[BCM] [KKH] [E3] [BIA] [P2] CBF [1] Emergency Obstetric Services

CBF-1 Emergency Obstetric Processes

Following the identification of the Sub-Critical Business Functions (Sub-CBFs) supporting Emergency Obstetric Services, the next stage of the Business Impact Analysis (BIA) is to assess the consequences of disruption to each function.

This assessment enables KKH to understand how interruptions affect the delivery of life-saving maternal and neonatal services, patient safety, clinical outcomes, regulatory obligations, and hospital operations.

Business impacts should be evaluated across impact areas, as each Sub-CBF contributes differently to the overall service.

While some functions have the greatest effect on clinical operations and patient safety, others primarily affect regulatory compliance, information integrity, resource availability, or multidisciplinary coordination.

Evaluating each impact area separately provides a more accurate understanding of organisational risk and helps ensure that continuity strategies address the most critical operational vulnerabilities.

Impact assessment also supports the prioritisation of recovery activities.

By estimating potential financial losses, identifying the Business Unit Minimum Business Continuity Objectives (BU MBCOs) that would be affected, and documenting the operational consequences of disruption, KKH can establish appropriate Recovery Time Objectives (RTOs), allocate critical resources effectively, develop practical Business Continuity Plans (BCPs), and strengthen operational resilience for emergency obstetric services.

