Risk Management Flashcards
Are medical errors the third leading cause of death?
Yes
After heart disease and cancer
Is risk management constantly changing?
Yes
What is risk?
An exposure to the chance of injury or financial loss
The major emphasis has been on the management of patient injuries
These injuries result in financial losses when the patient brings a claim for compensation
What are the nature of claims?
May be based on physical or psychological injuries
Usual concern has been with physical injuries because of the reluctance of the courts to award substantial compensation for nonphysical injuries
Are risks just concerning patients?
No, also the providers
A comprehensive quality control program should also include the management of risks to the hospital’s employees and other members of the health care provider team
What are the different categories of risk?
Patient care related risk
Medical Staff related risk
Employee related risk
Property related risk
Financial risk
Other risk
What are the risks within patient care related risk?
Clinical Care Risk
Informed Consent
Confidentiality
Right to Care Issues (non-discrimination)
Access to Care
Personal Safety in Setting
Is cost effectiveness critical for developing a quality control program?
Yes
Many risks may be prevented only at a cost greatly in excess of the cos of their occurrence
Not always ideal to prevent all risks (although it is ideal)
What is the process of risk management?
Identification of risks
Analysis of those risks in terms of probably loss, frequency, and severity
Development of alternative risk control and risk financing techniques and choice of proper technique
Implementation of technique
Monitoring the programs effectiveness and modifying it as risks change over time
What is the goal of risk identification?
To discern which risks are present (present in the sense that the setting has an exposure to the risk)
Identifying risks in a setting requires that you become aware of all the potential exposures
Every part and operation should be considered, not just those associated with patient care
What are some risk identification resources for us to access?
Internal incident (occurrence) reports
Reports and surveys from accrediting bodies such as Joint Commission and NCQA (will tell them the areas of concern)
Risk identification aides from insurers
Professional practice guidelines
Professional ethics documents
Regulatory guidelines and requirements
Equipment maintenance and operation manuals
Walking the Beat
How are risks classified?
Based on the relative value of the cost of managing the risk weighed against the cost of the occurrence and degree of liability applied to an occurrence of the risk
How likely it is to happen and how much it will cost us if it does happen
What questions need to be asked when you are analyzing risks?
What is the likelihood of injury
How severe would the injury be
Will the organization be hurt
Will someone sue
Which course of action is best
What are some management options for risks?
Loss Prevention
Loss Reduction
Controlling Exposure
Risk Acceptance
Risk Transfer
Risk Avoidance
What is risk prevention?
A strategy that seeks to reduce the likelihood of adverse event or the frequency of the event
Having back up computer files is a good example of this strategy
What is risk avoidance?
A strategy of choice when a risk posesa significant threat and it cannot be prevented or reduced to an acceptable levels
What is risk reduction or minimization?
Loss control methods used to limit the consequences of an event that has already occurred
This includes controlling exposure, loss reduction and risk transfer
What is reliability?
Performing as intended in common and uncommon circumstances
Want it to work well every time
Does the organization have to commit to high reliability?
Yes
Need to give examples of how things are done from the top (leadership commitment)
Also safety culture (report) and robust process improvement (methods, training, and spread)
What is the three level design of safe and reliable systems of care?
Prevent - design the system to prevent failure
Identify - design procedures and relationships to make failures visible when they do occur so they maybe intercepted before they do harm
Mitigate - design procedures and build capabilities for fixing failures when they are identified or mitigate the harm when they do occur
Who is James Reason?
Expert on human error and system safety - talks of the existing blame culture in healthcare
Concerns in healthcare happen not because of a single event, or because of a single person’s error, but because a combination of risk factors within the system itself have aligned and made the error more likely to happen
Swiss cheese model - the holes in the system align and open up opportunities for errors to happen
Is insurance another management technique?
Yes
Can transfer the remainder of the risk to a 3rd party
Can also self-insure
What are the risk areas for audiology?
Earmold impressions
Cerumen removal
Failure to diagnose
Infection control
Programming, verification, and testing
Informed consent
Documentation
What are the 12 patient safety goals for the joint commission?
To improve the accuracy of patient identification
To improve the effectiveness of caregiver communication
To improve the safety of using medications
To reduce the risk of health care-associated infections
To accurately and completely reconcile medications across the continuum of care
To reduce the risk of patient harm resulting from falls
To reduce the risk of influenza and pneumococcal disease in institutionalized older adults
To reduce the risk of surgical fires
To implement applicable National Patient Safety Goals and associated requirements by components and practitioner sites
To encourage patients’ active involvement in their own care as a patient safety strategy
To prevent health care-associated pressure ulcers
To organize and identify safety risks inherent in its patient population
What is root cause analysis (RCA)?
A step by step method that leads to the discovery of a fault’s first or root cause
The process should be “Thorough and Credible”
What is an adverse event?
Untoward incidents, Therapeutic misadventures, iatrogenic injuries (caused by you), or other occurrences directly associated with care or services provided. Adverse events may result from acts of commission or omission
What is a sentinel event?
A death
