Hospital Toolkit

According to the United States Department of Health and Human Services, “broadly defined, risk management includes any activity, process, or policy to reduce liability exposure. This involves all aspects of a health centers infrastructure and services, including financial matters, facility maintenance, fire safety, compliance with applicable laws and regulations, and clinical care”.

Florida is a unique state across the country in that hospital, ambulatory surgical centers, nursing homes and other healthcare facilities are required to have an "Internal Risk Management" program as established in state statutes. The Florida’s Healthcare Risk Managers – A 30 Year Retrospective publication presents a history of how risk management and risk management requirements evolved in our state.

An Effective Healthcare Risk Management Program varies according to size, structure and function of the organization or delivery setting. The generally agreed upon key structural components include:

Authority
Visibility
Communication
Coordination
Accountability

The generally agreed upon scope of an effective risk management program includes:

Patient Care Related Risk Exposures
Medical Staff Related Risk Exposures
Property Related Risk Exposures
Financial Related Risk Exposures

An essential method of controlling medical injuries is a comprehensive program of risk management, as required in law. According to Florida law, the key to such a program is a competent and qualified healthcare risk manager. The Role of the Healthcare Risk Manager varies according to size, structure and function of the organization or delivery setting. The generally agreed upon functional areas include:

Loss Prevention and Reduction
Claims Management
Risk Financing
Regulatory and Accreditation Compliance
Risk Management Operations
Bioethics

The FSHRMPS Core Competencies and Professional Development Framework was compiled and developed by members, subject matter experts, and volunteers. The framework provides information on the knowledge and skills that risk management and patient safety professionals should have at the entry, intermediate, and executive levels as well as a suggested inventory of professional development opportunities and the associated ultimate professional attainment goals. The Framework can be used by public stakeholders to understand the scope of work, competency components, and professional development opportunities for Healthcare Risk Management and Patient Safety Professionals practicing in the state of Florida. Click here to review the framework document.

Healthcare Risk Management is a process that uses a five-step management decision making model that seeks to protect the assets of an organization through the delivery of safe patient care. The risk management process consists of five steps:

Identify and analyze loss exposures.
Consider alternative risk techniques.
Select the best risk management technique or combinations of techniques.
Implement the selected technique(s). This is also known as risk mitigation.
Measure, control and monitor.

Risk Identification & Analysis is the process of gathering and reviewing data related to potential risk management exposures. Such data can include:

Generic Occurrence Screening
Patient Complaints / Grievances
Incident Reports
Regulatory Survey Reports

Risk Control includes strategies such as:

Exposure Avoidance strategies reduce the possibility of loss to a zero by not offering services that could result in a given risk exposure.
Loss Prevention strategies reduce the likelihood of a risk by reducing the frequency of a service that could result in a given risk exposure.
Loss Reduction strategies attempt to limit the potential consequences and severity of a given risk exposure.

Risk Financing includes strategies that are meant to pay for loss exposures. Risk Financing includes risk retention through funded or unfunded reserves and risk transfer that involves the purchase of insurance.