RISK MANAGEMENT KEITH PAINTIN – NATIONAL LEAD, LUCID CONSULTING, AUSTRALIA
Are your assets and services critical or risky?
Keith Paintin, national lead for strategic advisory services at Lucid Consulting, looks at the concepts of ‘risk’ and ‘criticality’ to understand the similarities and differences between them, and how they should be used in a health environment.
Anecdotally, the terms ‘risk’ and ‘criticality’ have been used interchangeably at an individual and organisational levels. This misuse has led to misunderstanding or poor investment decision making. l A definition of risk: “The impact of uncertainty on objective.”
l A definition of critical: “Of decisive importance in relation to the outcome of something.”
Let us consider criticality first. We consider criticality to be the impact of the loss of an asset/system/facility on the organisational performance along with patient safety/wellbeing. This could be at an organisational/health district/ function/ building/room/asset level. From this statement, criticality is scalable and can be applied at different levels through the organisation if it is taken in the correct context. Where there are similar systems/assets/ facilities across a portfolio, it may mean that there is a systemic level of criticality that needs to be considered across the whole organisation. How critical are these
systems? While it is easy to say they are all critical, some will be more critical than others. One of the key
Table 1. List of criticality ratings. Rating
Title 1. Non-critical 2. Routine 3. Important 4. Critical 5. Highly critical Low-impact assets Minor assets Supportive assets Essential assets
considerations could be how long the system is unavailable for; an interruption of an hour may be acceptable, but unavailability for a week will have more serious consequences. It may be that one has to go to the next level of detail and consider the assets involved in that system to be able to get a more accurate picture of the level of criticality
Table 2. List of likelihood ratings. Description
Frequency Rare
Unlikely Possible Likely
Certain
Beyond 5 years Between 1-5 years 3-12 months
Once in 3 months Within a month
across the system(s). These could then be graded on a 1-5 scale (see Table 1). Once we have a view of the how the criticality of the hospital systems can be determined and the assessments made against the assets/systems, what can we do with this information? We now need to consider the likelihood of failure of these assets/systems. As an example, we could use a timeline approach (see Table 2).
Risk management The combination of impact and likelihood of failure is risk management. We can combine these two aspects to understand the risk exposure that the organisation faces should the asset failure occur. Risk is subjective, as you are
Keith Paintin
With over 40 years of industry experience in the UK, Middle East, North Africa, Singapore, and Australia, Keith’s skills lie in the areas of development of strategic asset management practices and processes. He is the national lead for strategic
advisory services at Lucid Consulting. Keith is also a member of the Asset Management Council in
Australia and the Institute of Asset Management in the UK as well as the Risk Management Institute of Australasia.
forecasting the likelihood of a future event. Also, the likelihood of failure can change quickly dependent upon the circumstances and so is variable. Once a threat has been identified, it should not always be assumed that the likelihood will never change. Criticality is more objective, as the impact from the loss of a system or asset can be relatively straightforward to identify and does not change.
Description
Assets that do not directly affect patient care or hospital operations.
May cause inconvenience but do not pose immediate risks.
Affects hospital workflow but not patient safety directly.
Directly affects patient care and hospital operations.
Life-supporting assets Failure could result in severe harm or death.
IFHE DIGEST 2026 Examples Office furniture, waiting room chairs.
Non-essential IT systems, general lighting.
Sterile supply storage, non-critical HVAC.
Operating room lighting, medical gas supply.
Ventilators, defibrillators, ICU monitors, emergency power.
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