There is the need to revise the risk assessment methodology that has been used in the differential monitoring approach. In the past risk assessment has always been listed along with the key indicator methodology as the two approaches for differential monitoring and abbreviated monitoring inspections. However, it has become clear that there is another level of risk within a monitoring system that should be addressed and that involves potential risk. Potential risk is the possibility that because of certain characteristics or factors possessed by a facility or program that may place it at increased risk when you observe its component parts. An example could be that a program is located in a high crime area that places clients at increased risk to harm. It doesn’t guarantee that it will happen but if certain safeguards are not in place it increases the potential risk that something negative could occur.

Potential risk are variables that should be looked upon as separate from actual licensing rules or standards and should be assessed prior to a monitoring review. It would be similar to a pre-audit looking for potential predictor risks. And this is where this new concept of risk combines the previous risk assessment and key indicator methodologies. Risk assessment (RA) is what it purports to be, an assessment of morbidity or mortality risk because of non-compliance with a specific rule or standard. A key indicator (KI) is a predictor rule or standard that predicts overall regulatory compliance or program quality depending on the type of measurement undertaken. The new potential risk (PR) metric is a combination of both. It would look something like this:

RA + KI = PR

The other nuance to potential risk is that it will be very individual to a specific facility or program. No two programs are the same. What may be potential risk indicators for one program may not be for another. It will be very important to determine the proper path for each program so that they can be successful in their implementation efforts. Potential risk assessment is very individual, there probably will not be a one size fits all approach.

This post is for regulatory scientists to think about as they move forward in the further development of differential monitoring approaches, especially those approaches that involve risk assessment.