Risk Management Flashcards
Define risk and identify its role in pharmacy practice.
- “Anything that threatens the ability of a person or organization to accomplish its mission”
- ## Pharmacists should be aware of risks and how to manage them
relationship between risks and threats
- Risk becomes a threat when there is a probability that a negative outcome will occur after exposure to a hazard
- Non-exposure to a hazard diminishes or eliminates threat
What are the types of risks?
- Speculative
- Pure
Speculative risks
- Chance of benefit or loss, individual decides on amount of risk willing to assume (willing to lose)
- not insurable
Pure risks
- Accidental, unanticipated, or unavoidable
- insurable
Identify the criterias for determining an insurable risk.
- Loss must be measurable in dollar figures
- Loss must be substantial
- Probability of event occurring in population can be accurately calculated
- Sufficiently large number of homogenous individuals with similar risks to make losses predictable
- Insured must have an insurable interest
- Insurance premium must be available for a reasonable cost
Identify the steps in the risk management process
- Establish the context
- Identify and analyze risks
- Evaluate and prioritize risks
- Select a strategy and implement
- Monitor update the program
Identify the steps in the risk management process: Establish the context questions to ask
- What are the goals of the risk management process?
- What are potential vulnerabilities of the business?
- Do employees or patients risk injuries?
- How might the reputation of the business/organization suffer due to a negative outcome?
- Could providing certain goods or services avoid costly negative outcomes?
Identify the steps in the risk management process: Identify and analyze risks specific to pharmacies
- Filling prescriptions
- Counseling
- Deliveries
- Building maintenance
- Sterile compounding
- Technology
- HIPAA
Identify the steps in the risk management process: Evaluate and prioritize risks
Risks with greatest potential for substantial loss should be prioritized first
Identify the steps in the risk management process: Select a strategy and implement
- Determine which risks should be avoided
- Develop policies and procedures
- Secure necessary insurance policies and riders
- Consult with specialists for further advice – attorney, accountant, consultant
What is a rider?
supplemental policies that provide additional coverage for something not included in additional policy for additional charge
Identify the steps in the risk management process: Monitor update the program
- Necessary to meet new challenges, threats, and opportunities
- Continuous quality improvement
Identify the appropriate techniques in managing risks.
- Risk Avoidance
- Risk Prevention / Modification
- Risk Absorption / Retention
- Risk Sharing / Transfer
Identify the appropriate techniques in managing risks: Risk Avoidance
- Avoid the risk
- Sometimes impractical
Identify the appropriate techniques in managing risks: Risk Prevention / Modification
- Smoke alarms
- Security systems
- Computer software
- Policies and Procedures
- Employee training and development
Identify the appropriate techniques in managing risks: Risk Absorption / Retention
- Accepting losses (ex. shoplifting, expired inventory, unsold front end merchandise)
- Insurance deductibles – higher in exchange for lower premiums
- Absorbing cost of risk altogether – opt out of insurance
Identify the appropriate techniques in managing risks: Risk Sharing / Transfer
- Insurance
* Often used in conjunction with risk prevention (Ex: Smoke alarm in conjunction with fire insurance)
What are the common insurance terms?
- Premium
- Deductible
- Coinsurance
- Copayment
- Out-of-pocket maximum
Premium
amount you pay for health insurance every month
Deductible
amount you pay for covered health care services before your insurance plan starts to pay
Coinsurance
% of costs you pay after you’ve paid your deductible
Copayment
fixed amount you after you’ve paid your deductible
Out-of-pocket maximum
the maximum you have to pay for covered services in a plan’s year
