By Gregory Freeman, Author

EXECUTIVE SUMMARY

Risk managers will fare best in the future by maintaining skills in a broad range of topics. New risks will emerge as the healthcare industry evolves.

• Risk managers are taking on more prominent roles in healthcare organizations.

• Violence and opioids will continue to be primary concerns.

• Successful risk managers will embrace technology.


The risk landscape of healthcare has changed drastically in the past decade, and consequently, the role of the healthcare risk manager has evolved tremendously, says Diane Doherty, CPHRM, senior vice president of Chubb Healthcare in New York City.

A successful career in risk management over the next 10 years will require anticipating changes and acting proactively, she says.

Today’s challenging healthcare climate is marked by consolidation and unprecedented change from new delivery and alignment models, and Doherty says she is seeing risk managers take on a more elevated role in their organizations, working closely with senior leadership and other departments to develop a more strategic enterprisewide approach to risk management.

“In addition to focusing on patient safety, clinical care, regulatory compliance, and finance, they are dedicated to proactively addressing myriad liability threats on a day-to-day basis,” she says. “This includes diagnostic and therapeutic errors, infections, alarm fatigue, violence, data breaches, social media missteps, and natural disasters, among other exposures. It makes risk managers a steady force in volatile times.”

Risk managers touch nearly every corner of a healthcare enterprise, Doherty says, and they strengthen organizational operations, both proactively (by identifying, preventing and mitigating loss) and reactively (through real-time damage control).

“It is critical that risk managers stay at the forefront of all healthcare changes, embrace those changes, identify the new related exposures, and be ready to implement strategic solutions to address them,” she says. “New risks require new solutions and a strong risk manager to lead that charge. Today, a robust risk management program requires more than just a written plan; it requires a well-credentialed and qualified risk manager to execute and bring it to fruition.”

To prepare for the future, and understand how much it might be different from the current risk management landscape, Doherty points to these three major changes in risk management over the past decade:

• Violence. Whether it’s a hospital, outpatient facility, or physician office, the reality is that the healthcare setting is just as vulnerable to the same problems that afflict society as a whole, Doherty says.

“Healthcare violence continues to be on the rise and risk managers must vigilantly work to prepare their institutions to prevent situations that can result in costly losses or liability,” she says. “For healthcare risk managers, violent incidents expose their organizations to not only critical safety issues but a wide range of insurance implications, including medical professional liability, workers’ compensation, general liability, and property exposures. The key to stemming these exposures is rooted in a review of their workplace violence prevention program.”

Risk managers should ensure their program is based on an annual facilitywide assessment that surveys all shifts, pays particular attention to high-risk areas, and is overseen by a multidisciplinary committee, Doherty advises. Once the program is updated, risk managers should conduct unannounced drills and staff trainings that focus on identifying violence red flags, when to try and diffuse a situation, and when to retreat to safety.

• Opioids. The national opioid crisis has forced risk managers to wear more hats than ever before, Doherty says.

“The statistics are staggering, with the CDC reporting more than 115 people in the United States die every day after overdosing on opioids. They further recently reported a 30% increase in emergency room visits for opioid overdoses in all parts of the U.S. from July 2016 through September 2017,” she says. “Risk managers are being called upon to do what they can to help curtail the crisis by taking a proactive approach to safeguard prescribing practices and minimize patient harm and associated liabilities.”

• Technology. Risk managers today have to face the rapid influx of progressively complex and state-of-the-art technology that poses many challenges for healthcare organizations, Doherty says. In this environment, risk managers have to stay on the cutting edge of new technology, including telehealth technologies, and develop comprehensive risk management strategies that evaluate and respond to possible liabilities.

She cites the example of video monitoring technology, also known as telesitting, which is increasingly popular with hospitals.

“It is considered by some as a cost-effective solution to improve patient safety and lower staff costs associated with observing inpatients at risk for falls, wandering, pulling out tubes, and other types of self-harm,” Doherty says. “From a risk perspective, there are many pros and cons of utilizing this virtual observation technology, as well as legal implications to consider.”

Three areas of primary concern with video monitoring are informed consent, HIPAA, and record access. Risk managers should work with legal counsel, the leadership team, and frontline staff before implementing such a program, Doherty cautions. An effective telehealth partnership requires careful examination of professional liability issues, including contract protections, practitioner credentialing requirements, technology safeguards, network security, applicable practice standards, and insurance coverage, she says.

To minimize their exposures, healthcare organizations should create a comprehensive risk management program to address each of those issues, Doherty says. Given that each organization faces unique challenges, there is not a one-model-fits-all risk management solution, she notes.

“Hospital risk management teams should be familiar with these issues and should be empowered to take action to mitigate the risks. Because of the potential adverse consequences, hospital risk management teams should report directly to the top leadership — the chief executives as well as hospital boards,” she says. “While risk managers are under constant pressure to do more with less, those that have the foresight to prepare for these emerging risks can reduce the chances of debilitating losses while strengthening their ability to deliver quality patient care.”

SOURCE

• Diane Doherty, CPHRM, Senior Vice President, Chubb Healthcare, New York City. Phone: (212) 703-7120. Email: diane.doherty@chubb.com.