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Ext. PublicationUncovering Hidden Risks in Health Care Organizations
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Looking closely at internal operations to spot and manage risks is a smart practice for any organization. It is especially crucial for organizations dedicated to health care delivery. Health care organizations — regardless of size or specialty — face significant risks across clinical, financial and operational functions. A process-level risk assessment (PLRA) helps uncover hidden vulnerabilities before they escalate. When leaders work together to assess and mitigate risk, they build stronger governance, improve patient safety and strengthen overall performance.
What is an Enterprise-Wide Process-Level Risk Assessment?
At a high level, a PLRA is like a gathering of the minds of organizational leaders based on experience to pinpoint critical risks within operations, finance, information technology, clinical operations and patient safety. By generating a “risk universe” — a comprehensive list of potential risks across the organization — risk assessments lead to a better understanding of the existence, prevalence and risk mitigation strategies within health care organizations.
The assessment typically consists of four distinct phases:
1. Plan the project: Determine the makeup and coordinate with members of the risk assessment team. This is typically 8-10 members of leadership, such as the chief nursing officer, chief financial officer, chief information officer, chief resource officer and chief information security officer. Outline the structure and process for delineating organizational channels, gathering information and communicating.
2. Identify the risk universe: Prepare and validate the risk universe with leadership, ensuring that all significant process areas are included. Coordinate with leadership to identify categories of risks, such as patient safety, regulatory, reputational, IT, fraud, financial or operational.
3. Assign rating scores: Work together in person in a “meeting of the minds” forum for one-two days depending on the size and complexity of the organization. Assign risk rating scores based on the probability and impact of identified events.
4. Evaluate and discuss results: Document and develop the risk response plan based on residual risk, including the business processes and internal controls in place to mitigate key risks. Finalize the risk universe and regroup with leadership to discuss the results.
What Are the Benefits?
Implementing an enterprise-wide PLRA can bolster organizational governance in health care in several ways:
- Fosters interdepartmental collaboration: An enterprise-wide approach fundamentally requires collaboration across various departments — from IT and finance to clinical operations, compliance and human resources. Internal audit, often a facilitator in these assessments, frequently coordinates with these functions for risk assessments and assurance work. This integrated effort breaks down organizational silos, fostering a more cohesive and effective governance structure where risks are understood and managed collectively.
- Enhances decision making and resource allocation: With a clear, detailed understanding of process-level risks, leadership and the board can make more informed decisions. They can prioritize resources more effectively, directing investments to areas of highest vulnerability or greatest potential impact on patient safety and operational efficiency. This proactive approach moves governance beyond merely reacting to incidents to anticipating and mitigating future challenges.
- Provides a comprehensive and granular identification of risks: A PLRA reveals risks that broad reviews often miss — like flaws in patient data access, charge capture inefficiencies or third-party vendor gaps. This detailed insight enables more precise risk mitigation strategies.
- Strengthens internal controls and compliance: A PLRA can be instrumental in designing and implementing robust internal controls at the process level. This is vital for maintaining financial integrity, ensuring data accuracy and upholding regulatory compliance. Internal audit’s role in assessing areas like financial integrity, fraud management and user access management directly contributes to a stronger control environment, protecting organizational assets and patient information.
How Weaver Can Help
From building the risk universe and facilitating leadership forums to documenting results and recommending targeted actions, we help guide health care organizations through every step of the PLRA process. Through industry-specific insights that help identify and address risks tied to patient safety, cybersecurity, compliance and operations, leaders will have a clearer picture of their risk landscape, enabling them act with confidence to protect patients, strengthen compliance and improve long-term resilience. Contact us to learn how a PLRA can support your organization’s goals.
Authored by Jeff Jones
©2025
