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Flashcards in Chapter 1 Deck (21):
1

Staff

Greatest commodity and greatest risk in health care

2

Staff competency KSAO

Knowledge
Skill
Ability
Other

3

RM Professional Background

Nursing
Admin
Insurance
**No lawyer or finance professional

4

Accidental loss

occurs by chance and is unexpected

5

Risk management

The process of making and carrying out decisions that will help prevent adverse consequences and minimize the negative effects of accidental losses on an organization

6

History of RM

Emerged during the malpractice crisis of the mid-70s health care organizations experienced rapid increase in claim costs and premiums, and major medical liability insurers left the market
Crisis prompted health care entities to develop the first risk management programs (insurance companies developed the model)

7

Malpractice

Improper professional actions or the failure to exercise proper professional skills by a professional advisor, such as a physician, dentist, or health care entity. Also professional misconduct, improper discharge of professional duties, or a failure to meet the standards of care of a professional, resulting in harm to another person

8

Sentinel event

An unexpected occurrence involving death or serious physical or psychological injury or the risk thereof, including loss of limb or function

9

Key structural elements of the risk management program

Authority
Visibility
Communication
Coordination
Accountability

10

Authority

-Risk management position must be relatively high in the organizational hierarchy (ideally should report to CEO or another member of the SMT)
-Must be able to make decisions, enable change, and be trusted with confidential/sensitive information

11

Visibility

i. Risk management professional should be highly-visible in the HCO
ii. Risk management professional must foster awareness of risk management practices and techniques among SMT, the governing body, medical staff, and employees at all organization levels through consciousness-raising, education, and communication

12

Communication

i. Risk managers should be equipped with information about mergers, acquisitions, and joint ventures early in the process to advise SMT on the risk management implications
RMP must have access to organization-wide communication system

13

Coordination

HCOs should establish both formal and informal mechanisms for the coordination of the risk management program with other departments

14

Accountability

RM professionals should be held accountable for performance
Job descriptions, performance appraisals, annual report to senior management summarizing claims, insurance, and RM program activities

15

Scope of RM Program

A. Patient care-related risk
B. Medical staff-related risk
C. Employee-related risk
D. Property-related risk
E. Financial risk
Other risk

16

RM Process

1. Identify and analyze loss exposures
2. Consider alternative risk techniques
3. Select best RM technique(s)
4. Implement techniques
5. Monitor and improve RM program

17

Risk identification

The process whereby the RM professional becomes aware of risks in the HC environment that constitute potential loss exposures for the institution

18

Incident reporting

Process in which employees report accidents and occurrences not consistent with normal operating routines or expected outcomes

19

Risk analysis

The process of determining the potential severity of the loss associated with an identified risk and the probability that such a loss will occur

20

Risk appetite

The amount and type of risk that an organisation is willing to take in order to meet their strategic objectives

21

Risk =

Impact + Likelihood