What if every staff member was asked to define risk management? It’s likely that no two responses would match. It’s even possible that some responses would be incorrect. In all likelihood however, everyone questioned would agree that risk management is essential given the increasingly litigious environment of long term care. It’s important for every staff member to understand that risk management is the key to important benefits such as fewer negative events, fewer survey deficiencies, improved reimbursement, lower costs for professional liability insurance and improved public relations. In addition to these benefits, controlling risk means more resources available for providing higher quality care. Here are 5 questions to ask before planning a risk management strategy:
#1 What is risk management?
Across any long term care organization, the phrase “risk management” conjures up different images – even conflicting ideas. Perhaps it’s better understood broken down. “Risk” is defined as the possibility of a loss or injury (in the occurrence of an adverse event) with the associated consequences. “Management” refers to the steps taken by an organization to prevent or mitigate any harm. Accordingly, risk management is the responsibility of every employee from the top administrator to front-line caregivers and everyone in between. It is the sum of every step taken to minimize harm.
While this view may not seem revolutionary on the surface, the actual practice and implementation of effective risk management strategies does require a shift in mindset for many organizations – one that involves a change from a reactive response to a preemptive strike.
#2 Why is data important?
For starters, an effective risk management program should be based on data that is continuously analyzed. After all, data is used by insurers, plaintiff attorneys and regulatory agencies for the purpose of sizing up any long-term care provider. Furthermore, public data (such as quality measures) is the basis for which many future residents will be placed in your care – or not.
Accordingly, facilities should embrace this information and learn how to use it as the foundation for a proactive risk management approach. When carefully examined and processed properly, data can help facilities rapidly identify residents who are at risk and put into place risk management resources before an incident occurs. It’s an approach that keeps small problems small.
#3 How can data give a facility an advantage in risk management?
A data-driven risk-management program is an inexpensive intervention as it leverages technology, existing resources and information already being collected. More specifically, it has demonstrated the ability to:
- Improve reimbursement accuracy
- Reduce survey deficiencies
- Obtain more accurate QI measures
- Reduce the occurrence of negative incidents
- Improve compliance with state and federal agencies
- Reduce professional liability premiums
- Improve public relations/marketing efforts
Sustained improvement depends on the ability to measure performance. By incorporating data into the foundation of a risk management approach, facilities gain the ability to benchmark, track, trend and continually monitor performance. Ideally, progress can be demonstrated in quantitative terms and communicated throughout the facility. In this way, the risk management program is viewed as every staff person’s responsibility.
#4 Why are policies and procedures important in risk management?
According to the Centers for Medicare & Medicaid Services, as nursing homes are charged with varying degrees of violations, most are the result of deviating from established federal or state rules and regulations. Facilities need to incorporate the adherence to government rules and regulations into policies and procedures and use training and ongoing testing to make sure employees are compliant. As one of the top regulated industries in the country, long-term care organizations need to identify high-risk areas and follow the very prescriptive guidance for managing such risk.
#5 What are the big-picture benefits of a risk-management program?
When implemented properly, an effective risk management program will bridge the widening gap between external challenges facing long-term care providers and the internal reality of providing quality care with limited resources. More importantly, a data-driven approach enables a facility to leverage available information to rapidly target resources, identify actual risk and proactively manage those “pre-incidents” to avoid negative events. Now is the time for facilities that are committed to optimizing their risk management program to discover the data’s full potential and demystify their risk management initiatives.
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