Risk Management in Health Care Institutions

by Kavaler, Florence; Spiegel, Allen D.

Edition: 2nd

ISBN13: 9780763723149

ISBN10: 0763723142

Format: Paperback

Pub. Date: 2003-03-01

Publisher(s): Jones & Bartlett

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Summary

Risk management for health care institutions involves the protection of the assets of the organizations, agencies, and individual providers from liability. A strategic approach can result in significant cost savings. Risk Management in Health Care Institutions: A Strategic Approach offers governing boards, chief executive officers, administrators, and health profession students the opportunity to organize and devise a successful risk management program. Experts in risk management have contributed comprehensive, up-to-date syntheses of relevant topics to assist with practical risk management strategies.

About the Authors	p. xix
Contributors	p. xxi
Introduction to Second Edition--Risk Management	p. xxv
Introduction to Risk Management Strategy
Risk Management Dynamics	p. 3
Risk Management Defined	p. 3
Progressive Steps in the Risk Management Process	p. 4
Risk Management Activities	p. 8
Classification of Risk Liabilities	p. 9
Risk Red Flags	p. 10
Risk Management Tools	p. 11
Risk and Quality of Care	p. 13
Risk Management/Quality Assurance Functions and Activities	p. 14
Administration of Risk Management Programs	p. 14
Specific Risk Management Functions	p. 18
Toward the Future	p. 26
Regulatory Environment: Standards and Risk Management	p. 29
A Standards Primer	p. 29
Promulgation and Implementation of Standards	p. 30
Legal Standards	p. 30
Federal Mandates	p. 30
State Legislation and Regulations	p. 42
State-Mandated Risk Management Legislation	p. 43
Local City and County Legislation Controls	p. 47
Reimbursement Requirements	p. 48
False Claims	p. 49
Practice Guidelines	p. 50
Ignorance of the Law Is No Excuse	p. 52
Identifying and Controlling Risks as an Employer	p. 57
Wrongful Dismissal or Discharge	p. 57
Discrimination Law	p. 60
Affirmative Action	p. 63
Sexual Harassment	p. 64
AIDS and the Health Care Workplace	p. 67
Workers' Compensation	p. 69
Employee Assistance Programs	p. 73
Americans with Disabilities Act	p. 74
Telecommuting	p. 78
Downsizing	p. 78
Retaliation and Whistleblowing	p. 79
Co-Employment	p. 79
Violence in the Workplace: Background Checks	p. 80
Mandatory Arbitration	p. 81
Enhancing Employee Satisfaction	p. 82
Patient/Consumer Communications to Reduce Risk	p. 91
A New Age in Health Care	p. 91
Why Do Patients/Customers Sue?	p. 92
Observe, Listen, and Communicate	p. 93
Consent, Informed or Otherwise	p. 96
Traditional Patient Education	p. 99
Satisfying the Patient Stops the Suits	p. 101
Patient Expectations and Patient Satisfaction	p. 102
Grading Health Care: Consumer Report Cards	p. 105
Information Technology	p. 107
Strategic Caveat	p. 108
Financing of Risk and Insurance	p. 113
Options in Implementing a Plan	p. 117
Insurance Options Based on Premium Size	p. 118
Considerations in Choosing an Alternative Insurance Program	p. 120
Choosing a Third-Party Administrator	p. 120
Structure of Risk Exposure Management	p. 121
Protection for a Rainy Day	p. 130
General Risk Management Strategies
Total Quality Management, Continuous Quality/Process Improvement, and Evaluation of the Risk Management Program	p. 133
Medical Injuries Are Neither New Nor Uncommon	p. 133
Injuries and Lawsuits	p. 134
An Ounce of Prevention	p. 134
The Challenge of Prediction	p. 134
Statistical Predictive Models	p. 135
Effectiveness of Risk Management	p. 136
Risk Management Process	p. 136
Quality Management	p. 137
Total Quality Management	p. 138
Barriers to Quality Management Initiatives	p. 138
Continuous Quality/Process Improvement	p. 139
Tools for Evaluation: Root Cause Analysis and Failure Mode, Effect, and Criticality Analysis	p. 139
A Focus on the Customer Is Vital	p. 141
The Patient Was Right!	p. 144
A Sampling of Potential Risk Management CQI Projects	p. 144
QIT Risk Management Examples	p. 145
CQI and Labor Relations	p. 145
Benchmarking Comparisons	p. 147
Medical Error Reduction	p. 147
