Risk-Aware Business Process Management: A Case Study in Healthcare

  • Ilaria Angela AmanteaEmail author
  • Antonio Di Leva
  • Emilio Sulis


Risk management and compliance evaluation is a key factor for the company’s success. Errors cause an increase in costs, a loss of quality and delays in the timescales. In health, such errors can lead to serious consequences and damage to both patients and healthcare facilities. This paper introduces an approach focused on the Business Process Management perspective concerning risks and compliance in the health sector by introducing a methodological framework based on modeling and simulation of business processes. This methodology was applied in particular to the processes in the Blood Bank department of a large hospital. Our results show that a simulation-driven approach is an effective way to intercept and assess real risks and provide decision support to guide department managers in making organizational decisions.


Business process modeling Risk management Compliance by law analysis Simulation-driven approach Decision support system 


  1. Abo-Hamad, W., & Arisha, A. (2013). Simulation-based framework to improve patient experience in an emergency department. European Journal of Operational Research, 224(1), 154–166.Google Scholar
  2. Amantea, I., Di Leva, A., & Sulis, E. (2018). A simulation-driven approach in risk-aware business process management: A case study in healthcare. In Proceedings of 8th International Conference on Simulation and Modeling Methodologies, Technologies and Applications—Volume 1: SIMULTECH, pp. 98–105. ISBN 978-989-758-323-0.Google Scholar
  3. Betz, S., Hickl, S., & Oberweis, A. (2011, September). Risk-aware business process modeling and simulation using XML nets. In 2011 IEEE 13th Conference on Commerce and Enterprise Computing (CEC) (pp. 349–356). IEEE.Google Scholar
  4. Blake, J., & McTaggart, K. (2016, July). Using simulation for strategic blood supply chain design in the Canadian prairies. In 2016 6th International Conference on Simulation and Modeling Methodologies, Technologies and Applications (SIMULTECH) (pp. 1–8). IEEE.Google Scholar
  5. Boero, R., Morini, M., Sonnessa, M., & Terna, P. (2015). Agent-based models of the economy: From theories to applications. Basingstoke: Springer.Google Scholar
  6. Business Process Model and Notation (BPMN), Object Management Group. (2014).
  7. Buddle, J. J., Burke, B. S., Perkins, R. A., Roday, L. E., Tartaglia, R., & Vermiglio, I. A. (2005). U.S. Patent No. 6912502. Washington, DC: U.S. Patent and Trademark Office.Google Scholar
  8. Chang, J. F. (2016). Business process management systems: Strategy and implementation. Boca Raton: CRC Press.Google Scholar
  9. Chartier, Y. (Ed.). (2014). Safe management of wastes from health-care activities. Geneva: World Health Organization.Google Scholar
  10. Chiozza, M. L., & Ponzetti, C. (2009). FMEA: A model for reducing medical errors. Clinica Chimica Acta, 404(1), 75–78.Google Scholar
  11. Coviello, A., & Di Trapani, G. (2015). Il risk management nelle imprese italiane tra previsione e ritenzione dei rischi. Rivista elettronica di diritto, economia, management, n. 3.Google Scholar
  12. DeRosier, J., Stalhandske, E., Bagian, J. P., & Nudell, T. (2002). Using health care failure mode and effect analysis™: The VA National Center for Patient Safety’s prospective risk analysis system. The Joint Commission Journal on Quality Improvement, 28(5), 248–267.Google Scholar
  13. Di Leva, A. (2014). La gestione dell’azienda basata sui processi e i sistemi informativi aziendali. Torino: CELID. ISBN 978-88-6789-017-0.Google Scholar
  14. Di Leva, A., & Sulis, E. (2017a). Process analysis for a hospital emergency department. International Journal of Economics and Management Systems, 2, 34–41.Google Scholar
  15. Di Leva, A., & Sulis, E. (2017b). A business process methodology to investigate organization management: A hospital case study. WSEAS Transactions on Business and Economics, 14, 100–109.Google Scholar
  16. Duffy, V., & Lightner, N. (Eds.). (2017). Advances in human factors and ergonomics in healthcare and medical devices. Proceedings of the AHFE 2017 International Conferences on Human Factors and Ergonomics in Healthcare and Medical Devices, July 17–21, 2017, The Westin Bonaventure Hotel, Los Angeles, California, USA (Vol. 590). Springer.Google Scholar
