LTR 158: Three Questions To Keep Risk Connected to Decisions

Summary“Tools do not remove uncertainty”In this Let’s Talk Risk! conversation, host Naveen Agarwal speaks with Vilma Nasteckiene, PhD, founder of Holistic Business Risk, about a broader and more human view of risk management. Vilma brings experience from banking, fintech, operational excellence, consulting, research, and business transformation. Her work focuses on reconnecting risk management with the real habits, decisions, tensions, and accountability practices that shape how organizations actually operate.This conversation moves beyond medical device risk management in the narrow technical sense. Instead, it explores risk as a business discipline: how companies grow, how complexity creates silos, how risk becomes disconnected from decision-making, and why mature risk management requires more than procedures, reports, and frameworks.Vilma offers three simple questions for a balanced approach to lifecycle risk management: What are we trying to achieve? What do we rely on to achieve it? How could it fail?The discussion connects directly to medtech, where product lifecycle, organizational lifecycle, regulatory expectations, patient safety, and business sustainability often collide.Listen to the full 30-minute podcast or jump to a section of interest listed below. Chapters00:00 – Introduction01:10 – Vilma’s journey into holistic business risk02:40 – When risk management drifts away from real business decisions05:55 – What lifecycle risk management means07:20 – Why companies lose risk visibility as they scale09:00 – Applying lifecycle thinking to organizations and products12:45 – Co-creating better risk expectations with regulators and industry15:25 – Mature business practices as risk management practices20:10 – Strategic planning as a risk control22:00 – Three questions for reconnecting risk with decisions25:20 – Why tools do not remove uncertainty27:20 – Closing remarks and key takeawaysIf you enjoyed this podcast, consider subscribing to the Let’s Talk Risk! newsletter.Suggested links:LTR: Lifecycle Risk Integration Under QMSR.LTR: Different Functions, Different Risk Lenses.LTR: LTR Risk Coach - AI-Powered Decision Support Tool.Key Takeaways* Risk management cannot be separated from business management. If risk is delegated entirely to a risk department, it will eventually lose contact with the decisions that actually create or reduce risk.* Organizations often outgrow their risk management systems. As companies scale, complexity increases. Risk may shift from real-time decision-making into reporting, dashboards, procedures, and post-hoc justification.* Lifecycle thinking applies at more than one level. It applies to the organization, the product, the service, and the regulatory relationship. A startup, a scale-up, and a mature company should not all manage risk in exactly the same way.* More procedures do not automatically mean better risk management. Vilma challenges the idea that visible documentation equals maturity. A company can have many procedures and still fail to connect risk with daily decisions.* Strategic planning can be a powerful risk practice. Growth, profitability, compliance, innovation, and safety can create competing pressures. If those tensions are not addressed at the strategy level, they are pushed down into functions.* Simple questions can reconnect risk to reality. Vilma’s practical questions are: What are we trying to achieve? What do we rely on to achieve it? How could it fail?* Risk maturity is more than frameworks and tools. Tools can help organize uncertainty, but they cannot remove it. They also cannot fully capture hesitation, silence, weak signals, informal concerns, or leadership behavior.* Regulators and industry can reduce “fake fear” by co-creating expectations. Vilma’s fintech example shows the value of bringing regulators, founders, and practitioners into the same room to design risk expectations that reflect real operating maturity.KeywordsRisk management, lifecycle risk management, risk maturity, holistic business risk, Vilma Nasteckiene, medtech risk, fintech risk, business risk, strategic planning, operational risk, risk culture, regulatory expectations, weak signals, leadership habits, decision-making, ISO 31000, risk governance, organizational maturity, risk-based thinking, Let’s Talk RiskAbout Vilma NasteckieneVilma Nasteckiene is the founder of Holistic Business Risk and describes her work as helping organizations “unfake and destigmatize risk management.” Her mission is to humanize risk perception and connect business and risk management to the daily habits of resilient, antifragile organizations. She works with managers, regulators, and auditors to connect purpose, client needs, processes, and risk management into visible collaborative practice.Vilma’s background includes banking, credit risk, operational risk, business process management, consulting, research, and system change. She contributed to fintech regulatory requirements and best-practice development in Lithuania, completed PhD research on risk management in management practices, helped initiate national adoption of ISO 31000 and related standards in Lithuania, and co-founded the Lithuanian Association of Risk Management Professionals. Her work emphasizes the practical connection between strategy, accountability, operations, leadership behavior, and risk maturity.Let’s Talk Risk! with Dr. Naveen Agarwal is a bi-weekly live audio event on LinkedIn, where we talk about risk management related topics in a casual, informal way. Join us at 11:00 am EST every other Friday on LinkedIn.DisclaimerInformation and insights presented in this podcast are for educational purposes only, and not as legal advice. Views expressed by all speakers are their own and do not reflect those of their respective organizations.Parts of this article were created using AI-generated content, which was subsequently reviewed, edited, and fact-checked by the author to ensure accuracy and alignment with our standards. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit naveenagarwalphd.substack.com/subscribe