Ten steps can improve a risk manager’s image

Health care risk managers have suffered from an image problem for too long, and 10 simple steps can greatly improve the way everyone else in your organization thinks of you, says Geri Amori, PhD, ARM, FASHRM, president of Communicating HealthCare, a risk management consulting firm in Shelby, VT, and past president of the American Society for Healthcare Risk Management (ASHRM). She says a risk manager’s image is about much more than just your self-esteem; your image can greatly affect how well you are able to do your job.

Amori presented her advice at the recent ASHRM conference in Seattle. She tells Healthcare Risk Management that her presentation sprung from an experience she had in which she was speaking at another gathering of health care professionals, and three of the speakers before her made disparaging comments about risk managers. Amori sat quietly as they slammed risk managers for playing little or no role in patient safety, urging providers not to talk to the patient, and being more worried about discovery than learning from mistakes.

"When it was my turn to speak, I got up and said, My name is Geri Amori, and I am a risk manager,’" she says. "It was like I had to admit this terrible thing. I made light of it at the time, but I realized there really is an image problem, and it’s not new."

Amori researched the issue and found that much of the negative image is based on misconceptions about risk management, and some is based at least loosely in fact. In the past, risk managers often were taught that their main role was to protect the assets of the organization, and one of the main cautions passed on from insurers was, "Don’t admit anything."

"The insurer actually meant that we shouldn’t admit any liability for the insurer; but over time, we became sort of paranoid about being truthful and honest," she says. "We have to admit this. We developed a tarnished image, and we became low on the food chain, considered the people who deal with bad things after they happen."

That image can cripple a risk manager’s ability to be proactive and to work at a high level within the health care organization, Amori says. If you carry that negative image with you everywhere you go, it will color every interaction with others even when you actually try to act counter to that image. She points out that once people have a certain image of you, they will look for anything in your words and actions to confirm that image.

"If they think risk managers are just naysayers, they’ll look for information that confirms that and they’ll find it even if you’re trying your best to be positive and helpful," she says. "You’ve got to deal with the negative image and get it out of the way so you can get on with your real work."

Amori summarizes the image problem by suggesting that many risk managers are seen as secretive, focused on data and not useful information, and not important in improving patient safety. The good news, she says, is that a health care risk manager can improve his or her image in 10 steps without spending an extra nickel. These are the 10 steps she recommends:

1. Don’t hide behind the "legal" excuses. Too many risk managers get used to saying "It’s not legal. You can’t do that." Amori says it is better to know the law but respect that it is an imperfect reflection of societal mores and responsibilities. Flexibility is always needed.

"Don’t be known as someone who comes out first with, We can’t do that because of the law,’" she says. "Seek to do what is effective and ethical and right. Be known for doing that."

2. Use numbers effectively. Data are important for a risk manager, but avoid being known as someone who just spouts numbers as an excuse for saying no or demanding better performance. Remember that data can lie. Use numbers carefully as part of your narrative rather than the whole explanation.

3. Be informed. Others in the organization need to see you as a resource. That means you must be very well informed. Reading professional publications and participating in on-line discussion groups can be excellent methods for staying current.

4. Become an indispensable resource to others. Once you are well informed, offer that information to others. Be the person whom everyone comes to for anything risk-related. Send information to people when you find it might be useful, and offer to speak, teach, and facilitate.

5. Be willing to unlearn. Unlearn the old way of doing things when necessary. Unlearn how you think of assets. Assets can be money, as in the old definition, but they also can be patients and staff.

6. Develop your power. A certain amount of power comes from your title, but your "referent power" is more important. That refers to the power that draws people to you and makes them want to be like you. Model nonpunitive attitudes, systems thinking, ethical mindsets, customer service, and the belief that you protect the organization best when you protect patients, staff, and visitors. If you become a leader that others admire because you have the right attitude and actually model the right behaviors, you develop a power within the organization that will be useful in many ways.

7. Be proactive. Always start with what you can do, not what you can’t. Whenever a colleague comes to ask you about the risk management implications of an idea or a goal, resist the urge to say "it can’t be done because . . ." If a clinician says he wants to obtain a drug that is useful in England, don’t say, "We can’t import drugs from foreign countries." It is much more productive to start out with the ideal goal and work backwards: "So you want to use this drug because it is effective in England. OK, let’s see how we can make that happen."

You might still run into roadblocks, but the way you approach the idea can greatly influence how the other person sees you. They can walk away thinking you were a partner in trying to make it happen, or you can be seen as the person who killed their idea. However, don’t be surprised if this helpful, collegial approach sometimes backfires.

"People often want us to be the naysayers," Amori says. "They want us to quash the whole idea so they don’t have to work on it anymore but they can blame it on us. Sometimes you’ll offer a helpful way to make their idea happen, and they’ll suddenly turn the tables and find reasons to say no. It’s still the right thing to do, because you don’t want to be the company bad guy even if that would make some people more comfortable."

8. Teach and coach. Don’t keep your thoughts to yourself. Think out loud, weigh the pros and cons, and ask others what they think might work. Every time you discuss a risk management issue with another person, you’re training a junior risk manager. The biggest sign of success is when someone calls you just to confirm that they’ve made the right decision. Make sure that person is rewarded for taking the right approach.

9. Articulate your value and your values. Speak up at every opportunity to make sure people know your attitude and your approach to risk management. Don’t let them assume you’re like every other risk manager. Write articles for your in-house newsletter, and write articles for your local newspaper explaining how your policies help patients. Advertise your success in patient safety.

10. Take responsibility for how you present yourself. Ultimately, your image is your own responsibility, Amori says. Consider actually marketing your risk management department with a new logo or motto. Do something fun to promote yourself or your department throughout the organization.

To start, Amori suggests you do an assessment of your risk management department. Look at how others see yourself, your office, and your staff. Find out what people are saying about your services.

"This is so important to determining where we will be as risk managers in five years or 10 years," she says. "If we don’t lose the negative image, we’ll be pushed aside to a lesser position, and a patient safety leader will take over."