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At least 163 records · Page 9Linked to original sources
PubMed1995

Risk management strategies in the provision of mental health services.

Psychiatric settings provide unique challenges for engaging in risk management activities. The author reviews principles of risk management--the systematic effort to avoid harm to patients and the subsequent threat of financial loss--as they apply to mental health organizations, including preconditions necessary for a risk management process, identification of risk, evaluation of risk, and the actual risk management process. He outlines recent relevant directions of the Joint Commission on Accreditation of Healthcare Organizations, especially the shift to continuous quality improvement and the organization of the 1995 standards around major functions such as improving performance. Today few mental health care organizations can afford not to have programs that actively seek to reduce and eliminate risk, the author believes, not only because of the financial consequences to the organization but also because a solid risk management program can significantly improve patient care.

Humans↗
PubMed2002

Clinical risk management study day review.

'A Practical Guide to Clinical Risk Management in Obstetrics, Gynaecology and Maternity Care', was held at the Royal College of Obstetricians and Gynaecologists (RCOG) to highlight the necessity for clinical risk management. The day examined effective risk management strategies in place, the most common causes of risk and how these risk factors could be counteracted.

England↗
PubMed1992

Hospitals find ways to integrate risk-management functions.

Hospitals that have successfully integrated the risk-management function with other hospital departments say that the process requires both education and teamwork. Among the major challenges: overcoming physician reluctance to participate in risk-management activities, and linking risk management to quality assurance.

Credentialing↗
PubMed1996

Selected issues in quality improvement and risk management.

OBJECTIVE: To provide an overview of selected issues in quality improvement and risk management. DATA SOURCES: Published articles, books, and standards pertaining to quality improvement and risk management. CONCLUSION: The changing health care environment has intensified the need for monitoring processes of home care, patient outcomes, and risk management issues. Quality improvement and risk management programs can provide guidelines for the home health staff to impact outcomes of patient care and patient and caregiver satisfaction. IMPLICATIONS FOR NURSING PRACTICE: Home health care nurses are involved in the evaluation of systems, processes, and outcomes. Their involvement in identifying problems, providing creative solutions, and successfully implementing systems and processes is essential for quality improvement. They also must be knowledgeable of risk management and be involved in the identification and resolution of potential risks to themselves and their patients.

Home Care Services↗
PubMed1997

Anesthesia patient risk: a quantitative approach to organizational factors and risk management options.

The risk of death or brain damage to anesthesia patients is relatively low, particularly for healthy patients in modern hospitals. When an accident does occur, its cause is usually an error made by the anesthesiologist, either in triggering the accident sequence, or failing to take timely corrective measures. This paper presents a pilot study which explores the feasibility of extending probabilistic risk analysis (PRA) of anesthesia accidents to assess the effects of human and management components on the patient risk. We develop first a classic PRA model for the patient risk per operation. We then link the probabilities of the different accident types to their root causes using a probabilistic analysis of the performance shaping factors. These factors are described here as the "state of the anesthesiologist" characterized both in terms of alertness and competence. We then analyze the effects of different management factors that affect the state of the anesthesiologist and we compute the risk reduction benefits of several risk management policies. Our data sources include the published version of the Australian Incident Monitoring Study as well as expert opinions. We conclude that patient risk could be reduced substantially by closer supervision of residents, the use of anesthesia simulators both in training and for periodic recertification, and regular medical examinations for all anesthesiologists.

Accidents↗
PubMed1998

Y2K, embedded chips, casualty hazards and due diligence in healthcare risk management.

Y2K raises challenges for healthcare risk managers that go beyond information technology issues. This article explains that (1) too little public attention is being paid to equipment which may well have Y2K faults and (2) few standards have been articulated for dealing with problems. Healthcare risk managers therefore must return to basic due diligence principles and develop their own standards and protocols. The article explains how to do due diligence and outlines suggested steps for dealing with the non-information technology side of compliance due diligence.

Budgets↗
PubMed1990

Risk management in psychiatry.

This article introduces some basic concepts of psychiatric risk management and demonstrates how risk management and quality assurance can work together. Risk exposure areas and loss prevention issues identified during a review of 98 psychiatric claims managed from 1976 to 1988 by the Risk Management Foundation of the Harvard Medical Institutions are detailed.

