2006 CONCURRENT SESSIONS
Oct. 30-Nov. 1, 2006
Monday, Oct. 30 | Tuesday, Oct. 31 | Wednesday, Nov. 1
CONTENT KEY
Essentials: For the newer risk management professional or someone who wants a refresher course
Experienced: For the more experienced risk management professional who desires in-depth analysis and study
10-11:30 a.m.
MON-01
Conveying Risk Management Efforts Through Financials: Mitigating Claims Costs
What are the key financial components of a strong risk management program, including the management of the claims and losses? How can a risk manager take charge of those costs on the claims management program as well as on specific claims? Negotiating, reserving, counsel management and resolution strategies are discussed through case studies.
Objectives: Identify key financials that drive the costs of the risk management program from a claims perspective. Identify ways to mitigate costs at the overall claims program level. Learn how to mitigate costs on the individual case level.
Session Level: Experienced
Pamela Popp, JD, DFASHRM
Stanford University Medical Center
Stanford, CA
Jeffrey Fulk, BA
Liability Claims Consulting, Inc.
Redwood City, CA
Daniel (Tim) Saunders
ISMIE Mutual Insurance Company
Chicago, IL
MON-02
Playing Well in the Sandbox: Risk Managers as Conflict Management Experts
Organizational theorists point to conflict, properly managed, as the source of change, growth, creativity and success. Risk management professionals must understand principles and techniques that make conflict a positive thing. They must be able to use its energy to improve care and relationships.
Objectives: Identify conflict situations and the parties involved. Become comfortable with conflict as a tool for change and growth. Help others approach conflict constructively to address patient safety and liability goals.
Session Level: Experienced
Kathryn Wire, JD, CPHRM
Kathryn Wire Risk Strategies
St. Louis
MON-03
Who Is Angrier: The Patient or Physician? Risk Management Tips for Difficult Discussions
The patient, angry about the adverse outcome, blames the doctor. The doctor, hostile toward the non-compliant patient, thinks the patient caused the adverse outcome. Anger derails important physician-patient communications, leads to litigation, affects fact-finding and prevents closure. Using a video and discussion, the presenters offer communication techniques to transform angry conversation into effective dialogue. The presentation includes a toolkit for guiding the angry conversation.
Objectives: Identify sources of anger for care providers and patients when confronted with an adverse outcome. Discuss the risk factors triggered by an angry conversation involving an adverse outcome. Describe practical risk management communication techniques to transform angry conversation into effective dialogue.
Session Level: Experienced
Fay A. Rozovsky, JD, MPH, DFASHRM
The Rozovsky Group
Bloomfield, CT
James Woods, MD
University of Rochester, School of Medicine
Rochester, NY
MON-04
Teamwork and High Reliability: Essential Links
This session explores the relationship between teamwork and highly reliable performance, emphasizing how CRM-based teamwork can help achieve high reliability. Building on the work of Wilson and Salas, the session illustrates how components of the crew resource management model of teamwork can be used to create the organizational infrastructure for reliable performance. An explanation of the matrix that outlines the relationship between teamwork and highly reliable performance is explored. The speaker also shows how the teamwork model can be deployed.
Objectives: Explain how closed-loop communication and situation awareness promote sensitivity to operations in a high reliability environment. Describe how backup behaviors and shared mental models support commitment to resilience. Explain how a team orientation provides the infrastructure for deference to expertise and preoccupation with failure.
Session Level: Experienced
Grena Porto, RN, MS, ARM, CPHRM
QRS Healthcare Consulting
Hockessin, DE
MON-05
Suspicious Minds: Caught in a Trap?
Natural behaviors influence negotiation and trust, and can be dealt with in a positive way. Research shows that the human mind constantly analyzes and responds to the environment of negotiation situations at conscious and subconscious levels. In health care, the ability to resolve questions about unanticipated outcomes of care and the claims that may follow may be closely related to how well an institution anticipates and responds to opportunities to keep the resolution process from becoming adversarial.
Objectives: Recognize tendencies toward attribution and suspicion. Understand how others may react to negotiation situations. Use techniques to promote trust between negotiating parties.
Session Level: Experienced
Dale Hetzler, MSCM, JD
Children’s Healthcare of Atlanta
Atlanta
MON-06
Obstetrical Crisis: Shoulder Dystocia
This session describes risk management issues related to shoulder dystocia with a focus on care during the medical emergency. A shoulder dystocia toolkit and documentation templates are shared with participants. The program highlights the concept of bundled steps in identifying, preventing and managing the event, and features a standardized rapid response approach.