  17. Dumas, M., Van der Aalst, W. M., & Ter Hofstede, A. H. (2005). Process-aware information systems: Bridging people and software through process technology. Hoboken: Wiley.Google Scholar
  18. Dumas, M., La Rosa, M., Mendling, J., & Reijers, H. A. (2013). Fundamentals of business process management (Vol. 1, p. 2). Heidelberg: Springer.Google Scholar
  19. Fishman, G. S. (2013). Discrete-event simulation: Modeling, programming, and analysis. New York: Springer Science & Business Media.Google Scholar
  20. Haimes, Y. Y. (2015). Risk modeling, assessment, and management. Hoboken: Wiley.Google Scholar
  21. Hayes, J. (2014). The theory and practice of change management. London: Palgrave Macmillan.Google Scholar
  22. Hashmi, M., Governatori, G., & Wynn, M. T. (2016). Normative requirements for regulatory compliance: An abstract formal framework. Information Systems Frontiers, 18(3), 429–455.Google Scholar
  23. Hornstein, H. A. (2015). The integration of project management and organizational change management is now a necessity. International Journal of Project Management, 33(2), 291–298.CrossRefGoogle Scholar
  24. iGrafx. (2015). iGrafxProcess 2015.
  25. Lawal, A. K., Rotter, T., Kinsman, L., Machotta, A., Ronellenfitsch, U., Scott, S. D., Goodridge, D., Plishka, C., Groot, G. (2016, February 23). What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review. BMC Medicine, 14, 35.Google Scholar
  26. McNeil, A. J., Frey, R., & Embrechts, P. (2015). Quantitative risk management: Concepts, techniques and tools. Princeton, NJ and Oxford: Princeton University Press.Google Scholar
  27. Ministero della Salute. (2008). Raccomandazione per la prevenzione della reazione trasfusionale da incompatibilità AB0. Raccomandazione n 5 Marzo 2008.Google Scholar
  28. Nicolini, D., Waring, J., & Mengis, J. (2011). The challenges of undertaking root cause analysis in health care: A qualitative study. Journal of Health Services Research & Policy, 16(1 suppl.), 34–41.Google Scholar
  29. Parker, C., & Nielsen, V. L. (Eds.). (2011). Explaining compliance: Business responses to regulation. Cheltenham and Northampton, MA: Edward Elgar Publishing.Google Scholar
  30. Racz, N., Weippl, E., & Seufert, A. (2010, July). A process model for integrated IT governance, risk, and compliance management. In Proceedings of the Ninth Baltic Conference on Databases and Information Systems (DB&IS 2010) (pp. 155–170).Google Scholar
  31. Sadgrove, K. (2016). The complete guide to business risk management. Abingdon: Routledge.Google Scholar
  32. Schrijvers, G., van Hoorn, A., Huiskes, N. (2012). The care pathway: Concepts and theories: An introduction. International Journal of Integrated Care, 12(Special Edition Integrated Care Pathways), e192.Google Scholar
  33. Sulis, E., & Di Leva, A. (2017, September). An agent-based model of a business process: The use case of a hospital emergency department. In International Conference on Business Process Management (pp. 124–132). Springer, Cham.Google Scholar
  34. Testi, A., Tanfani, E., & Landa, P. (2017). L’uso di modelli di simulazione per programmare, gestire e valutare i percorsi clinici ospedalieri. Politiche sanitarie, 18(4), 196–205.Google Scholar
  35. Tomiyama, T., Gu, P., Jin, Y., Lutters, D., Kind, C., & Kimura, F. (2009). Design methodologies: Industrial and educational applications. CIRP Annals-Manufacturing Technology, 58(2), 543–565.Google Scholar
  36. Van der Aalst, W. M., Nakatumba, J., Rozinat, A., & Russell, N. (2010). Business process simulation. In Handbook on Business Process Management 1 (pp. 313–338). Berlin and Heidelberg: Springer.Google Scholar
  37. Van der Aalst, W. M. (2013). Business process management: A comprehensive survey. ISRN Software Engineering.Google Scholar
  38. Vincent, C., Taylor-Adams, S., Chapman, E. J., Hewett, D., Prior, S., Strange, P., & Tizzard, A. (2000). How to investigate and analyse clinical incidents: Clinical risk unit and association of litigation and risk management protocol. BMJ: British Medical Journal, 320(7237), 777.Google Scholar
  39. Vincent, C. (2017). Patient safety. Hobokan, NJ: Wiley-Blackwell.Google Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Ilaria Angela Amantea
    • 1
    Email author
  • Antonio Di Leva
    • 1
  • Emilio Sulis
    • 1
  1. 1.Computer Science DepartmentUniversity of TurinTurinItaly

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