Transcript RISK MANAGEMENT ORIENTATION

RISK MANAGEMENT AND
PATIENT SAFETY
NEW FACULTY OREINTATION
AUGUST 14, 2013
PURPOSE
• PROTECT THE ASSETS OF THE
INSTITUTION
• LOSS PREVENTION
– MEDRISK TRAINING PROGRAM
• LOSS CONTROL
• LOSS FINANCING
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RISK MANAGEMENT STAFF
• DIRECTOR
• MANAGERS
– RISK
– CLAIMS
• SUPPORT STAFF
– INSURANCE VERIFICATION
– CREDENTIALING
– EDUCATION
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PROFESSIONAL LIABILITY
INSURANCE PROGRAM
• COVERAGE
– DUTIES OF POSITION
– OTHERS WITH WU DEAN
APPROVAL
• RESIDENTS - BJH/SLCH
• LIMITS 2014 - $6M
SIR/$20M/$10M/$10M
• VERIFICATION OF INSURANCE
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FACT AND EXPERT WITNESS
TESTIMONY
• FACT TESTIMONY
– CARE PROVIDED BY WUSM
FACULTY
• EXPERT WITNESS TESTIMONY
– OPINION TESTIMONY
– WUSM CODE OF CONDUCT
– EXPERT WITNESS AFFIRMATION
FORM
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STATUTE OF LIMITATIONS
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MALPRACTICE--2 YRS
WRONGFUL DEATH--3 YRS
MINORS--20 YRS; DEATH THEN 3 YRS
EXCEPTIONS
– PSYCHIATRY
– CONTINUING TX
– PRODUCTS
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EARLY REPORTING
• ACCURATE
RECALL
• LEGAL
REPORTING
REQUIREMENTS
• EARLY PATIENT
DISCUSSION
• ACCURATE HX
DATA - EXCESS
INS
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• EVALUATE
EXPOSURE
• ADJUST BILLS
• DECREASE
FINANCIAL LOSS
BY ID TRENDS
• ADEQUATE
FUNDING
LEVELS
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REQUIRED REPORTS
• DEATH
• PARAPLEGIA,
QUADRIPLEGIA,
PARALYSIS
• SPINAL CORD
• NERVE INJURY,
NEUROLOGICAL
DEFICIT
• BRAIN DAMAGE
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• TOTAL/PARTIAL
LOSS OF LIMB
OR USE OF LIMB
• SENSORY OR
REPRODUCTIVE
ORGAN LOSS OR
IMPAIRMENT
• SERIOUS
DISFIGUREMENT
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OTHER RISK MANAGEMENT
INQUIRIES AND ACTIVITIES
• RECORD
REQUEST
• LIEN LETTERS
• SUBPOENA
• SUMMONS
• EARLY
RESOLUTION
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• BOARD OF
HEALING ARTS
• DEBRIEFINGS
• ROOT CAUSE
ANALYSIS
• ATTORNEY
CALLS
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SUMMONS
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PETITION
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SUBPOENA
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BOARD OF HEALING ARTS
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HOW TO REPORT
• WU CALL RM--362-4686 or 362-6956
– SAFE LINE—747-SAFE (7233)
• RISK MANAGEMENT PRO—
– ELECTRONIC REPORTING SYSTEM (ERS)
– ERS is http://ers.wusm.wustl.edu
• WRITE/DICTATE “IN ANTICIPATION OF
LITIGATION”
• DISCUSS W/RM, DEPT HEAD, LEGAL
COUNSEL
• ATTORNEY CLIENT PRIVILEGE
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COMMUNICATE AND
DOCUMENT
• BE AVAILABLE
• GOOD LISTENER
• COMMUNICATE
WITH FAMILY
MEMBERS
• EDUCATE
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• RETURN
TELEPHONE
CALLS
• BILLS (MEDICARE
REQUIREMENTS)
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INFORMED CONSENT
• DUTY OF PHYSICIAN
• PATIENT’S DECISION - DON’T PRESSURE
• REALISTIC EXPECTATIONS, OWN
LANGUAGE
• DO NOT RELY ON STANDARD FORMS
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ELEMENTS
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DEFINE PROBLEM
RISKS, BENEFITS, ALTERNATIVES
ALTERNATIVES -- RISKS AND BENEFITS
LIKELY TO HAPPEN IF UNTREATED
PRESENTED LEVEL OF UNDERSTANDING
CONFIRMATION - ASK PATIENT WHAT
THEY UNDERSTAND WILL HAPPEN
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MEDRISK TRAINING
PROGRAM
• PROMOTE PATIENT SAFETY AND
DECREASE MEDICAL ERRORS
• SUBSPECIALTY-SPECIFIC TRAINING
MODULES
• CME 4-5 HOURS
• ON LINE
• http://washu.medrisk.com/Medrisk/Welcome/d
efault.aspx
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RISK MANAGEMENT
WEB SITE
http://medicine.wustl.edu/risk
• GENERAL INFORMATION
• RISK MONITOR PRO – EVENT
REPORTING SYSTEM (ERS)
• PROFESSIONAL LIABILITY
INSURANCE
• EDUCATION SECTION
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PATIENT SAFETY—
WUSM PS Physician Council
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Anesthesiology
Emergency Dept.
Internal Medicine
Neurosurgery
OB/GYN
Ophthalmology
Orthopedics
Otolaryngology
Pediatrics
Radiation Oncology
Radiology
Surgery
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Andrea Vannucci
Chris Carpenter, Richard Griffey, Rob Poirier
Emily Fondahn, Mike Lane, Myra Rubio
Paul Santiago
vacant
David Vollman
Kathryn Keeler
Brian Nussenbaum
Nikoleta Kolovos, Pele Yu, George Van Hare
Imran Zoberi
James Duncan, Andrew Bierhals
Doug Schuerer
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PATIENT SAFETY—
Patient Safety Office Resources
• Patient Safety Education
• WUSM Event Reporting System
• Support for Communication of Adverse Events
to patients and families
• Event Analysis support: debriefings, root cause
analysis, second victim support
• PS/QI Projects based upon high volume or high
risk processes with identified failures
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Patient Safety Education
• Curriculum available on PS Website
• Speaker’s bureau of WUSM PS Experts
available
• Conferences and webinars available onsite
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PATIENT SAFETY
WUSM Event Reporting System
• http://ers.wusm.wustl.edu
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Traditional Voluntary Reporting in Hospitals
Lost Opportunities to Learn
 Key Findings:
 Hospital staff did not report 86% of events to incident reporting
systems
 Physician accounted for less than 2% of reports
Hospital Incident Reporting Systems Do Not Capture Most Patient Harm.
January 2012 OEI-06-09-00091
 Low physician reporting is problematic because it hinders the ability to
identify and mitigate risks. Physicians view health care through a unique
lens, which allows them to identify certain types of hazards and certain
contributing factors better than others.
Noble, DJ, Pronovost, Underreporting of Patient Safety Incidents Reduces
Health Care’s Ability to Quantify and Accurately Measure Harm Reduction.
J Patient Saf 2010; 6:24
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A Different Approach to Physician Reporting
—Stimulated Reporting
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M & M cases
Patient Safety Triggers: National or Local
PS Indicators (AHRQ)
IHI Global Trigger Tool
PS Triggers (see pocket card)
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Click Quick Submit to enter a new event
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A Quick Submission takes <30 seconds!
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WUSM Patient Safety Office
• Mary Taylor, JD
[email protected]
747-2933
Robin Woltman (ERSystem)
[email protected]
747-6388
Sharepoint site
http://patientsafety.wusm.wustl.edu
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QUESTIONS?