Paediatric Homecare Risk Management: An Application of Functional Resonance Analysis Method (FRAM)

Paediatric homecare is an advancing field of healthcare, bringing care direct to patients in their own homes. Risk management is an integral component of homecare services, including incident and risk assessment management. The objective of the study was to investigate risk management in homecare focusing on two aspects: incident reporting and risk assessments. A Grounded Theory approach was used to gather key functions of these aspects; these were then mapped using the Functional Resonance Analysis method (FRAM). Nineteen nurses working in paediatric homecare services were interviewed for the study. The interviews were semi-structured and focused on risk, quality, complaints, audit, care, and management. The interview data were transcribed and coded using Nvivo; the data were then converted into functions for utilization in the FRAM tool. The FRAM detailed the process of incident reporting and risk assessment management of the actual work carried out as viewed by the participants of the study. The information was then analysed and contrasted with the organizational policy to gain an understanding of the systems of incident reporting and risk assessments, which then led to the development of a refined process that could have less variability in function. Consequently, changes to policy and training in risk management were recommended to enhance the systems.