Objectives: Review shoulder dystocia obstetrical claims and risk management challenges. Explore challenges regarding identification and prevention of shoulder dystocia. Demonstrate a teamwork approach to managing the medical emergency and utilize tools to improve compliance with standard of care.
Session Level: Experienced
Michelle Hoppes, RN, MS, AHRMQR, DFASHRM
Robert Cain, DO
William McCullough, MD
Tristate Patient Safety Foundation
Grand Ledge, MI
MON-07
Creating Risk Management Alliances With Physicians: Strategies That Work
Unless physicians see benefits in a risk management plan they have little incentive to spend time doing the work necessary to help achieve its goals. This program offers proven strategies for engaging physicians in not only decreasing liability and the specter of claims but achieving service excellence across the continuum from practice to hospital.
Objectives: Discuss the loss control impact of positively influencing physician attitudes toward risk management. Understand barriers to physician-institution collaboration and how they can be overcome. Apply strategies for collaborative event management and effective communication to reduce the potential for a claim or litigation.
Session Level: Experienced
James Saxton, Esq.
Patricia Kearney, RN, MPA, ARM, DFASHRM
Stevens & Lee
Lancaster, PA
MON-08
Integrating Patient Safety into Risk Management: Win-Win Solutions
As an emerging discipline with many organizational models, patient safety has undergone rapid change with significant impact upon more traditional risk management operations. Integration and alignment issues can lead to conflicts, decreased effectiveness and dissatisfaction. This program explores organizational delivery models and barriers to effectiveness and strategies for incorporating patient safety principles into risk management programs.
Objectives: Identify organizational models used to deliver risk management, quality and patient safety services and discuss barriers of each. Describe risk management and patient safety paradigms and functions, identifying areas of conflicts. Explore solutions to conflicts and ways to incorporate patient safety principles into risk management programs to increase effectiveness.
Session Level: Experienced
Becky Kanjirathinkal, MS, RN, CPHQ, CQMgr, CPHRM
CNA Insurance
St. Joseph, MO
MONDAY, Oct. 30
1:15-2:45 p.m.
MON-09
Sexual Assault: Responding to a Crisis in Your Institution
Risk management and litigation issues (civil and criminal) can arise from a patient’s claims of sexual assault by a health care provider. The presentation discusses appropriate responses to inquiries by the patient, the patient’s family and governmental entities. The presentation also focuses on duties, responsibilities and privileges that apply in complaints involving potential criminal conduct. Finally, the presentation reviews procedures for obtaining evidence and interviewing witnesses in the aftermath of a sexual assault claim and providing employee support when accusations are proved false.
Objectives: Identify the risk management issues involved in claims of sexual assault. Gain familiarity with requirements for timely gathering of evidence in response to a claim. Understand the responsibilities and duties of responding to governmental inquiries.
Session Level: Experienced
Earnest Wotring, JD
Connelly Baker Maston Wotring Jackson
Houston
Craig Morgan, RN, BSN, CPHRM
St. Luke’s Episcopal Health System
Houston
MON-10
The Risk Dashboard: Building and Utilizing Financial Models To Quantify and Manage Risk
A risk dashboard can provide timely information that permits risk managers and financial executives to quantify and evaluate operational and financial risks, ranging from measuring the volatility in their risk financing programs to modeling the financial impact of improvements in the quality of patient care. This session demonstrates models and run scenarios to illustrate the impact of a risk dashboard in the enterprise risk management process.
Objectives: Learn essential components of a risk dashboard. Identify and quantify traditional and nontraditional risks through the use of a risk dashboard. Identify opportunities to reduce overall costs while improving the quality of care.
Session Level: Experienced
Kevin Junod, BS
Aon Healthcare
Philadelphia
MON-11
Regulatory, Legislative and Case Law Update
This annual review covers professional liability, emergency medicine, medical staff issues, informed consent and employment practices liability case law. It also updates adopted and proposed federal and state legislation and regulation of interest to risk managers. New legislation and case law that affect health care risk management also are discussed.
Objectives: Explain recent developments in the law of medical malpractice. Explain developments in the law of informed consent. Explain developments in jurisprudence surrounding EMTALA and other statutes. Review court decisions that affect risk management or provide guidance for risk managers. Recognize trends and contemporary issues that are receiving attention of legislators. Identify and research new rules or requirements applicable to local risk management practices.
