Chubb Healthcare

How Healthcare Risk Managers Make a Difference

By Diane Doherty, MS, CPHRM

In an industry marked by healthcare consolidation and unprecedented change from new delivery and alignment models, risk managers remain a steady force in volatile times. Uniquely positioned at the intersection of patient safety, clinical care, regulatory compliance and finance, risk managers proactively address a myriad of liability threats on a day-to-day basis, including diagnostic and therapeutic errors, hazardous conditions, workplace violence, data breaches, social media missteps, and natural disasters, among other exposures.

Touching nearly every corner of a healthcare enterprise, risk managers strengthen organizational operations, both proactively – by identifying, preventing and mitigating loss – and reactively – through real-time damage control. It’s important that we recognize and acknowledge how professional risk managers make the following everyday differences in their organizations:

Detecting risk exposures

Risk cannot be appropriately mitigated without a comprehensive system for tracking and recording adverse occurrences. Risk managers work at the center of that system, categorizing incidents according to type of event, time of day and department, as well as how frequently an event occurs and its potential for financial impact. By implementing clear, detailed policies regarding incident reporting, risk managers ensure occurrences are promptly detected, investigated and remediated through staff training, improved communication protocols and other proactive practices.

Impacting quality of care

Risk managers make hundreds of decisions in busy healthcare settings that ultimately improve the quality of life for patients. By remaining up-to-date on industry trends, they are well suited to help shape proactive patient care practices. Trained to conduct detailed risk analyses of potential exposures, risk managers quantify in relevant terms the impact of risk and also define practical measures that providers and staff can take to prevent them from occurring.

Educating physicians, nurses and other providers

On any given day, risk managers can be found engaging staff through timely and meaningful in-service programs. Their goal is to not only inform providers of industry trends and the potential impact they have on the delivery of care, but also to reassure them that proactive changes protect patients, employees, volunteers and the organization’s financial bottom line.

Creating realistic policy

Risk managers understand firsthand the benefits of uniform policies and procedures, and willingly accept the challenge of maintaining an organization’s listing of current rules and practices. In order to ensure that policy remains accurate and relevant, risk managers also work in concert with leaders, other managers, committees and advisory groups to continually examine factors that can dictate change in practice, such as an organization’s capabilities, resource levels, liability experience and performance ratings.

Bolstering documentation practices

The electronic or written patient record is the first line of defense in professional liability lawsuits. As such, risk managers dedicate a good portion of their time to addressing the major pitfalls of documentation, which include inaccuracy and incompleteness. They play a pivotal role in engineering standard documentation templates to help generate consistent content, as well as reviewing and revising protocol to ensure external records are uniformly incorporated into the patient chart – such as laboratory and diagnostic results, outside clinical records and handwritten notes. Risk managers also serve a central role in ongoing review of record keeping systems and associated policies, especially with respect to important legal requirements such as the Health Insurance Portability and Accountability Act.

Managing crisis and near-miss events

Last, but certainly not least, risk managers play an integral role in responding to crisis and near-miss events, particularly with respect to patient evacuation, staff control, data and record protection and continuity of operations. They readily respond to inquiries from patients, family members, governing leaders and media outlets in the wake of a critical mishap. In fact, they are often the first to receive a call following an event and are looked upon by leadership to guide the essential components of medical disclosure and media strategy. In today’s challenging climate, a robust risk management program requires more than a written plan; it calls for a qualified risk manager to bring it to fruition. Please join us at Chubb in thanking professional risk managers nationwide for the countless ways they impact patient safety and influence positive changes in the delivery of healthcare.

Risk managers understand firsthand the benefits of uniform policies and procedures, and willingly accept the challenge of maintaining an organization’s listing of current rules and practices. In order to ensure that policy remains accurate and relevant, risk managers also work in concert with leaders, other managers, committees and advisory groups to continually examine factors that can dictate change in practice, such as an organization’s capabilities, resource levels, liability experience and performance ratings.

Bolstering documentation practices

The electronic or written patient record is the first line of defense in professional liability lawsuits. As such, risk managers dedicate a good portion of their time to addressing the major pitfalls of documentation, which include inaccuracy and incompleteness. They play a pivotal role in engineering standard documentation templates to help generate consistent content, as well as reviewing and revising protocol to ensure external records are uniformly incorporated into the patient chart – such as laboratory and diagnostic results, outside clinical records and handwritten notes. Risk managers also serve a central role in ongoing review of record keeping systems and associated policies, especially with respect to important legal requirements such as the Health Insurance Portability and Accountability Act.

Managing crisis and near-miss events

Last, but certainly not least, risk managers play an integral role in responding to crisis and near-miss events, particularly with respect to patient evacuation, staff control, data and record protection and continuity of operations. They readily respond to inquiries from patients, family members, governing leaders and media outlets in the wake of a critical mishap. In fact, they are often the first to receive a call following an event and are looked upon by leadership to guide the essential components of medical disclosure and media strategy.

In today’s challenging climate, a robust risk management program requires more than a written plan; it calls for a qualified risk manager to bring it to fruition. Please join us at Chubb in thanking professional risk managers nationwide for the countless ways they impact patient safety and influence positive changes in the delivery of healthcare.

The material presented in this article is not intended to provide legal or other expert advice as to any of the subjects mentioned, but rather is presented for general information only.  You should consult knowledgeable legal counsel or other knowledgeable experts as to any legal or technical questions you may have.

ABOUT CHUBB

Chubb is the world's largest publicly traded property and casualty insurance company, and the largest commercial insurer in the United States. With operations in 54 countries and territories, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients. For more than 25 years, healthcare organizations have relied on Chubb for insurance products and services that provide an effective insurance program for managing their risk. The company has a broad appetite, and serves a wide range of organizations—from an assisted living facility to an urgent care center to a nationally recognized children’s hospital.