STRENGTHENING LOCAL HEALTHCARE GOVERNANCE THROUGH HYBRID RISK ASSESSMENT: A CASE STUDY FROM SOUTH INDIA

Abstract

In contemporary healthcare delivery, patient safety is a governance concern as much as it is a clinical one. Operational hazards, human errors, and insufficient compliance with standard operating procedures (SOPs) often undermine the effectiveness of local healthcare systems. This study introduces a governance-oriented hybrid risk assessment framework that integrates Pareto analysis, Analytical Hierarchy Process (AHP), and Complex Proportional Assessment (COPRAS) to systematically evaluate safety risks in healthcare institutions. Data collected from 200 healthcare professionals in a major South Indian hospital highlights key institutional vulnerabilities. The findings reveal that improper medication handling, lapses in infection control practices, and inadequate biomedical waste disposal constitute the most significant risks, while human error remains the predominant cause of safety failures. To ensure validity, Fault Tree Analysis (FTA) was applied as a verification tool. By linking technical risk assessment with healthcare governance, the proposed framework provides local administrators and policymakers with actionable insights to improve patient safety, strengthen institutional accountability, and enhance resilience within healthcare delivery systems.