Session Level: Essentials
John C. West, JD, MHA, DFASHRM
Risk Management and Patient Safety Institute
Lansing, MI
Dan Groszkruger, JD, MPH, CPHRM
Tri-City Medical Center
Oceanside, CA
MON-12
When the Call Bell Rings: The Roots of Patient Injury
Many factors can culminate in a patient injury. Nursing claims are the focus of this session and suggestions for dealing with individual and system issues are presented. The session gives an overview of the roots of injury and further focuses on lack of knowledge, inexperience and cultural differences.
Objectives: Identify the roots of injury which can begin “when the call bell rings.” Define how competency-based orientation identifies lack of knowledge or skills and inexperience. Identify the role of cultural differences in creating the potential for patient harm.
Session Level: Essentials
Patricia Iyer, MSN, RN, LNCC
Med League
Flemington, NJ
Barbara Levin, BSN, RN, LNCC
Massachusetts General Hospital
Bingham, MA
MON-13
Part 1: Enhancing the Effectiveness of Incident Reporting Mechanism for Risk Identification
A review of current incident reporting processes and practices can help enhance the effectiveness of information captured on incidents, loss-producing events, near misses and unsafe conditions. This presentation suggests improvements in data analysis and conversion of data into a format to identify problems.
Objectives: Understand the benefits of a real-time incident reporting system. Improve proactive response to untoward events. Convert data into a useable format to provide an accurate picture of patient safety problems.
Greg Terrell, MS, CSP, ARM, CPHRM, FASHRM
Tenet Healthcare
Dallas
Part 2: Complexity of the Shift Change Process
The shift change is critical in communication of patient information. Variables can interfere with that communication process and introduce the potential for error. Discussion here includes the human factor components of staff diversity, variability of processes, fatigue, environment and the complexity of systems. Methods to improve current processes to prevent error and improve patient outcomes also are covered.
Objectives: List three human factors that can affect communication during change of shift. Describe a complex system and its influence on communication of patient information. Identify two ways to enhance communication during patient handoff at change of shift.
Sessions Level: Experienced
Maripat Burrell
John C. Lincoln Health Network
Phoenix
MON-14
Captive Basics: A Case Study in Captive Implementation and Management
This session is aimed at risk managers who are evaluating the pros and cons of establishing a captive. Topics to be discussed include understanding the captive concept, domicile options, captive feasibility and implementation, and operational issues. Participants will be led through a case study to see risk management issues that arise in incorporating and managing a captive.
Objectives: Understand the basics of captive insurance companies and why they are formed. Appreciate the process to incorporate a captive. Recognize differences among various on-shore and off-shore domiciles.
Session Level: Essentials
Jennifer Murkison
Marsh Management Services (Bermuda)
Hamilton, Bermuda
Mitch Melfi, JD
Catholic Health Initiatives
Erlanger, KY
MON-15
Involving Patients in Root Cause Analysis: Legal and Psychological Implications
There are benefits and challenges in involving patients and families in root cause analysis. This interactive workshop is designed to stimulate consideration of the benefits of transparency with patients, particularly by including them in the process. The presenters provide real-life examples of experiences as well as legal and psychological framework for understanding how apology works and how transparency affects trust.
Objectives: Explore benefits and challenges of involving patients and families in the RCA. Explore the benefits and challenges of transparency in the RCA process. Discuss the psychological aspects of honesty and apology from the perspective of the patient and health care giver.
Session Level: Experienced
Theresa Zimmerman, RN, JD, ARM, CPHRM
Barberton Citizens Hospital
Barberton, OH
Geri Amori, Ph.D., ARM, CPHRM
Risk Management and Patient Safety Institute
Shelbourne, VT
MONDAY, Oct. 30
3-4 p.m.
MON-16
Staff Privilege Litigation: The View from the Trenches
Staff privilege litigation is a contentious, high-stakes matter. Crimes and conspiracies are alleged. Types of staff privilege litigation, how to initially reduce the risk of getting sued, how to handle the press, deciding whether to settle or try the case, fighting the discovery fights, maintaining unity within the defense team, educating the judge and narrowing the issues for the jury are discussed.
Objectives: Reduce the risk of staff privilege litigation. Educate physicians, executives and directors about their roles in such litigation. Understand the complexity and contentiousness of such litigation.