Fees, Medical↗
PubMed2004

A discussion of findings and their possible implications from a workshop on bioterrorism threat assessment and risk management.

In November 2001, the Monterey Institute of International Studies convened a workshop on bioterrorism threat assessment and risk management. Risk assessment practitioners from various disciplines, but without specialized knowledge of terrorism, were brought together with security and intelligence threat analysts to stimulate an exchange that could be useful to both communities. This article, prepared by a subset of the participants, comments on the workshop's findings and their implications and makes three recommendations, two short term (use of threat assessment methodologies and vulnerability analysis) and one long term (application of quantitative risk assessment and modeling), regarding the practical application of risk assessment methods to bioterrorism issues.

Bioterrorism↗
PubMed1986

Informed consent: myths and risk management alternatives.

The doctrine of informed consent, an enigma to many risk management personnel, is fuel for many malpractice claims. But the doctrine of informed consent is a rational, useful concept that can advance many of the goals of risk management. This article analyzes seven common "myths" or misperceptions about informed consent in relation to risk management and suggests five ways to address the risk management issues related to informed consent.

Financial Management↗
PubMed2001

Risk management on the labour ward.

Risk management describes a process whereby the risk of adverse events is eliminated or where the effects of those events are reduced as far as possible. This is particularly relevant to the labour ward setting with respect to intrapartum care.

Delivery Rooms↗
PubMed1994

Participatory risk management: promoting physician compliance with practice guidelines.

BACKGROUND: Claims that result from at-risk medical practices, especially those involving medical records and systems failure-related problems, cost significantly more than the average claim to resolve, primarily due to additional defense costs required for expert witnesses. An analysis of these claims areas has pinpointed specific problems that can be addressed and corrected. OBTAINING PHYSICIAN PARTICIPATION IN RISK MANAGEMENT: A participatory risk management program requires all physicians applying for insurance to comply with established general and specialty-specific practice guidelines. Additionally, physicians and their staff receive premium-credit points by attending regularly scheduled continuing education programs on reducing liability risk. If a claim arises in which there is some question about whether the physician followed the guidelines, the circumstances are thoroughly reviewed with the physician after defense of the claim has been completed. Additionally, a medical records consultation program helps individual practices audit their records and identify and correct any at-risk problems. REWARDING PARTICIPATING PHYSICIANS: Based on the success of the program, a new premium program has been instituted in which all physicians are placed in the lowest premium group, but they must participate regularly in risk management activities and avoid adverse actions to maintain the low premium rate.

Colorado↗
PubMedDate not supplied

Pressure sores: adopting the principles of risk management.

This article examines the continuing problem of pressure sores in the NHS from a purchasing and a providing manager's perspective. Risk management and the need for clinical effectiveness in treatment and prevention strategies are discussed. Reporting systems are advocated as a means to estimate risk and to form a store of information that will enable a response to made when problem areas are identified. Nursing advice and input into the contracting process is vital. The need for purchasers and NHS managers to work together to ensure that effective interventions are implemented to reduce both the financial burden on the NHS and the physiological insult offered to patients is stressed.

Health Policy↗
PubMed1998

Risk management for plausibly hormetic environmental carcinogens: the case of radon.

Risk management typically involves efforts to reduce human exposures by establishing regulations that limit the concentration of the substance in environmental media. In cases where a substance is widely used in commerce or is naturally occurring in the environment, compliance costs can be substantial because of nationwide requirements to add expensive control technologies. Uncertainties in a dose-response function further impact risk management decisions because they may correspond to large differences in health benefit per unit exposure reduction. These problems are highlighted in the case of plausibly hormetic environmental carcinogens, for which a linear-no-threshold (LNT) dose-response model has been the traditional regulatory default assumption. In this case, model uncertainty is pivotal, and risk management is consequently inherently controversial. However, marginal cost functions that arise for plausibly hormetic carcinogens are expected to possess a common analytic feature that may be particularly useful for this type of risk management problem. Specifically, marginal cost functions in this context are expected to have roots reflecting contaminant concentration values above which regulatory goals may be optimally placed subject to cost constraints. Here we illustrate this heuristic feature in the case of residential radon, using both a LNT model and a biologically plausible hormetic model to predict associated risks of lung cancer mortality.

