Building a Viable Flight Risk Assessment Process in Business Jet Operations: Selecting a Risk Assessment Tool, Setting Baselines, Trigger & Mitigation Points

BACKGROUND: The present article outlines the process of instituting an assessment of risk of problematic use of medications with new patients in an ambulatory chronic noncancer pain (CNCP) clinic. It is hoped that the authors’ experience through this iterative process will fill the gap in the literature by setting an example of an application of the ‘universal precautions’ approach to chronic pain management.OBJECTIVES: To assess the feasibility and utility of the addition of a new risk assessment process and to provide a snapshot of the risk of problematic use of medications in new patients presenting to a tertiary ambulatory clinic treating CNCP.METHODS: Charts for the first three months following the institution of an intake assessment for risk of problematic medication use were reviewed. Health care providers at the Wasser Pain Management Centre (Toronto, Ontario) were interviewed to discuss the preliminary findings and provide feedback about barriers to completing the intake assessments, as well as to identify the items that were clinically relevant and useful to their practice.RESULTS: Data were analyzed and examined for completeness. While some measures were considered to be particularly helpful, other items were regarded as repetitive, problematic or time consuming. Feedback was then incorporated into revisions of the risk assessment tool.DISCUSSION: Overall, it is feasible and useful to assess risk for problematic use of medications in new patients presenting to CNCP clinics.CONCLUSION: To facilitate the practice of assessment, the risk assessment tool at intake must be concise, clinically relevant and feasible given practitioner time constraints.

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Targeting Missing Persons Most Likely to Come to Harm Among 92,681 Cases Reported to Devon and Cornwall Police

Cambridge Journal of Evidence-Based Policing ◽

10.1007/s41887-020-00051-2 ◽

2020 ◽

Vol 4 (3-4) ◽

pp. 160-177

Author(s):

Ryan Doyle ◽

Geoffrey C. Barnes

Keyword(s):

Risk Assessment ◽

High Risk ◽

Assessment Tool ◽

Error Rates ◽

Assessment Process ◽

Age And Gender ◽

Risk Assessment Process ◽

Missing Persons ◽

Actual Harm ◽

And Gender

Abstract Research question Given the information available to Devon and Cornwall Police at the time when they received a missing person report, which knowable variables indicated increased odds of the person coming to serious harm? Data The study examines all 92,681 missing reports received by Devon and Cornwall Police over 11 years from 2008 through 2019, for which 3481 (3.8%) persons came to harm, or about one in 27. Variables known at the time the report was filed included (A) risk levels estimated by police applying the College of Policing risk assessment template (high, medium, low), and (B) the missing person’s age, gender, in-care status, disability, dyslexia, learning disability, hearing or visual impairment, reduced mobility, mental illness, child sexual exploitation risk, reported suicidal, vulnerable adult status and previous reports of being missing. Methods Odds ratios are used to estimate differences in likelihood of missing persons coming to harm in a series of single-variable tests. Matrices are used to assess the accuracy of the current risk assessment process used by police services in England and Wales, as applied in Devon and Cornwall. Limited multivariate analysis was undertaken. Findings Application of the current College of Policing protocol for risk assessment by subjective professional judgements yields substantial error rates, with 89% of the predicted high risk cases having no actual harm and 59% of cases with actual harm after not being predicted as high risk. The odds of harm based on single variables examined are highly conditional on age and gender as third factors. Both men and women over 18 are 4 times more likely to be harmed (6.8%) than those under age 18 (1.7%). Conclusions This study casts substantial doubt on the accuracy of the current subjective risk assessment process for missing persons. As the authorizing body for Approved Professional Practice, the College of Policing could use this evidence to endorse further development and implementation of a multivariate evidence-based risk assessment tool for missing persons that takes into account the age and gender of the missing person as well as all other factors in a single forecasting model.

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