Strategic Report 01 Strategy 02 03 04 Principal Risk/Uncertainty Key Drivers/Trends Mitigation Clinical risk Hospital-acquired infections and Our operations involve treatment of We continue to prioritise and enhance our communicable diseases at any of our patients with a variety of infections infection control and prevention (“ICP”) facilities, and especially their epidemic and communicable diseases. programme. New ICP working groups or outbreak, could adversely affect our and multidisciplinary infection control patients and our business, in common Failures in prevention could result in committees were established in the with other healthcare facilities worldwide. intra-hospital infections, especially in high-risk hospitals and in the head office. Infection areas such as intensive care units, emergency control nurse position was set up in If our hospitals fail to carry out accurate and departments and operating theatres. referral hospitals and specially selected timely prevention activities, or to comply with and trained nurses were appointed. internationally-recognised clinical care and Infection control and prevention has to cover quality standards, previously uninfected a variety of our activities, including: clinical ICP protocols and related standard operating people may contract and spread serious practice, cleaning and sterilisation, laundry, procedures (“SOPs”) were standardised and communicable diseases. Irrational use of waste management, rational antibiotic use implemented network-wide in accordance antibiotics or neglecting to follow waste and protection from communicable diseases. with national and international disposal or other clinical protocols could Historical practices in Georgia, including in recommendations. Databases for hospital also have social or environmental impacts. many of the facilities we have acquired in acquired infections, antimicrobial resistance recent years, are well behind international (“AMR”) and antibiotic use were created. Safety is a cornerstone of clinical risk best practices. management in modern medical facilities We also continue to work closely with the and risk management programmes shouldHospitals, by nature, are a high-risk areaUS Centre for Disease Control and Prevention be focused on overall safety in hospitals for injuries. Healthcare workers have a representatives in South Caucasus (the for patients and visitors and staff as well. high risk of workplace injuries and illness. “CDC”). CDC experts work closely with the Chief Quality Officer, Chief Medical Officer, Maintenance of properly functioning Our services involve using high-tech Chief Epidemiologist and experienced medical equipment is another significant medical equipment which require regular practitioners responsible for overseeing matter for healthcare facilities worldwide. maintenance and monitoring to ensure infection and communicable disease control continuously high standard of patient care and prevention at our facilities. Impact and avoid delays in service provision. Failure to diagnose and/or adhere to Infection control and prevention is a standing standards and protocols for hospital agenda item each time the Clinical Quality associated infectious and communicable and Safety Committee meets (at least diseases could result in: quarterly) to review our clinical services •to our patients and negativelydamage and performance, internal governance impact outcome of treatment; and controls as well as compliance. • decreased patient trust in our services; • damage to our reputation which may We have implemented strict procedures result in an inability to attract new patients that adhere to regulations and best practice, or retain existing patients; including an Environmental and Social Policy, • claims for damages; in relation to the proper handling of waste • escalation of the epidemic or outbreak; and its safe disposal. • creation of bacteria resistant to antibiotics; • occupational health hazards for our staff We continue to improve the clinical risk and resulting staffing shortages; and/or management activities and incorporate • operational limitations imposed by them in overall risk management. our regulators. Based on data analysis and case reviewing Improper disposal of waste increases these results several improvement projects were risks and can impact the environment. conducted network-wide in 2018: Early Sepsis Management, Surgery Care Improvement and Community Acquired Pneumonia Management and Rational Antibiotic Therapy Improvement projects. 55