Air Pollution, Indoor↗
PubMed2001

Economic impact of community pharmacist intervention in cholesterol risk management: an evaluation of the study of cardiovascular risk intervention by pharmacists.

The Study of Cardiovascular Risk Intervention by Pharmacists, a randomized, controlled trial in over 50 community pharmacies in Alberta and Saskatchewan, Canada, demonstrated that a pharmacist intervention program improved cholesterol risk management in patients at high risk for cardiovascular disease. In a substudy, costs and consequences were analyzed to describe the economic impact of the program. Two perspectives were taken: a government-funded health care system and a pharmacy manager. Costs were reported in 1999 Canadian dollars. Incremental costs to a government payor and community pharmacy manager were $6.40/patient and $21.76/patient, respectively, during the 4-month follow-up period. The community pharmacy manager had an initial investment of $683.50. The change in Framingham risk function for the intervention group from baseline also was reported. The 10-year risk of cardiovascular disease decreased from 17.3% to 16.4% (p<0.0001) during the 4 months. The intervention program in this study led to a significant reduction in cardiovascular risk in the intervention group during the 4-month follow-up period. The incremental cost to provide the program appeared minimal from both government and pharmacy manager perspectives. It is hoped that these results could support negotiations for reimbursement of clinical pharmacy services with payors.

Aged↗
PubMed1984

Fiscal accountability through effective risk management.

This article conceptualizes the role that risk management should take in therapeutic recreation to help attain fiscal accountability. The public is becoming increasingly aware of risk or harm to patients associated with medical care and is demanding a higher level of care. A litigious public has created a tremendous amount of caution within the health care community. This caution often has led to a mandated conservative approach to therapeutic recreation programs. Therapeutic recreation is faced with the task of designing risk management programs which will lessen financial concerns while creating a safe and effective treatment environment.

Financial Management↗
PubMed2005

Medical professional liability insurance and its relation to medical error and healthcare risk management for the practicing physician.

PURPOSE: To review the history and current issues surrounding medical professional liability insurance and its relationship to medical error and healthcare risk management. DESIGN: Focused literature review and authors' experience. METHODS: Medical professional liability insurance issues are reviewed in association with the occurrence of medical error and the role of healthcare risk management. RESULTS: The rising frequency and severity of claims and lawsuits incurred by physicians, as well as escalating defense costs, have dramatically increased over the past several years and have resulted in accelerated efforts to reduce medical errors and control practice risk for physicians. Medical error reduction and improved patient outcomes are closely linked to the goals of the medical risk manager by reducing exposure to adverse medical events. Management of professional liability risk by the physician-led malpractice insurance company not only protects the economic viability of physicians, but also addresses patient safety concerns. CONCLUSIONS: Physician-owned malpractice liability insurance companies will continue to be the dominant providers of insurance for practicing physicians and will serve as the primary source for loss prevention and risk management services. To succeed in the marketplace, the emergence and importance of the risk manager and incorporation of risk management principles throughout the professional liability company has become crucial to the financial stability and success of the insurance company. The risk manager provides the necessary advice and support requested by physicians to minimize medical liability risk in their daily practice.

Delivery of Health Care↗
PubMedDate not supplied

Risk management for IEC 60601-1 third edition.

With the examples above we have demonstrated for our selected topics that our device meets the risk management requirements of 60601-1. An expansion of the tables to include all of the risk management requirements would be useful to identify how the manufacturer has met all of the risk management requirements of the standard. By setting up a file system under the manufacturer's quality system that meets the requirements of the 14971 risk management standard, the manufacturer will be able to effectively demonstrate compliance with a number of applicable standards, including 60601-1, and also be able to demonstrate the device meets FDA product safety requirements. The file system would also be useful in creating the technical file for the MDD. A risk management summary table similar to the one recommended by the GHTF will assist the manufacturer in tracking the documentation required to support this effort. A list of the hazards identified for the product is contained in the summary table and the summary table will also aid in determining if all of the required steps in the risk management process have been completed for each hazard. This table will become an important record in the risk management file.

Biomedical Technology↗