the main goal or mission of the risk management role in a hospital?

A: The role is similar to any other business, where we have to know our risk profile. At Primaya Hospital, we have carried out risk profiling as part of our JCI accreditation process, and also so we can put in control measures to manage these risks.

Risk management has become more and more important in hospitals here, not only because of the pandemic, but also because of the shifts in the healthcare landscape in Indonesia. This includes the introduction of the BPJS (universal insurance) programme, and changes in government regulations. The recent introduction of the Omnibus Law, while not directly impacting the healthcare industry, will also lead to further changes in other regulations in the country. Hospitals will have to be ready to manage these legal and regulatory risks and how it will impact hospital operations and development.

Q: In your opinion, what are some of the key elements that need to be in place within any successful risk management system? How have the hospitals’ risk management systems changed over the years?

A: It is important for leadership to understand risk management, not just the CEOs or directors, but also the middle managers. In our everyday operations we serve thousands of patients, and there could be mistakes or oversights that occur. The managers and staff will need to react and resolve the issues immediately, following the SOPs and policies that are already in place, making sure the risk controls are implemented.

In addition, risk management involves data. Each hospital has its own risk profile that will be different from another hospital. The more data you have, you would be able to profile your risks more accurately, allowing you to quantify the impact, or the frequency of each risk.

Indonesian hospitals also have to be ready to manage the risk of natural disasters, such as earthquakes, floods, and haze. In terms of disaster response, it is key to have a clear communication structure, so each staff member knows who to contact once an incident happens.

Mrs Leona Karnali

Q: Could you share an example of an area of risk that was identified at the hospital, and the actions taken to address it?

A: Infection control is crucial for hospitals during this COVID-19 pandemic. We took note of the potential risk of infection spread amongst the hospital staff. While our staff spend the majority of their time in protective gear, there is a risk of spread if they share their meals together outside the hospital with their family and friends, as eating together is common as part of the country’s culture. Hence, we put in new guidelines, prohibiting staff members to eat together, or eating out at restaurants. This is to protect them and their families as well.

Q: What risk area do you think would become more important in the next few years?

A: With global climate change, we have to be ready for extreme weather and increased frequency of natural disasters. There is also the possibility of new diseases. We had stopped talking about infectious diseases for a long time, focusing on chronic diseases such as heart diseases, and then COVID-19 emerges. I think we have to be ready for the next infectious disease outbreak; it could happen again and we have to be prepared for one that may be even worse than COVID-19.