Scoring system, risk assessment

The BTS endorses a severity assessment model for community-acquired pneumonia which allows patients to be stratified into groups at specific risk of mortality and therefore suitable for different clinical management pathways. A validated six-point scoring system was proposed with one point for each of confusion urea >7 mmol/L respiratory rate >30/min blood pressure low (systolic <90 mmHg or diastolic <60 mmHg) and age >65 years. This is known... 

Table 15.2. The clinical features and scoring for the ABCD system of assessing risk of stroke in the seven days after a transient ischemic attack...

The compliance gap is calculated by subtracting the state of validation score from the maximum possible risk assessment score for that system s level of risk. The maximum possible risk assessment scores for LOW, MEDIUM, and HIGH risk systems are 35,49, and 63, respectively. To avoid negative scores the state of validation assessment should be designed so that its maximum score is equal to or less than the maximum possible risk assessment score for a LOW risk system. The compliance-gap score can be included in the system inventory. The priority attached to validation should be based on tackling the systems with the highest compliance-gap scores first. 

Common methods of risk assessment include relative risk numerical scoring methods and numerical probabilistic methods. With relative methods, scores and weighting factors are assigned to various risk factors and grouping of factors, based on system attributes, and an overall risk score is generated. The methods determine a score for likelihood of failure, the severity of the consequences of failure, and the... 

Each of the risks should be assessed from two angles (1) the likelihood of the function failing and (2) assessment of the GLP criticality of the function. A scoring system is used to classify the risk the higher the rating of the risk, the greater will be the need for stress testing the function. It must be accepted that the assessment process can be subjective therefore, it relies heav-iiy on the experience of the risk assessors. 

Intelligent use of this risk scoring system is proposed, Users of it should recognize that the risk assessment process is as much art as science and that the statistical outcomes derived from its application are to be just one element in the decision-making. 

In Chapter 13, Comments on Hazards and Risks, I discussed the unlikelihood of having accurate numbers representing the probability of incident occurrence and the severity of their consequences in making hazards analyses and risk assessments. I suggested that safety professionals be wary of numerologists, and of scoring systems whose creators suggest that they are to be the ultimate factor on which decisions are based. 

Risk is determined by assessing its two components the severity of harm or damage resulting from a hazard-related event and the probability that the event could occur. Table 15.1 presents a sample Risk Assessment Matrix, illustrating how these two factors are combined to obtain a risk level. A review of the many published risk assessment matrices appears in chapters titled A Primer On Hazard Analysis And Risk Assessment and Risk Scoring Systems in this authors book titled Innovations In Safety Management. 

A simplified fire safety evaluation of a building (see Table F.2). It consists of analyzing and scoring hazard and other related risk parameters to produce a rapid and simple estimate of relative fire risk. A detailed fire risk evaluation may not include attributes such as human behavior and attitudes. The structure of a risk index system facilitates quantification and inclusion of such factors. Where a quantitative fire safety evaluation is desirable, detailed fire risk assessment may not be cost-effective or appropriate. Fire risk indexing may provide a cost-effective means of fire safety... 

A risk assessment is always temporary. For instance the elements Distributor s own quality assurance system and business relation with the supplier will probably appear to be much more important and determine the way of evaluating the suppliers. Furthermore the scores will have to be changed for instance at a risk review after 2 years. 

Some risk assessment systems include numerical categories for probability and severity levels and computations are made to arrive at a number that determines the risk level. Arriving at those numerical categories is entirely judgmental. Some of those numerical risk assessment systems are discussed in Chapter 10, Three-and Four-Dimensional Numerical Risk-Scoring Systems. ... 

For this primer, two-dimensional risk assessment matrices are discussed. They are displays of variations for two categories of terms the severity of harm or damage that could result from a hazards-related incident or exposure, and the probability that the incident or exposure could occur. They also show the risk levels that derive from the various combinations of severity and probability. A review of three- and four-dimensional risk assessment systems is given in Chapter 10, Three- and Four-Dimensional Numerical Risk-Scoring Systems. ... 

B155.1 s Subsection 6.4, Assess Initial Risk, says that risks shall be assessed using a risk scoring system. The Example Risk-Scoring System shown in the standard is taken from MIL-STD-882D. It is identical to the Risk Assessment Matrix depicted in Table 7 in Chapter 8, A Primer on Hazard Analysis and Risk Assessment, and shown here as Table 4. 

However, the world of risk assessment is in transition. Some systems now in use are three- or four-dimensional, and they require numerical risk scorings. Safety professionals can expect that variations of numerical risk scoring systems will proliferate. Nevertheless, it needs to be said that two-dimensional, qualitative risk assessment systems are not obsolete. Often, a two-dimensional system will be selected because it is sufficient for the hazards and risks encountered and it works well within an organization. This chapter will inform safety professionals on ... 

Similarly, some engineers are using numerical risk scoring systems to meet the risk assessment requirements placed on manufacturers who sell machinery to countries in the European Community. One such system in use for that purpose is four-dimensional. Also, a three-dimensional numerical risk-scoring system is in use in a segment of the heavy machinery manufacturing industry. It was introduced by engineering personnel to meet the demands for product safety. 

For example, it has been used with minor modification by at least one U.S. company to meet the European Community risk assessment requirements as set forth in ISO 14121, the Safety of Machinery—Principles for Risk Assessment Standard. As will be illustrated later, this risk-scoring system has major shortcomings. 

This system has a particular focus. It applies only to personal injury, principally to employees, that could derive from machinery operation. As will be seen, all of the listings for Degree of possible harm involve personal injuries. There are no entries for possible damage to property or the environment. The terms used to establish gradations and scores in the Likelihood of occurrence and Frequency of exposure categories are comparable to those in previously cited risk assessment systems. They follow in Tables 14-16. 

The goal was to create a three-dimensional numerical risk-scoring system that serves the needs of those who are more comfortable with statistics in their risk assessments, addresses the strong beliefs of those who want frequency of exposure given separate consideration in the risk assessment process, and maintains credibility and efficacy. An example demonstrating how the risk-scoring system is applied appears in Table 26. 

Numerical risk-scoring systems can serve a real need. Nevertheless, it should be remembered that they consist of numerics arrived at through subjective judgments. Risk assessment is still as much art as science. 

An Internet search will also show that numerous ergonomics risk assessment and risk scoring systems have been developed, and their use is recommended. Bruce Lyon of the Hays Companies and Georgi Popov who is at the University of Central Missouri have given permission to duplicate an Ergonomic Task Analysis Scoring Tool— Initial Evaluation (see Figure 20.1). They say this about it ... 

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