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Risk Management for Healthcare Clinics

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Since healthcare clinics treat a wide variety of conditions, including asthma, cardiovascular disease, diabetes, and hypertension, it is imperative healthcare clinics ensure that patients receive the appropriate level of care. Additionally, many healthcare clinics also provide obstetric care, a high-risk area.

Risk management for healthcare clinics includes any activity, process, or policy designed to reduce liability exposure. This involves all aspects of a healthcare clinics infrastructure and services, including clinical care, financial matters, facility maintenance, fire safety, and compliance with applicable laws and regulations.

Top risk management issues for healthcare clinics are:

  1. Communication
    • Test results reporting and tracking
    • E-mail
    • Physician-to-physician communication
    • Patient education

  2. Obstetrical risk management

  3. Special patient concerns
    • Newborns
    • Minors
    • Elderly
    • Pregnant patients

Not only must a healthcare clinic risk management plan be designed to support the mission and vision of the clinic as it pertains to clinical risk and patient safety, but it also must address visitor, third party, volunteer, and employee safety. Additional considerations are potential business, operational, and property risks.

For a successful risk management program, management, providers, volunteers, and staff must operate as a team with all members participating in risk management protocols. This means that team members must be comfortable with the following:

  • Readily and proactively identifying unsafe conditions and hazards
  • Reporting or analyzing medical or patient care errors
  • Opening discussing mistakes
  • Making suggestions for systemic improvements

The goals and objectives of a patient safety and risk management program for a healthcare clinic are:

  • To continuously improve patient safety and minimize and/or prevent the occurrence of events, errors, and system breakdowns that can lead to harm for patients, staff, volunteers, visitors, and others through proactive risk management and patient safety activities.
  • To minimize adverse effects of errors, events, and system breakdowns when they do occur.
  • To minimize losses to the organization overall by proactively preventing, identifying, controlling, and analyzing potential clinical, business, and operational risks.
  • To assure compliance with regulatory, legal, and accrediting agency requirements.
  • To protect human and intangible resources, such as reputation.

There are 16 risk management practices that healthcare clinics should include in their risk management program to reduce medical malpractice claims and ensure patient safety.

  1. Establish an active quality improvement program – includes reviewing clinical outcome data and conducting long-term projects aimed at improving clinical care.
  2. Appropriate use of clinical protocols – establishing guidelines for providing clinical care that healthcare practitioners use.
  3. Clear communication with patients – assuring patients have a voice in determining their care and receive information about their care in a way that they can comprehend (includes translation services).
  4. Clear communication with providers – communication by healthcare clinic leadership about provider roles and responsibilities, and establishing communication between providers.
  5. Comprehensive patient medical records – documentation of the patient healthcare (either paper or electronic).
  6. Credentialing of healthcare professionals – verification that healthcare providers meet all required educational and licensing requirements.
  7. Documentation of informed consent – adequately informing patients about the risks and benefits of their treatment.
  8. Formal patient grievance mechanism – collecting, analyzing, and addressing complaints received from patients and/or staff.
  9. Internal incident reporting system – collecting and analyzing information on adverse events that occur within the healthcare clinic resulting from inappropriate care.
  10. Ongoing peer review of patient cases – reviewing medical records or patient cases by healthcare professionals to ensure that appropriate care was provided.
  11. Onsite assessment of risks and risk management practices – assessing the potential risks to the healthcare clinic and the clinic’s activities to reduce its risks.
  12. Patient tracking system – ensuring that key patient information, such as test results, missed appointments, and care at different healthcare institutions, is not overlooked.
  13. Privileging of healthcare professionals - verifying, on a routine basis, that practitioners have the appropriate clinical competencies, and the ability to perform clinical procedures effectively.
  14. Regular patient satisfaction survey – surveying patient satisfaction with the level of service and clinical care that they received.
  15. Regular staff training on risk management – providing staff either onsite or offsite training on topics related to risk management.
  16. Up-to-date policies and procedures on risk management – having written documentation that explicitly describe a healthcare clinic’s operations and processes related to risk management.

Note: Assessments and surveys can be done by the healthcare clinic or by outside consultants.

At Highland Risk Services, we are familiar with the many facets of a risk management program that serves the specialized needs of the healthcare clinic environment. We are ready to help you assess the needs of your clients. Please let us serve you by calling one of our two offices in Chicago at 847-832-9100 or Lansing at 517-676-7100.

www.highlandrisk.com

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Tags: risk management, Highland Risk Services, insurance, commercial insurance, healthcare facilities insurance

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