Injury, Corrective Action, and Risk Management

I tore the bursa under my left shoulder a couple of days before Christmas. (Oh, and I cracked my left humerus at the shoulder.) Not a good thing to do at any age, but especially bad when you’re in your forties and beyond. My recuperative powers, I’m continually reminded, are not what they once were. (Really? I’d never have guessed.)

Shoulder anatomy

Figure 1 – Basic Anatomy of the Shoulder

I’ve been dealing with the discomfort of an injured shoulder for almost three months[1]. In comparison, I broke my right radius and ulna at the start of my freshman year of high school and was back to normal activity within six weeks. Yes, getting old is hell. (Don’t laugh – if you’re smart and lucky you’ll get there, and in reasonable shape.)

It could be worse. I’m in better-than-average condition for someone 5-10 years younger, let alone someone my age, so I’m making a decent recovery. I’m also being diligent about the stretching exercises – they tell me “10 reps, holding for 10 seconds each, done twice a day” and that’s what I do. Because of my diligence, and my attention to detail, I’m making good progress. My shoulder feels considerably better than it did on Christmas Eve.

It also could be better. I wasn’t seen by an orthopedic specialist until almost four weeks had passed. My shoulder was x-rayed twice and CAT-scanned once before an ultrasound scan finally pinpointed the problem with the bursa. The doctor prescribed a round of physical therapy, which did not begin until six weeks after the injury.

This has generally proved to be a sound correction. Maybe – I’m hoping, anyway, that – I won’t have to have cortisone shots, the next step in the rehabilitation process if PT doesn’t work. Surgery is a last resort, as far as the doctor is concerned, and I concur.

Note that I called the physical therapy a “correction”. That distinguishes it from a corrective action. A correction is addressing the problem as soon as possible, to prevent – or reduce the likelihood of – further damage. An aspirin (or other NSAID) and perhaps a sling, a trip to one or more MDs for a diagnosis, and a prescribed treatment are what I call the correction. A corrective action, on the other hand, consists of:

  1. Identifying the nature and scope of the problem
  2. Identifying the root cause of the problem
  3. Planning a corrective action to eliminate the root cause
  4. Implementing the action plan
  5. Following up on the corrective action (i.e., verify that the problem isn’t recurring)

What sort of corrective action will I be taking here?

  1. Several medical professionals teamed up to identify the nature and scope of my injury – a slight tearing of the left shoulder bursa and a small fracture of the left humerus.
  2. I had already identified several causes of the injury, though not a single “root cause”, before I was seen by any health care professional:
    1. I was skating, for the first time in a year. In fact, I haven’t skated regularly in the last two decades.
    2. I was not wearing any protective gear (though it’s unlikely that a set of shoulder pads would have prevented the injury).
    3. I caught my skate blade in a rut – I threw myself off balance while kicking at a puck on the ice.
    4. My skate blades haven’t been sharpened in a long time, so that they didn’t slice right through the rut. When I was skating regularly (playing hockey), I was having my skates sharpened at least once every season.
  3. The corrective action will consist of:
    1. Sharpening my skate blades. (I could really use a new pair of skates, but their blades would also need sharpening. No, you can’t use them right out of the box! Well, you could but…)
    2. Skating more often, to refamiliarize myself with the activity and work on my technique. I am so badly out of practice. I could use a few skating lessons.
  4. I’ll implement my corrective action in the fall, when I’ll feel more like skating. (Spring and summer are for baseball, picnics, and swimming pools.) Besides, I hope to have my shoulder close to 100%, even if the “ortho guy” says it will never be 100% again.
  5. We shall see.

Sure, I could prevent a recurrence of the problem by simply staying off skates for the duration. The problem with that “corrective action” is that it doesn’t take the “yang” to risk’s “yin” into account.

yin-yang-ios-7-symbol_318-34386

Figure 2 – Yin and Yang

In other words, ice skating presents risks and opportunities. If I stop skating, I remove the risk of falling painfully onto the ice – and suffering the attendant embarrassment – but I also deprive myself of an opportunity to get needed and enjoyable exercise, to socialize, and recharge myself. To me, the opportunities given me by ice skating are well worth the risks.

In business, risk-based thinking is quickly becoming the norm[2]. Risk analysis and risk management have always been integral to running an organization, but it was due to Sarbanes-Oxley’s insistence on risk assessment and risk prioritization that the business world recognized the importance of formal risk management frameworks.

ISO has incorporated risk management into several standards. ISO 31000:2009[3] provides organizations a set of risk management guidelines. The most recent release of ISO 9001[4], “Quality Management System Requirements”, has also incorporated the concept of risk-based thinking into its structure. Companies that want to comply with ISO 9001 must carefully consider opportunities and risks prior to acting on them, while acting on them, and while following up on them.

This isn’t just a standards organization (ISO) talking the talk. Risk-based thinking – not only considering and weighing risk and opportunity prior to making decisions, but continuing to manage risk throughout the business cycle – is sound business. Good for your business.

“You can observe a lot just by watching.”
Lawrence Peter “Yogi” Berra (1925-2015)

There’s a valuable lesson in this parable. The next time you consider taking a risk or seizing an opportunity, keep my mishap in mind. Who knows? Maybe you’ll keep your organization from taking an unnecessary and painful fall.

Best wishes. Hope to see you again soon.

FOOTNOTES

[1] It could be a few more months before I regain the full use of my left arm, assuming I can get back to 100%.

[2] “De rigueur, even!”, as Snagglepuss might say

[3] A revision of ISO 31000 is in process, which may be available later this year

[4] ISO 9001:2015

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Posted in ISO 31000, ISO 9001:2015, Risk Management, Risk-based thinking

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