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V sodobnem, dinamičnem in pogosto tudi ne povsem predvidljivem poslovnem svetu, so uspešne le fleksibilne organizacije, ki učinkovito predvidevajo težave v prihodnosti in prepoznavajo nevarnosti – to velja seveda tudi za javne zdravstvene zavode. Trenutni način financiranja javnega zdravstva in posledice gospodarske krize postavljajo v ospredje nalogo poslovodstva, da izdela sistem ukrepov in jih nenehno izvaja znotraj vseh procesov v javni bolnišnici. V magistrskem delu smo definirali poslovno tveganje, tj. vsak neugoden dogodek, ki vpliva na realizacijo zastavljenih ciljev javne bolnišnice in ki ga z lahkoto prepoznamo tako, da se vprašamo: kaj gre lahko pri našem delu narobe. Želeli smo tudi ugotoviti stopnjo upravljanja tveganj v slovenskih bolnišnicah in prikazati orodje, ki ga poslovodstvo lahko (ob ustreznem zavedanju in znanju, ob pomoči notranjih revizorjev) uporablja za obvladovanje le-teh in tako dosega zastavljene cilje ter s tem tudi uresničuje poslanstvo oz. po drugi strani racionalno porablja proračunska sredstva. Register poslovnih tveganj predstavlja sistematičen zapis poslovnih in strokovnih (medicinskih) tveganj ter procesov, ki so usmerjeni k zagotavljanju učinkovitega in uspešnega odzivanja na tveganja. V pomoč nam je zlati pri upravljanju tveganj, ki izhajajo iz notranjega poslovnega okolja in na katera imajo javne bolnišnice vpliv v večji meri kot na tveganja iz zunanjega okolja. Odlično sodelovanje med notranjerevizorsko službo in odgovornim poslovodstvom je zagotovilo za upravljanje tveganj na še sprejemljivi ravni ter za doseganje zastavljenih ciljev, kar potrjuje tudi primer dobre prakse v SB Celje. Prikazan je tudi problem zastarele zakonodaje na področju upravljanja javnih bolnišnic ter pobuda za izoblikovanje elektronskega registra tveganj v okviru že obstoječih informacijskih sistemov, ki jih uporabljamo v javnih bolnišnicah. Na ta način bo register kot orodje upravljanja tveganj vedno aktualen in približan poslovodstvu javnih bolnišnic. In a modern, dynamic and often not entirely predictable business world, the only organizations that are thriving are flexible, successfully foresee the future and recognize hazards. This also applies to public health institutions. The current method of public health financing and the consequences of the economic crisis highlight the task of management to have a system of measures in place implemented within all processes on an ongoing basis. In this thesis, a business risk is identified, i.e. any adverse event affecting the implementation of public hospital goals. It is easily recognizable by asking the question “what can go wrong in our work?” The aim was to determine the level of risk management in Slovenian hospitals, and present a tool that can be used by management with due awareness and knowledge, with the assistance of internal auditors, in order to manage the risks and thus achieve the set objectives and fulfill its mission and, the other hand, rationally utilize the given resources. A register of business risks represents a systematic record of business and professional (medical) risks and processes that are aimed at ensuring an efficient and effective risk response. It is mostly helpful in the management of risks arising from the internal business environment over which public hospitals have a bigger influence than over risks from the external environment. Excellent cooperation between the internal audit department and responsible management is a guarantee of keeping the management of risk at an acceptable level and achieving the objectives, as demonstrated by an example of good practice in Celje General Hospital. The thesis also shows the problem of obsolete legislation in the field of public hospital management and the initiative to form an electronic register of risks within existing IT systems used by public hospitals. In this way, the risk register as a risk management tool will be adopted by the management of public hospitals and always up to date. |
