Running head: Week 6 You Decide

Malpractice, Tort Reform, Institutional Ethics Chandra Beasley Keller Graduate School of Management Health Rights and Responsibilities HSM 542 March 4, 2013 Professor Gomillion

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Malpractice, Tort Reform, Institutional Ethics Risk Management Plan for Little Falls Hospital Patient Safety and Risk Management Program 1. Purpose:

The Risk Management Plan is designed to support the mission and vision of Little Falls Hospital as it pertains to clinical risk and patient safety as well as visitor, third party, volunteer, and employee safety and potential business, operational, and property risks

2. Culture Principles: The Patient Safety and Risk Management Program supports the Little Falls Hospital philosophy that patient safety and risk management is everyones responsibility. Teamwork and participation among management, providers, volunteers, and staff are essential for an efficient and effective patient safety and risk management program. The program will be implemented through the coordination of multiple organizational functions and the activities of multiple departments. Little Falls Hospital supports the introduction of a just culture that emphasizes implementing evidence-based best practices, learning from error analysis, and providing constructive feedback, rather than blame and punishment. In a just culture, unsafe conditions and hazards are readily and proactively identified and admitted, medical or patient care errors are reported and analyzed, mistakes are openly discussed, and suggestions for systemic improvements are welcomed. Individuals are still held accountable for compliance with patient safety and risk management practices. As such, if evaluation and investigation of an error or event reveal reckless behavior or willful violation of policies, disciplinary actions can be taken. The Little Falls Hospital Risk Management Plan stimulates the development, review, and revision of the organizations practices and protocols in light of identified risks and chosen loss prevention and reduction strategies. Good doctor-patient relationship is a vital component in preventing malpractice lawsuits. It is not just about providing good medical care but is also the essence of the problem of a medical malpractice.

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3. Governing Body Leadership:

The success of the Little Falls Hospital Patient Safety and Risk Management Program requires toplevel commitment and support. The governing board authorizes the formal program and adoption of this Plan through a resolution documented in board meeting minutes. The governing board is committed to promoting the safety of all patients, visitors, employees, volunteers, and other individuals involved in organization operations. The Patient Safety and Risk Management Program are designed to reduce system-related errors and potentially unsafe conditions by implementing continuous improvement strategies to support an organizational culture of safety. The governing body empowers the organization leadership and management teams with the responsibility for implementing performance improvement and risk management strategies. The Patient Safety and Risk Management Program are administered through the risk manager and/or designee, who reports to the administrator or the CEO. The risk manager interacts with administration, staff, medical providers, and other professionals and has the authority to cross operational assignments in order to meet the goals of the program. The risk manager sets the activities of the Patient Safety/Risk Management Committee. The committee meets regularly and includes representatives from key clinical and services. Just to mention a few of the personnel that could join the team are Barbara Gillium who is the Director of Radiology and Max Dillon, the Hospital Pharmacist. The composition of the Patient Safety/Risk Management Committee is designed to facilitate the sharing of risk management knowledge and practices across multiple departments and to optimize the use of key findings or issues from risk management activities in making recommendations to reduce the overall chance of adverse events and improve patient safety. The Committees activities are an integral part of a patient safety and quality improvement and evaluation system. Documentation of the designation of the risk manager is contained in the Patient Safety Risk Management Plan. The risk manager is responsible for overseeing day-to-day monitoring of patient safety and risk management activities and for investigating and reporting to the insurance carrier actual or potential clinical, operational, or business claims or lawsuits arising out of the organization, according to requirements specified in the insurance policy and/or contract. The risk manager serves as the primary contact between the organization and other external parties on all matters relative to risk identification, prevention, and control. The risk manager oversees the reporting of events to external organizations, per regulations and contracts, and communicates analysis and feedback of reported risk management and patient safety information to the organization for action.

