The healthcare industry is devoted to reducing as much risk as possible. However, the healthcare industry is not risk-free for any patient that transacts within it.
Over 10% of all deaths in the United States are caused solely by medical error. Over 250,000 Americans die annually due to medical errors. And that may be a conservative estimate – some experts believe that the amount may be higher.
Some studies suggest that some physician-related medical errors may be more attributable to professional burnout than negligence. But that fact is little compensation for grieving families or the reputations of affected medical institutions.
Healthcare organizations use risk management to proactively and systematically protect patient safety as well as the organization’s:
- Reimbursement levels
- Brand value
- Accreditation
- Community standing
- Assets
- Market share
But there are many kinds of risks involved in healthcare.
Let’s talk about risk management in healthcare.
OptiMed Hospitalists specialize in risk management and relationship-based medicine. Take a look at our current locations and services to get the help you need.
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What is Risk Management in Healthcare?
Risk is considered anything that has the potential to result in an unforeseen event or a loss. Risk can be found in almost any area, including the financial sector, transportation, markets, liquidity, and, of course, health care.
While there is no way to prevent all types of risk, there are ways to manage them. This is where risk management comes into play.
The clinical and administrative systems, processes, and reports used to detect, monitor, analyze, reduce, and prevent hazards are referred to as risk management in healthcare.
Risks in the health care sector include, but are not limited to:
- Faulty equipment
- Unexpected hazards
- Medical malpractice
- Incorrect procedures
To keep people safe and secure while keeping costs down, the health care business must manage these and other risks.
Hospitals, long-term care homes, and other healthcare companies can reduce the risk of loss by implementing risk management measures.
What is a Health Risk Manager in Healthcare?
Risk managers in the healthcare industry come from various professional and educational backgrounds.
They are, by nature, adaptable experts who play an important role in ensuring the safety and trustworthiness of healthcare facilities.
The following is a list of what they do:
- Risk financing
- Event and incident management
- Clinical, financial, legal, and general business aspects
- The psychological and human factors of health care
- Statistical analysis
- Insurance
- Claims management
Nevertheless, their job descriptions are exclusive to the companies they are employed.
What Are the Eight Domains in the Evolution of Risk Management in Healthcare?
Hospitals and other healthcare facilities are embracing a more holistic approach called Enterprise Risk Management (ERM) to expand the role of risk management.
Standard risk management features like patient safety and medical liability are included in ERM and a “big picture” approach to risk across the enterprise.
ERM is divided into eight risk domains:
- Operational
- Clinical & Patient Safety
- Strategic
- Financial
- Human Capital
- Legal & Regulatory
- Technological
- Environmental- and Infrastructure-Based Hazards.
What Are the Tenets of Risk Management in Healthcare?
There are at least 5 things that any healthcare organization should prioritize to successfully carry out their risk management plan.
Doing so will save new and old employees time, money, and stress.
Let’s go over each one.
Develop a Healthcare Risk Management Plan
To assess potential hazards, healthcare executives should undertake organization-specific risk analysis.
The analysis should help identify:
- What may be possible to happen, according to the analysis?
- What is the probability of something happening (risk measurement)?
- What would be the consequences if something went wrong?
- How and to what extent can the likelihood of something happening be reduced in advance?
- What can be done (and to what extent) to lessen the impact?
- What is the risk of exposure, and what cannot be prevented in advance?
Risk managers can use analysis results to evaluate the likelihood of various unfavorable events and their consequences and rate prospective risks in terms of severity.
Only then can plans for reducing risks and dealing with them correctly can be created.
Risk management plans are also subjected to quality checks to ensure that the proposed interventions and actions are addressed as real-world issues.
Once a strategy is in place, it is closely monitored and adjusted as necessary.
Develop Proactive Strategies for Patient Protection
While minimizing potential financial penalties is important, the requirements of the patients are usually the top focus.
Institutional Review Boards (IRBs) examine proposed research plans before they are executed in clinical studies, for example, to guarantee minimal danger to human subjects.
Risk management plans must include patient-specific hazards and be thoroughly documented and available to individuals who work with patients.
Many patient risks can be reduced by properly training physicians and staff, creating effective employee communication, providing counseling to those who work with patients, and conducting competency assessments.
Other threats to patient safety can be reduced by implementing patient-specific risk management measures like:
- Communicating with patients
- Not filling expired prescriptions
- Prevent falls and immobility
- Sufficient record retention
- Following up on missing test results
- Tracking missed appointments
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Vendor Risk Management Strategies
To safeguard patients from injury and enforce business due diligence, credentialing techniques that involve risk audits of third-party contractors are critical.
Risk managers are in charge of overseeing the recruiting methods of external contractors, business associates, and workers and the protocols and policies that govern them.
Risk managers should not only collaborate with other key stakeholders like Human Resources, Supply Chain, Legal, and Materials Management to identify and implement meaningful policies.
Risk managers should also evaluate potential technologies to streamline the validation and ongoing monitoring of third-party business associates across federal and state sanction databases (FAC, FDA, LEIE, and SAM).
At OptiMed, we strive to be the most innovative, patient-focused, and sought medical group looked after. That is why our hospitalists are so well-spoken in many places. You can check out our list of our providers and look at our medical directory to see how friendly we are.
Healthcare System Data Security
To protect the organization from cyber assaults, risk managers must focus on formulating strategies and collaborating closely with their IT counterparts.
Personal health information (PHI) data is greatly sought after by data thieves. Hackers are employing increasingly sophisticated tactics to steal data and resell it on the black market.
Healthcare providers must make increasingly significant expenditures in cybersecurity to reduce the danger of:
- Data breaches
- Potential costly lawsuits
- Damage to the healthcare facilities’ reputation
All of these things can put a healthcare facility’s finances in jeopardy. That is why healthcare institutions and facilities should develop complete strategic cybersecurity alliances to assess possible risks and implement preventative plans.
Learn From “Near Misses” and “Good Luck”
When mistakes or adverse events are avoided due to luck or intervention, “near misses” and “good luck” occur.
However, these types of occurrences are frequently the most effective methods for detecting and preventing risk.
Healthcare providers should cultivate a culture that encourages reporting to preventative measures and best practices that have been proven to work.
Looking for a professional team of hospitalists to help you monitor your risk management and health care facility needs? We can help! Get in touch with us today