[BCM] [NUHS] [ERM] [C4] Integrating BCM into the ERM Framework

Chapter 4

Integrating BCM into the ERM Framework

In a healthcare system as dynamic and complex as NUHS, risk and continuity cannot be managed in silos.

While ERM provides the strategic oversight of enterprise-wide risks, BCM offers the operational resilience needed to ensure essential services continue amidst disruption.

Integrating Business Continuity Management (BCM) into the Enterprise Risk Management (ERM) framework is not only a best practice, but it is also essential for safeguarding lives, protecting institutional trust, and ensuring regulatory compliance.

Aligning BCM with ERM Principles

At their core, both ERM and BCM aim to protect the organisation from uncertainty. However, their approaches differ:

Alignment means ensuring that both functions:

• Use consistent risk language.
• Share common risk categories and impact metrics.
• To facilitate effective collaboration, feed insights and data into one another’s assessments and decision-making processes.
• Operate under a unified risk appetite and tolerance framework.

Example: A cyber risk identified in the ERM register should directly inform BCM’s IT disaster recovery plans, backup strategies, and communication protocols.

How BCM Supports the ERM Cycle

BCM is a critical enabler of each phase of the ERM cycle:

1. Identify

• BCM helps uncover operational vulnerabilities that may not be visible in enterprise-level assessments.
• Business Impact Analyses (BIA) highlight interdependencies and recovery priorities.

2. Assess

• BCM contributes quantitative and qualitative data (e.g., Recovery Time Objectives, RTOs) to risk assessments.
• Identifies the downstream consequences of risk events (e.g., loss of patient data impacting continuity of care).

3. Manage

• BCM provides response strategies (e.g., alternate sites, emergency staffing) that become part of the broader risk mitigation plan.
• BCM plans can trigger early interventions to reduce impact.

4. Monitor

• BCM includes drills, simulations, and real-time monitoring of continuity capabilities.
• These feed into ERM’s risk monitoring dashboards and key risk indicators (KRIs).

Key Point: BCM gives ERM a tangible, tested layer of defence that transforms risk registers into actionable continuity strategies.

Governance Structure for Integrated Risk and Continuity

An integrated governance model ensures accountability and coherence:

This governance ensures that BCM is not just an operational checklist but a strategic capability embedded in enterprise risk thinking.

Reporting and Monitoring Mechanisms

Integrated reporting allows stakeholders to see:

• Which strategic risks lack corresponding continuity plans?
• Which business functions are recovery-critical (as identified in BIA)?
• How simulated and real-life disruptions perform against established RTOs and Recovery Point Objectives (RPOs).

Common tools and practices include:

• Integrated dashboards that track ERM and BCM KPIs.
• Heat maps that correlate risk severity with continuity readiness.
• After-action reviews (AARs) from BCM exercises feed into ERM learning loops.

Real-World Example: Continuity During COVID-19 Disruptions

During the height of the COVID-19 pandemic, NUHS’s ability to continue critical services—while reconfiguring operations for surge capacity—was a testament to the value of integrated ERM and BCM.

How it worked:

• ERM identified pandemic risk scenarios early, supporting proactive decision-making at the system level.
• BCM plans were activated to manage alternative staffing models, the rollout of telemedicine, supply chain constraints, and infection control protocols.
• Coordinated governance facilitated timely communication across all NUHS institutions, including academic, acute, and community care settings.
• Monitoring mechanisms tracked PPE inventory levels, staff infections, and continuity of outpatient services, feeding real-time data into ERM dashboards.

This integration ensured that patient safety, operational continuity, and public trust were maintained despite unprecedented challenges.

Summary and Takeaways ...

Business Continuity Management is not a separate or secondary function—it is a pillar of resilient enterprise risk management in healthcare.

By embedding BCM into the ERM framework, NUHS enhances its capacity to protect patients, staff, and services in the event of disruption.

As we move forward, this integrated model will be crucial for navigating an increasingly complex and risk-prone healthcare environment.

NUHS & Business Continuity Management
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