Table P2: Impact Area Assessment for CBF-1

Sub-CBF Code	Sub-Critical Business Function	Impact Area	Financial Impact – Monetary Loss (Estimated)	Financial Impact – Calculation Formula	Impact on BU MBCO – Affected MBCO	Impact on BU MBCO – Business Impact	Remarks / Description
1.1	Emergency Patient Arrival and Registration	Operational	S$20,000–40,000/day	Additional staffing + manual registration cost + ambulance diversion cost	Ability to register and admit all emergency obstetric patients	Delays in patient identification and commencement of emergency treatment	Increased waiting time, patient diversion, higher clinical risk and administrative backlog.
1.2	Obstetric Triage and Clinical Prioritisation	Operational	S$80,000–150,000/day	Clinical delay cost + additional emergency intervention cost	Continuous triage of all emergency obstetric patients	Critical cases may not receive immediate assessment, increasing maternal and fetal risk	Potential deterioration before treatment and increased emergency resource utilisation.
1.3	Emergency Clinical Assessment	Clinical / Operational	S$120,000–250,000/day	Additional treatment cost + delayed diagnosis cost + specialist overtime	Timely specialist assessment for all high-priority patients	Delay in diagnosis and treatment planning may compromise patient outcomes	Significant increase in clinical complications and prolonged hospitalisation.
1.4	Diagnostic and Laboratory Support	Technology	S$100,000–200,000/day	Laboratory service disruption cost + outsourced diagnostic services + recovery cost	Availability of essential laboratory and diagnostic services	Clinical decisions cannot be made promptly due to unavailable diagnostic results	Delayed surgery, transfusion, and emergency interventions.
1.5	Emergency Obstetric Decision-Making	Operational	S$150,000–300,000/day	Specialist decision delay cost + additional treatment cost	Availability of senior obstetric decision-making	Inability to authorise timely emergency interventions	Increased risk of maternal and neonatal morbidity with possible legal consequences.
1.6	Emergency Theatre Preparation	Operational	S$250,000–450,000/day	Theatre downtime + emergency resource mobilisation + external support cost	Availability of at least one emergency obstetric operating theatre	Emergency surgical procedures cannot commence within required clinical timeframes	High risk of surgical delays affecting maternal and fetal survival.
1.7	Emergency Obstetric Surgery and Delivery	Customer / Stakeholder	S$500,000–1,000,000/day	Emergency surgery delay cost + medico-legal exposure + recovery cost	Capability to perform emergency obstetric surgery	Life-saving surgical interventions cannot be delivered when clinically required	Severe patient safety implications with substantial reputational and legal exposure.
1.8	Anaesthesia and Perioperative Care	Human Resources	S$300,000–600,000/day	Anaesthetist replacement cost + cancelled procedures + overtime	Continuous emergency anaesthetic support	Surgical procedures cannot proceed safely due to lack of anaesthetic services	Significant reduction in emergency surgical capacity.
1.9	Neonatal Emergency Support	Customer / Stakeholder	S$250,000–500,000/day	Neonatal intensive care cost + emergency transfer + specialist support	Neonatal resuscitation capability	Compromised ability to stabilise newborns immediately after delivery	Increased neonatal morbidity and urgent transfer to external facilities.
1.10	Maternal Critical Care and Stabilisation	Operational	S$350,000–700,000/day	ICU/HDU treatment cost + emergency intervention + prolonged admission	Stabilisation of critically ill mothers	High-risk mothers cannot receive appropriate post-operative critical care	Increased mortality risk and prolonged recovery periods.
1.11	Blood Products and Medication Management	Third-Party Dependency	S$400,000–800,000/day	Emergency blood procurement + pharmaceutical replacement + logistics cost	Availability of blood products and emergency medications	Life-saving transfusions and medications become unavailable or delayed	Immediate impact on haemorrhage management and emergency surgery.
1.12	Clinical Communication and Care Coordination	Information	S$100,000–250,000/day	Communication failure recovery + operational delay + coordination cost	Reliable multidisciplinary communication	Clinical teams cannot coordinate emergency patient management effectively	Increased treatment delays and greater likelihood of clinical errors.
1.13	Patient Monitoring and Ongoing Clinical Management	Technology	S$180,000–350,000/day	Monitoring equipment replacement + extended admission cost	Continuous monitoring of high-risk patients	Clinical deterioration may not be detected promptly	Increased adverse clinical events and longer inpatient stays.
1.14	Patient Transfer and Continuity of Care	Operational	S$80,000–180,000/day	Additional transport cost + bed management inefficiency + overtime	Safe transfer to appropriate care units	Delays in transferring patients reduce treatment capacity and continuity of care	Bed shortages, congestion and delayed admissions for new emergency cases.
1.15	Clinical Documentation and Regulatory Reporting	Regulatory	S$50,000–120,000/day	Documentation recovery cost + compliance remediation + audit cost	Accurate clinical documentation and regulatory reporting	Clinical records become incomplete, delayed or unavailable	Regulatory non-compliance, medico-legal exposure and compromised continuity of care.

Assessing the impact of disruptions to each Sub-Critical Business Function provides KKH with a structured understanding of how Emergency Obstetric Services could be affected during operational incidents.

The analysis identifies where disruptions create the greatest risks to patient safety, clinical service delivery, regulatory compliance, and hospital operations, enabling management to focus continuity efforts on the most critical functions.

Indicative financial impact estimates provide an additional dimension for decision-making by quantifying the potential cost of service interruptions.

Although these estimates are intended for Business Impact Analysis rather than financial accounting, they help justify investments in resilience measures, contingency resources, and recovery capabilities.

The findings from this impact assessment directly support the establishment of Recovery Time Objectives (RTOs), prioritisation of recovery activities, allocation of critical resources, development of Business Continuity Strategies, and preparation of Business Continuity Plans (BCPs).

By understanding the operational, financial, regulatory, and stakeholder consequences associated with each Sub-CBF, KKH can strengthen its ability to sustain essential emergency obstetric services during disruptive events while enhancing overall organisational resilience.

eBook 3: Starting Your BCM Implementation
MBCO	P&S	RAR T1	RAR T2	RAR T3	BCS T1	CBF

CBF-1 Emergency Obstetric Services
DP	BIAQ P1	BIAQ P2	BIAQ P3	BIAQ P4	BIAQ P5	BIAQ P6

		BCS T2	BCS T3	PD

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