How Does The Office of Risk Management Help Your Hospital?

What does Hospital Risk Management do?  Well, that depends on who you ask.

Every organization assigns different responsibilities to Risk Management.  Much like Medical/Professional Staff Offices, the roles can vary considerably from organization to organization.

The Yale School of Medicine / Yale New Haven Hospital posts the following about the goals of its Office of Risk Management:

Offices of Risk Management are concerned with a wide range of issues, however the overall goal is improvement of the quality of care and to eliminate or minimize the number of accidents with an eye towards claims prevention.

Goals of the Yale New Haven Hospital Office of Risk Management: 

1. Decrease severity and number of patient and visitor injuries by:

• receiving and reviewing incident and occurrence reports, as well as patient/visitor complaints.
• working closely with quality assurance/improvement committees.
• periodically reviewing credentialing procedures.
• being involved in the education of medical staff and employees via grand rounds, inservices and other venues.

2. Assure that documentation of care is adequate by:

• working closely with medical record committee.
• educating medical staff and employees.

3. Limit financial loss related to clinical care and provide a mechanism to deal fairly with issues related to claims from adverse outcomes in clinical care. The office: 

• investigates professional liability claims (i.e., malpractice) and negotiates fair resolution.
• manages certain insurance policies which have been secured by the hospital and its employees.

Whether or not you have an interest in the field, most would agree that these goals provide value, both to the organization and to it's patients.

I personally liked the YNH statement because limiting financial loss was included last.  Not because it isn't important, but because taking care of items one and two will help item number three take care of itself, and help keep patients safer in the process.

Comments

[Amanda]

I agree, it is an important role for the risk manager to limit financial loss, and ultimately the best way to do that is by tightening standards on patient care- which is closely tied to malpractice claims. Not surprisingly, when a patient is unhappy with their physician's bedside manner, they are more likely to sue.

Recently, JCAHO has been tightening standards for physician behavior, outlining the qualifications of a "disruptive physician". Risk managers will have to include these types of individuals in their assessment of risk. Thankfully, more programs are underway for training in patient care and consulting firms are starting to assist in treating & coaching these individuals. Anyway, something to think about when defining the role of a risk manager in this process.

[George Anderson]

As a major national provider of Executive Coaching/Anger Management for Disruptive Physicians, my experience has been that by the time that a physician is mandated for coaching he or she would have had an average of 6 reported incidents of abusive/abuse/angry episodes. Therefore, prevention is the key.
Risk Managers should think of the potential risk imposed by disruptive physicians and make referrals early in the process.