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Risk & Quality - Working Together

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Ann Marie Swindler

on 22 July 2016

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Transcript of Risk & Quality - Working Together

Partners for Patient Safety
Risk and Quality
As It Was........
We learned we are human.....really human.
It became obvious that the way we were doing
things was not preventing harm.
We needed to look at SYSTEMS and PROCESSES.
In 1999, everything changed..................
The role of the risk manager has shifted. Today's risk manager focuses on:
Risk identification and evaluation
Loss prevention
PATIENT SAFETY
Education
Today risk management is focused on systemic
mindfulness and prevention.
Risk Management
Origins in malpractice crisis
Reactive
Event-driven
Protective
Secretive
deny
defend
delay
deflect
Risk Management and Quality were both playing with the same toys, just on different playgrounds.....
Information often went
unshared. Efforts were
frequently duplicated.
Lessons that might have been learned
from adverse events were lost due
to fear of disclosure or fear of loss of
protection from discovery.
"Building safety into processes of care is a more effective way to
reduce errors than blaming individuals."-(IOM, "To Err")
Most of all, the Enterprise Risk Manager focuses on collaborating with and coordinating the efforts of multiple disciplines for the purpose of furthering the shared goals of Quality, Risk Management, and Patient Safety.
As a result, the role of Risk Management has
evolved to include:

Integral roles in Patient Safety

Working to identify and address all sources of risk and loss;


A collaborative relationship with the legal department in investigating adverse events; and


Working with all departments in the hospital to achieve and maintain regulatory compliance.
Risk Management in the
Health Care Setting
A patient suffers an injury as a result of receiving treatment based upon erroneous lab values.

An incident report is filed:
Old Method – No collaboration between departments.
Using a centralized incident management and reporting system = collaboration between QUALITY ,RISK, NURSING, and LAB to determine where the process breakdown took place.
For Example


A Centralized Incident Management and Reporting System:

Improves communication and insight between collaborating departments.

Reduces and contains risks, cuts costs and improves process efficiency.

Trending and analyzing incident data keeps the health care organization one step ahead of the issues they face.

Risk Management in the
Health Care Setting
Turbulent economic times led health care
organizations to take a broader perspective on
managing risks.

Tort Reform was the lawmakers’ response to the turbulent economic times.

There has been a SHIFT from “reactive risk
management” to “strategic risk management”.

Strategic risk management utilizes a centralized
incident management and/or reporting system.
Risk Management in the
Health Care Setting
This lack of centralized reporting led to disparate, duplicative efforts and unnecessary spending.

Relevant trends and patterns were overlooked because it never occurred to one department to share certain information with another.

The study of overall data was difficult or impossible.
Risk Management in the
Health Care Setting

Historically, health care
organizations managed
risks in a reactive manner.

Each department worked
independently to resolve
its own issues.
Risk Management in the
Health Care Setting
Two terms prevalent in risk management literature as defined by the International Risk Management Institute, Inc. (1991), are:

Risk: “Uncertainty arising from the possible occurrence of a given event”.

Exposure: “A state of being subject to loss because of some hazard or contingency”.
Risk Management
“…the process of making and carrying out decisions that will assist in the prevention of adverse events and minimize the effects of those events.”
Risk Management
Enthusiasm without knowledge is like running in the dark.
The lab implements a process to reduce labeling errors in response to repeated patient incidents; however, nursing was not part of the development process, as a result:

The process required multiple revisions;
Patient safety was compromised by the repeated revisions; and
Additional costs were incurred because of the duplicative efforts.
For Example:
Risk Management was introduced into the health care industry in response to the “malpractice crisis”.

Hospitals were facing higher settlements and more plaintiff verdicts.

Higher insurance rates.

Decreased availability of some specialties.
Risk Management in the Health Care Organization
Looking at the elephant......
...from a different angle.
So, now that we've all agreed that sharing information is inportant, where's all this information going to come from?
It's All About Relationships
Respect
Support
Compassion
Shared purpose
Listen...
Check your motives
Examine your assumptions
Make it safe
Now that we have the information, what do we do with it?
Analyze
Utilize
Disseminate
Benchmark
Ann Marie Swindler BSN, JD, CPHRM
And most of all......
Full transcript