Program Evaluation Issues and Methods	p. 148
External Evaluation	p. 149
Risk Management Self-Assessment Manual	p. 154
Depositions	p. 154
Evaluation Is an Appraisal	p. 155
Ethical Issues for Risk Managers	p. 161
Ethical Guidelines for Risk Managers	p. 161
Ethical Standards	p. 163
Code of Ethics	p. 164
Confidentiality and Ethics	p. 164
Informed Consent	p. 165
Decisional Capacity to Weigh Risks	p. 166
Clinical Applications of Ethics	p. 167
Research on Human Subjects	p. 176
Ethics Committees	p. 180
Ethics Are Not Just Values	p. 182
Assuring Safety and Security in Health Care Institutions	p. 187
Infection Control	p. 189
Indoor Air Pollution	p. 190
Employee Health Intervention Strategies	p. 192
Emergency Situations	p. 192
Fire Prevention	p. 192
Emergency Preparedness and Disaster Planning	p. 194
Safe Environment	p. 195
Violence on the Job	p. 198
Protecting Patient Valuables	p. 202
Criminal Behavior	p. 203
Securing Information Systems	p. 206
Proactive Security Departments	p. 208
Technology Enhanced Security	p. 210
Safety and Security in Ounces and Pounds	p. 211
Specific Strategies for Specific Risk Areas
A Primer on Medical Malpractice	p. 215
A Science of Mistakes	p. 215
Medical Malpractice Law--In Brief	p. 217
Negligence	p. 217
Medical Malpractice	p. 219
Physician-Patient Relationship	p. 220
Duty to Perform Professionally	p. 220
Additional Theories of Liability	p. 222
Hospital Liability for Medical Malpractice	p. 223
Hospital Liability Regarding Staff Privileges	p. 226
Liability Theories Apart from Medical Negligence	p. 227
Types of Damages	p. 228
Statutes of Limitation	p. 228
The Most Common and Most Expensive Malpractice Allegations	p. 229
Obstetricians Under Fire	p. 234
Risk Management Issues in Professional Liability Litigation	p. 235
Strategies to Reduce Liability: Managing Physicians and Litigation Alternatives	p. 241
Professional Practice Acts	p. 241
Federation of State Medical Boards	p. 245
National Practitioner Data Bank	p. 246
Clinical Practice Guidelines	p. 248
Peer Review	p. 254
Liability Alternatives: Tort Reform and Nonjudicial Proposals	p. 258
Removing Malpractice Litigation from Judicial Systems	p. 261
No-Fault Proposals	p. 262
To Tort or Not to Tort	p. 264
Proactive Liability Reduction	p. 265
Risk Management in Psychiatry	p. 269
Informed Consent	p. 269
Right to Treatment	p. 271
Right to Refuse Treatment	p. 274
Clinical Risks in Psychiatry	p. 275
Confidentiality and Stigma	p. 283
High-Risk Incidents	p. 285
Fraud and Abuse	p. 290
Psychiatric Concerns Are Everywhere	p. 291
Identifying and Controlling Risks in Long Term Care: Nursing Homes and Home Health Care	p. 297
Demographics of Long Term Care	p. 298
Long Term Care Providers	p. 299
Long Term Care Regulations	p. 299
Management of Residents	p. 300
A Portrait of Physiological Aging	p. 301
Elder Abuse and Violence	p. 309
Employee Risks	p. 310
Subacute Care	p. 311
Home Health Care	p. 312
Regulation of Home Health Care	p. 313
Who Receives Home Health Care?	p. 314
Patient Management	p. 314
Home Health Care Employees	p. 318
Hospice Care	p. 320
Growing Industry, Growing Risks	p. 320
Risk Management in Selected High Risk Hospital Departments	p. 325
Emergency Medicine	p. 326
Obstetrics and Neonatology	p. 333
Surgery and Anesthesia	p. 350
Risk Management in Managed Care Organizations	p. 365
Introduction	p. 365
Pressures on MCOs	p. 365
Public Perception of MCOs and Litigation	p. 366
MCO Structure and Liability	p. 366
Models of MCOs	p. 367
Statutes and Administrative Regulations	p. 369
Theories of MCO Liability Other than Negligence	p. 372
Statutory Liability	p. 376
Corporate Negligence	p. 380
Vicarious Liability	p. 388
MCO Defense	p. 392
MCO Crystal Ball Gazing	p. 398
Integrated Health Care Delivery Systems	p. 403
Overview of Integrated Networks	p. 403
Risk Management Issues, Challenges, and Solutions	p. 405
Legal Issues	p. 411
Areas of Liability Exposure	p. 411
Additional Legal Issues	p. 413
Afloat in Uncharted Waters	p. 416
Index	p. 419
Table of Contents provided by Rittenhouse. All Rights Reserved.

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