Risk Management Flashcards
What is risk
Possibility of suffering loss or harm
A dangerous element or factor
Something or someone that creates a hazard - can be good too though
Risk management is what
Trying to avoid risk/harm
Identify, analyze/assess, and address potential risk or threats
Processes to avoid accidents, decrease liability when incidents occur and improve quality
Protects assets from loss
Goals of risk management
Meet requirements
Economic
Personal (your own safety and safety of everyone you serve)
Societal (provide quality care in safe manner)
Risk assessment - you are looking at
What can go wrong
What is the likelihood that it will go wrong
What are the consequences
Risk Assessment includes
Risk identification Risk analysis Risk evaluation Risk control - risk avoidance and control/manage risks Constant monitoring Transfer risk
Risk Assessment includes - Risk identification
Identify possible risks that can happen - ways to identify:
Daily checks, pt surveys, audits
Risk Assessment includes - Risk analysis
Analyze each risk that you identified and determine how much risk is there
Look at all the processes you have in place - personnel, environment
Risk Assessment includes - Risk evaluation
Evaluate all the data and determine where you are at and where you need to be
Calculate the risk - compare the risk you identified to where you want to be
Risk Assessment includes - Risk Control
Avoidance - avoid that activity
Control/Manage - put something in place to prevent that risk from happening
Risk Assessment includes - Constant monitoring
Looking at policies and procedures and making sure that everyone understands them and that changes are being made as needed
Risk Assessment includes - Transfer the risk
Sharing the risk? Who shares in the risk of you treating somebody? - Academic institution - Patient - Physician
General and Medical Liability Insurance Carriers - includes what
Standards of care
Standards of practice
Performance improvement program
Risk management program
General and Medical Liability Insurance Carriers - Standards of care
Legal concept - are you doing what another prudent practitioner would be doing
General and Medical Liability Insurance Carriers - Standards of Practice
More of a regulatory concept - are you competent to provide those services
General and Medical Liability Insurance Carriers - Performance improvement program
Are you involved in any of these
Are you always trying to improve - con ed
General and Medical Liability Insurance Carriers - Risk management program
Do you have a risk management program in your clinic
Are you always trying to mitigate the risk
General and Medical Liability Insurance Carriers - Risk avoidance vs. Risk sharing
Avoidance = stay away from those activities Sharing = doing things to get rid of that risk (drivers ed, con ed)
General and Medical Liability Insurance Carriers - Two elements to identify potential issues
The things you do frequently or infrequently
The things that have high risk or low risk
Frequently tends to be a lower risk because you’ve been doing it longer and you learn from it each time
Areas of potential risk
Reputation Human capital Hazard Market Operations
Areas of potential risk - Reputation risks
Quality care
Communication
Personnel interactions
Confidentiality
Areas of potential risk - Reputation risks - Quality care
In PT practice your reputation could be tarnished providing quality care
Harder to come back from 1 bad pt experience than to build a new one
Areas of potential risk - Reputation risks - Communication
Communication with therapists and patient that gets back to the case manager for example
Areas of potential risk - Reputation risks - Personnel interactions
Good repour with your patients - if something does go wrong, less likely to build up into anything
Areas of potential risk - Reputation risks - Confidentiality
HIPPA - big reputation risk
If big enough can get into media
Areas of potential risk - Human capital risks
Current job descriptions Backup people for critical roles Work force shortages Hiring Termination Failure to perform - malpractice
Areas of potential risk - Human capital risks - Current job descriptions
As a practitioner you need to ensure that you have current job descriptions
You are getting the right person for the job
Always have to keep it updated and will help with ADA too
Areas of potential risk - Human capital risks - Backup people for critical roles
Especially with private practice - critical roles like billing and insurance
Need to have a back up to make sure that money comes into your practice if that person is out
Areas of potential risk - Human capital risks - Work force shortages
You have 3 PTs out and lots and lots of pts
- PTs burn out, rushed will end up with dec quality care, pt outcomes not as good, unhappy employees - so what will you do for these kind of shortages
Areas of potential risk - Human capital risks - Hiring
Need to check for accurate credentialing - background checks
Areas of potential risk - Human capital risks - Termination
Lawsuit - unlawful termination - need to have policies and procedures in place and make sure you follow those consistently with everyone at termination
Areas of potential risk - Human capital risks - Failure to perform - malpractice
As a practice owner, you have liability to what what your employees are doing
Areas of potential risk - Hazard Risk
Dangers
Natural disasters (need to have plan in place) Hazardous materials (identifying materials you and your employees are exposed to - mitigate the risk with education, material safety data sheet) Handwashing - specific, maybe broader would just be infection control
Areas of potential risk - Market Risk
Constituents you work with
Changes in target market - large employer charges insurance plan for rehab, change in referral base, population shift, technological advances
Cash flow
Areas of potential risk - Operations
Operation day to day of your business
Clinical equipment/furnishings Environmental safety (ADA, liability) Security and personal safety Patient care safety Documentation (audits, medical records, other records)
Malpractice
Type of negligence that pertains to professionals, specifically:
- failure to provide the degree of care required of a professional under the scope of license
- Resulting in injury, death or damage
Any health care professional can be sued
How does a patient define malpractice
Their perception of wrong doing
Feel that something was done incorrectly or should have been done and wasn’t
Elements of malpractice
Duty
Breach
Cause
Harm
How can you prevent a pt feeling like some malpractice has gone on
Being upfront Open communication Tell the truth Don't try to cover it up Develop a good relationship PT lawsuits are small % of healthcare lawsuits
Incident reports - what is an incident
Any event that happens outside of the ordinary
Incident reports - Report of an injury
Reporting on the event that happened
Incident report is a report of
inappropriate action
Can be various types
What is included on the report
The names of those involved, including witnesses What occurred, When, and Where Outcome of the occurrence Action taken Plan for follow up
What is not included in the incident report
Interpretive information like the -
Cause of the occurrence
Corrective actions taken for the future
Incident reports compliance
Incident reports depend on employees complying with the IR requirements (quality assurance program)
Not all actually report occurrences
Types and causes of errors
Communication between providers
Education provided to pts, caregivers, other providers
Documentation of interventions
Supervision over pts, students, other providers
Tx providers
Inattentive blindness
Types and causes of errors - Inattentive blindness
Capacity
Expectation
Mental workload
Types and causes of errors - Inattentive blindness - Capacity
We have a certain capacity for how we practice - if it is hindered by lack of sleep, alcohol, or drugs - will set you up for attentiveness
Types and causes of errors - Inattentive blindness - Expectation
If you are expecting something to happen
You took them up the stairs 4 times before and all was fine so you think this time will be too
Types and causes of errors - Inattentive blindness - Mental workload
So much to do and you are multitasking and the pt gets injured
Sentinel event
Incidences or occurrences that result in a death or serious physical or psychological injury
Event that occurs independently of a pt’s condition
Commonly reflects a hospital system and process deficiency, results in unnecessary outcome for patients
Deposition
Testimony taken in writing under oath
Risk management - things to remember
Remember the ounce of prevention adage
Be observant and pro active
Be aware of an always adhere to policies and procedures - 100% of the time
Accidents do happen
Respond swiftly and appropriately
Look upon accidents as opportunities to improve
RM plan - potential components
Purpose Authority and role of risk manager Scope - collaboration, P&P, liability exposures, influence Objectives Components
Practice risk management for your safe patient care
Be involved and proactive in your organizations quality initiatives
- quality management
- risk management
- infection control
- patient safety principles
Stay up to date
Be aware of the types and causes of errors
