Educate staff for late-night risks
Risk managers can’t be on site all the time, especially when there are only one or two staff members in the department, but you can create deputy risk managers by training those employees who work the graveyard shift, weekends, and holidays.
At one hospital where he was risk manager, R. Stephen Trosty, JD, MHA, ARM, CPHRM, president of Risk Management Consulting in Haslett, MI, and a past president of the American Society for Healthcare Risk Management (ASHRM) in Chicago, focused first on the administrative staff who took phone calls from concerned patients or family, as well as the head of nursing and chief of staff. They were trained annually on essential risk management issues, with an emphasis on how to respond to weekend situations that could not wait until Monday.
"We attempted to have personnel who were familiar enough with risk management actions and approaches in order to provide immediate responses until the risk manager arrived on his or her next day. If the administrative personnel, head of nursing, or chief of staff felt that it was necessary or appropriate, the risk manager was called," Trosty says. "He or she would either come into the facility or provide guidance on the phone that would allow the staff member on call to provide immediate and appropriate risk management services."
The risk manager was to be called if the individual employeess had any concerns or felt that the situation was beyond what they could handle. Afterward, these situations were reviewed with the members of the administrative staff , the head of nursing, and the chief of staff to assess the response and, if necessary, to determine how the situations should have been handled better.
This training was a requirement for all new hires and on an annual basis for all employees, including administrative and medical staff. Identified risk management situations and issues from the facility were incorporated into this training. "We wanted all staff members to have at least a basic understanding of risk management principles, how to identify issues that should be reported to risk management, what method to use for such reporting, and when it was necessary to also alert senior personnel," Trosty says. "We attempted to train each member of the staff to assist with being the eyes and ears for risk management on a regular and continuous basis."
The large and medium size hospitals in which he worked also offered risk management seminars for physicians and provide continuing medical education (CME) credits.
"We would present sample situations that involved risk management and clinical-related issues. We would discuss the sample cases in terms of the clinical issues and problems that existed, how they presented risk management issues and concerns, appropriate responses to these issues, lessons learned," Trosty says. "We found that physicians enjoyed these types of presentations, and we got relatively decent attendance and participation. That is not to say that the CME did not assist in getting them to show up."
