The Importance of Risk Management in Healthcare
Risk Management in Healthcare provides organizations the opportunity to mitigate any risk that may harm them. To achieve this goal, Risk Managers develop strategies to manage risks related to patient record access, protection, and more. In these strategies, they also implement contingency plans for unexpected catastrophic events and evaluate administrative systems & processes that enable operational and financial efficiency.
And because risks are present in all situations, employees must be trained in risk mitigation strategies so they can reduce risk as they perform their job duties.
In theory, this is an excellent plan, but there is no way to protect your organization from every risk it faces. But it is possible to mitigate or decrease the likelihood of many of these risks from happening. In this article, we are going to go over some ways you can avoid risks in the healthcare industry.
According to the American Society for Healthcare Risk Management (ASHRM), “Enterprise risk management in healthcare promotes a comprehensive framework for making risk management decisions which maximize value protection and creation by managing risk and uncertainty and their connections to total value.”
What does Risk Management Mean in Healthcare?
Risk Management is the process of identifying risk factors by analyzing processes and practices that are in place and following procedures to address those risks.
In healthcare, a strong risk management plan means the difference between life and death. Here are some examples of where these risks can come up:
- Equipment malfunction.
- Malpractice.
- Accidents and mistakes in procedures.
- Exposure to virus and disease.
While these risks all sound scary, they are preventable if a strong risk management plan is set in place. But it is important to remember that putting a risk management plan in place is not enough. You need to make sure all employees are on board and following procedure. This means knowing what to do when a risk arises and who and when to report it to.
Healthcare Risk Managers can identify and evaluate all the Risks a Company would face and work to reduce injury to patients, staff members, and visitors within an organization. Risk managers work proactively and reactively to either prevent or minimize the damages following an event.
The Importance of a Risk Manager
It is difficult for one person to handle risk on their own. It is beneficial for any organization to have a dedicated risk manager to rely on. In health care risk management, it is important to have someone in the field to know what to look out for and how to evaluate unique risks.
For example, if a medication has dangerous side effects, but still offers meaningful results in curing a chronic problem, a risk manager needs to investigate this medication. Your risk manager will help you determine if giving this medication to patients is worth the potential lawsuits that could arise from side effects or other problems. Your risk manager also helps you decide whether you have the right insurance in place for protection.
Health care risk managers look at more than just medications. They can help you look at basic procedures, everyday practices, and protocols to determine where there are weak points and where to make changes.
In conclusion, Risk Managers are trained to handle several settings determined by the specific organizational needs. One thing in common these professionals have is that they typically work in the following areas of medical administration:
- Financing, insurance, and claims management.
- Event and incident management.
- Clinical research.
- Psychological and human healthcare.
- Emergency preparedness.
It is also important to take note that due to the dynamic and multifaceted nature of risk management in healthcare, the role is constantly evolving. Some of the current responsibilities of the healthcare risk manager include communicating with stakeholders, documenting, and reporting on risk and adverse circumstances, and creating processes, policies, and procedures for responding to and managing risk and uncertainty. Additionally, risk managers must continually monitor the ever-shifting landscape of the healthcare risk continuum.
Health Care Risk Management Best Practices
As we have seen, Risk Management in Healthcare comprises clinical and administrative systems, processes, and reports employed to detect, monitor, assess, mitigate, and prevent risks.
Deployment of healthcare risk management has traditionally focused on the key role of patient safety and the reduction of medical errors that jeopardize an organization’s ability to achieve its mission and protect against financial liability.
But in the past decades, the Healthcare industry has become increasingly reliant on technology and big data. With the expanding role of healthcare technologies, increased cybersecurity concerns, the fast pace of medical science, and the industry’s ever-changing regulatory, legal, political, and reimbursement climate, healthcare risk management has become more complex over time.
While members of the industry understand the significance of expanding risk management in healthcare beyond patient safety and medical liability, the transition has been slow.
And for this mix of technology, legal practices, and the focus on concerned people, here are some best practices you can follow on your own.
- Do not fill expired prescriptions.
- Follow up on test results.
- Track missed appointments.
- Communicate with patients.
- Make sure your office is clean and accessible.
Another notable best practice to follow is to make sure you and all employees in your practice have up-to-date insurance. This is important because medical lawsuits are expensive, and doctors often must settle.
If you are a risk manager in charge of a mid to large–sized practice, keeping up with who has insurance and who does not is an enormous job. The best way to keep track is to make sure there is a Certificate of Insurance (COI) tracking software in place.
This software allows employees to upload their insurance certificates to the software which reads the cert with Optical Character Recognition (OCR) and makes sure all the limits are met. The software then uses compliance reports to tell you who complies and who needs to update their policy. To learn more about COI tracking for health care, visit SmartCompliance.