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4. Goals: * Continuously improve patient safety and minimize and/or prevent the occurrence of errors and events leading to harm to patients, staff, volunteers, visitors, and others through proactive risk management and patient safety activities. * Minimize losses to the organization overall by proactively identifying, analyzing, preventing, and controlling potential clinical, business, and operational risks. * Facilitate compliance with regulatory accrediting agency requirements like the 2010 National Patient Safety Goals which states: 1. Use at least two ways to identify patients. For example, use the patients name and date of birth. This is done to make sure that each patient gets the correct medicine and treatment. 2. Make sure that the correct patient gets the correct blood when they get a blood transfusion. 3. Before a procedure, label medicines that are not labeled. For example, medicines in syringes, cups and basins. Staff should do this in the area where medicines and supplies are set up. 4. Take extra care with patients who take medicines to thin their blood. 5. Record and pass along correct information about a patients medicines. Find out what medicines the patient is taking. Compare those medicines to new medicines given to the patient. Make sure the patient knows which medicines to take when they are at home. Tell the patient it is important to bring their up-to-date list of medicines every time they visit a doctor. 6. In order to improve staff communication staff should get important test results to the appropriate professional on time. * Protect human and intangible resources (e.g., reputation). 5. Hospital Professional Liability Insurance: Liability insurers are strong proponents of risk management; in fact, insurers can cut premiums for doctors and healthcare facilities who embrace risk management policies. Little Falls Hospitals Executive Board along with the Risk Management Department should discuss the possibility of changing or renewing its hospital professional liability insurance program which is a

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complex process with many decision points. There are several components that should be agreed upon when contracting or renewing the policies, some of the key points are the following: * Is the policy form a "pay on behalf" or an "indemnify"? * Does the policy form cover defense in addition to or within limits? * Is the coverage written on an occurrence or claims-made basis? * If coverage is on a claims-made basis, what is the retroactive date? * Is the policy rated on a flat or auditable basis? * How does the policy define "medical services" or "professional liability"? * Who is considered an insured? It is possible that when negotiating either renewal or change of insurance carrier to prove that Little Falls hospital does maintain a Risk Management Policy in order to get cuts on the premium costs. Most of the time the insurance carrier also provides a personalized Risk Management Plan or its own insurance agents that do a thorough study of the establishment identify risks and issues and proposes an alternative solution. If Little Falls Hospital opts to choose this method, it could also save considerable costs, resources, and time; however, Little Falls Hospital would have to comply with all the needed resources and documentation to elaborate their plans. A great deal of a Risk Management Policy is not only to define, produce, implement, supervise and reevaluate outcomes but also, to offer a clean cut ERP System (Enterprise Resource Planning). ERP is business management software that allows an organization to use a system of integrated applications to manage the business. There are many of these ERP systems in the market to explore and possibly purchase such as the First Priority Enterprise. It contains a Risk Manager Module that can be featured to the needs of the Risk Management Department in Little Falls Hospital and gathers data, documentation, compilation of events, complaints, reports; link to the hospital professional insurance, etc. The basic goal is provide one central repository for all information that is shared by all the various ERP facets in order to smooth the flow of data across the organization. This would definitively be a big but necessary investment in hospital technology that could potentially cut operational costs, reduce workload to non-risk management departments; store target information in its appropriate module, provide internal audit, risk profiling and analysis, and last but

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not least increase controls, reliability, efficiencies and productivity throughout all the departments of Little Falls Hospital.

Week 6 You Decide References

Accreditation, Health Care, Certification | Joint Commission. (n.d.). Accreditation, Health Care, Certification | Joint Commission. Retrieved October 13, 2012, from http://www.jointcommission.org/

IRMI Risk Management and Insurance Education and Information. (n.d.). IRMI Risk Management and Insurance Education and Information. Retrieved October 13, 2012, from http://www.irmi.com/

"Welcome to First Priority. ( n.d.) Governance Risk and Compliance Solution. Retrieved October 13, 2012, from http://www.firstpriorityenterprise.com/

Pozgar, G. D. (2007). Legal Aspects of Health Care Administration. Sudbury: Jones and Bartlett Publishers.

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