Health Canada Decision-Making Framework for Identifying, Assessing,
and Managing Health Risks - August 1, 2000
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2.5 Implement the Strategy
Strive to implement risk management strategies in an effective, expeditious,
and flexible manner, and with the support of interested and affected parties.
This step involves developing and carrying out a plan to implement the
selected risk management strategy. It also involves identifying criteria
that can later be used to monitor and evaluate the effectiveness, impacts,
and implementation of the strategy.
Implement the Strategy - General Tasks
- Prepare an Implementation Plan.
- Carry Out the Plan.
Prepare an Implementation Plan
The implementation plan is one of the most important documents prepared
during the risk management process, as it is the basis for carrying out
the selected strategy and monitoring and evaluating the results. As such,
the plan and the way it is carried out have a major impact on the effectiveness
of the strategy.
The implementation plan should include: specific tasks to be undertaken
and timeframes involved; the roles, responsibilities, and accountabilities
of participants; plans for communication, and for involvement of interested
and affected parties; and the criteria that will be used for monitoring
and evaluation.
The latter include: the activities that will be undertaken (the things
done to carry out the risk management strategy; they typically require
resources and generate products or services); the outputs that will result
(tangible products or services that can be counted and that are produced
or provided as a result of activities); who will be reached by these activities
and outputs (those who are affected by, or interested in, outputs, including
primary targets [generally clients or recipients of outputs], co-delivery
agents, and other interested parties); what direct or short-term outcomes
are intended (the impacts on those groups who are immediately affected
by products or services, including service and behavioral influence outcomes);
and what long-term outcomes are intended (changes in the original conditions
that were the basis for developing and implementing the risk management
strategy).
In order to prepare an implementation plan it is necessary to:
- review the goals of the risk management strategy;
- identify the roles and responsibilities of all parties who will play
a role in implementation;
- review existing agreements or other considerations that may impact
upon the way that the strategy is implemented, and incorporate these
as required;
- identify the milestones required to achieve the goals of the strategy,
the items required to achieve the milestones, the target dates for completion
of the items, and the party responsible for carrying out each item;
- identify the criteria that will be used to monitor the effectiveness
of the strategy in achieving the risk management goal(s) (e.g. reducing
incidence of disease, or level of exposure);
- identify the criteria that will be used to monitor the effectiveness
of the implementation process itself (i.e. for evaluation purposes);
- identify key decisions to be made;
- identify resource requirements;
- establish consultation/negotiation strategies;
- identify complaint resolution mechanisms;
- develop enforcement mechanisms, if necessary;
- develop training plans for individuals involved in implementing the
strategy, if necessary;
- prepare communication plans; and.
- obtain approval of the plan from the decision-maker(s).
Health-Based Outcome Measures
Health-based outcome measures are impacts, effects or changes
in the health of a defined population resulting or related to a specific
risk management strategy. These measures may be used as a basis for monitoring
and evaluating risk management strategies.
Examples of health-based outcomes include: health status outcomes, which
are often disease-focused, and reflect changes (or a lack of change) in
the physical or mental status of a population; risk status (or intermediate)
outcomes, which reflect changes (or a lack of change) in the risk that
has been demonstrated or assumed to be associated with health status;
social functioning outcomes, which reflect changes (or a lack of change)
in the ability of individuals to function in society; and client satisfaction
outcomes, which reflect the response of individuals to services received
from a health provider, program or risk management strategy. Although
it is desirable to measure different impacts, those related to physical
health effects are often easier to measure than those related to non-physical
health effects, such as stress. An important challenge in the use of health-based
outcome measures involves dealing with situations where the impact of
a risk management strategy is only seen in the long term, as in the case
of reductions in environmental contaminants.
Further information on health-based outcomes and development of a framework
for identifying and measuring these outcomes can be found in the draft
Guidance Document on Developing Health-Based Outcome Measures.
Carry Out the Plan
This involves implementing the plan noted above. Both the details of
the implementation process and any changes to the plan must be noted.
Regional Involvement in Implementation
The implementation of risk management strategies by Health Canada may
involve some or all of the regional offices. Regional involvement may
vary depending on the nature and scope of the risk issue, the risk management
strategy and the region's areas of expertise. If the level of the risk
is high or if there are national implications, the issue will usually
be handled at a national rather than regional level.
Involving Interested and Affected Parties
Interested and affected parties can play an important role in implementation
by participating in the development or review of the implementation plan,
implementing part or all of the risk management plan, and helping to develop
criteria for monitoring (and evaluation). Interested and affected parties
may provide a wide range of perspectives, information, and expertise that
can lead to the development of action plans that are more acceptable,
more effective, less expensive, and easier to implement.
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