4 Best Practices for Hospital Risk Management

Risk management in a hospital is complex, as it involves identifying, assessing and averting risks in virtually every area of the hospital. This role is particularly difficult and important as new regulations under the Patient Protection and Affordable Care Act take effect. Maureen McGovern, RN, director of risk management and patient safety officer of South Nassau Communities Hospital in Oceanside, N.Y., shares four best practices for managing risk at a hospital.

1. Proactively perform risk assessments. Risk managers should perform risk assessments to identify risks before problems occur rather than reacting to an event, Ms. McGovern says. Managers should conduct failure mode effects analyses, which score a process or product based on potential failures, the probability of these failures occurring, their likely frequency and the ability to detect them. The resulting risk score enables managers to proactively establish practices that will reduce or eliminate these risks for failure.

For example, South Nassau Communities Hospital conducted an FMEA for treating surgical patients with obstructive sleep apnea. By analyzing potential safety and efficiency problems, the FMEA team developed a process to identify patients with obstructive sleep apnea, notify the care team and monitor patients as they move from the operating room to the post-anesthesia care unit to the postoperative area.

2. Hardwire risk-mitigating practices. To maintain a low-risk environment, risk managers need to standardize appropriate practices across the organization. Hardwiring these practices into people's workflow requires managers to educate providers and staff, and establish redundancies that ensure certain steps are completed. Including alerts or other messages in electronic health records that remind staff of appropriate practices can help make processes consistent, according to Ms. McGovern.

Risk managers can evaluate adherence to standard practices by observing practices, reviewing charts or talking to staff, depending on what the practice is. For instance, if the standard practice is for staff to be aware of certain policies, risk managers can ask staff to explain the policies to check for understanding, Ms. McGovern says.

3. Prioritize tasks. With increasing federal oversight of hospital processes and outcomes, risk managers have an impressive workload. To perform all their responsibilities, risk managers need to constantly prioritize their work, which involves assessing the risk of completing one task over another, according to Ms. McGovern. "Everyone in healthcare is stretched to the limit with compliance, adhering to regulations and reporting. It is a challenge to get everything accomplished; prioritizing the workload is key," she says.

4. Establish a just culture. While risk managers have the main responsibility to identify risks, it would be difficult for them to detect every single risk throughout an entire organization. Instead, providers, staff members and leaders should be able and encouraged to report observed risks. Creating a "just" culture, a non-punitive environment in which people feel comfortable speaking up about areas of risk or near misses is crucial. Patient safety is everyone's responsibility; patients and families should also "speak up" and be active participants in their healthcare, according to Ms. McGovern.

More Articles on Risk Management:

Class Action Risk in the Healthcare Industry and the Need for Mitigation Strategies
How Hospitals Can Improve the Culture of Safety in the Surgical Suite: 10 Interventions to Mitigate Risk and Create a Culture of Safety in the OR

7-Step Risk Assessment Process for Joint Commission Compliance

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