Session Level: Essentials
Randy Andrada, JD
Andrada & Associates Professional Corp.
Oakland, CA
MON-17
Risk Management: NOT for Dummies
Health care risk managers struggle with three basic issues: 1) identifying potential compensable claims associated with adverse events, 2) aggregating significant data from those events and 3) analyzing and interpreting data to prevent recurrences. This session facilitates evaluation of processes used by risk managers to meet these challenges, assess the effectiveness of those processes and propose the application of Six Sigma techniques to improve the quality of care.
Objectives: Enhance knowledge of case identification, aggregation of data and analysis of data.
Session Level: Experienced
Clara Flora, CPHRM, RHIA
South Bay Hospital
South City Center, FL
MON-18
Long-Term Care Update on Case Law and Regulations
Statutes, regulations and case law affecting the long-term care industry that have been recently promulgated or reported are described and discussed. Examples include nursing hours, influenza vaccine regulations and the OIG’s indication of long-term care areas that are targeted for review. In addition, Medicaid legislation is pending regarding asset transfer and Medicare Part D affects long-term care residents. Emphasis here is placed on legislation and case law relevant to a wide audience, not just certain states.
Objectives: List new statutes and regulations that affect long-term care. Discuss case law relevant to the industry. Describe how residents are affected by implementation of Medicare Part D.
Session Level: Experienced
Mary Marta, Esq.
Erickson Retirement Communities
Baltimore
MON-19
Joint Commission Requirements for Risk Managers
This session provides risk managers with an understanding of Joint Commission requirements that uniquely affect risk managers. The periodic performance review, which provides the framework for continuous standards compliance and focuses on the critical systems and processes that affect patient care and safety, is discussed. Risk-related implications of voluntary reporting to a federally designated patient safety organization also are discussed.
Objectives: Identify six Joint Commission requirements that uniquely affect risk managers. Understand the risk implications of the four periodic performance review options. Describe the risk-related implications of voluntary reporting to a federally designated patient safety organization.
Session Level: Essentials
Mark Crafton, MPA, CPHQ
Joint Commission on Accreditation of Healthcare Organizations
Oakbrook Terrace, IL
MON-20
Creating a Loss Run that Matters
The presenter shares knowledge gained from years of trial and error – reviewing the reasons for creating a loss run and describing the basics as well as finer points of creating a loss run.
Objectives: Improve the understanding of the uses of loss runs and appreciate the need for them to be as accurate as possible. Be able to put the basic loss run elements into a spreadsheet.
Session Level: Essentials
Clare M. Bello
Vertical Claims Management
Pittsburgh, PA
MON-21
Emergency Medicine: Improving the Risk Profile
This session looks at clinical, systems, communication, documentation and operational issues that contribute to emergency medicine malpractice. Patient safety and claims prevention techniques are highlighted. Key concepts in improving the risk profile include practice management, behavioral and clinical skills, and creating a risk-adverse culture. Lessons learned from a multi-state emergency medicine evaluation and a review of the audit template tools are shared.
Objectives: Review high-risk issues and contributing factors in emergency medicine. Understand of the malpractice risk and trends in emergency medicine. Demonstrate practical solutions and claims prevention techniques.
Session Level: Essentials
Graham Billingham
Emergency Medicine Patient Safety Foundation
Auburn, CA
Michelle Hoppes, RN, MS, AHRMQR, DFASHRM
Tristate Patient Safety Foundation
Grand Ledge, MI
MON-22
Getting the CEO’s Attention: The Case for Integrating Risk & Performance Improvement
What are the contributions that risk management and performance improvement can make to organizational performance? Two applications of an enterprise risk management approach will be demonstrated. In addition, the American Hospital Association Quality Center will be introduced. The Quality Center, created in 2006, will be a convener of people and ideas and a catalyst to support users’ efforts to identify and foster innovations in quality and patient safety.
Objectives: Understand the linkage between cost of risk and the costs of poor quality. Understand human factors aspects of system performance, and how proactive assessment of potential flow issues may mitigate or eliminate defects and liability. See examples of how to quantify both active and latent costs of risk or quality in order to establish the contribution of risk management and performance improvement to the financial performance of the organization.
Session Level: Experienced
Stephen Mayfield, BS, MBA, MBB
AHA Quality Center
Chicago
MON-23
Pandemic Preparedness In Healthcare: What Healthcare Risk Managers Should Know
Healthcare clinical risk consultants will discuss Pandemic Preparedness and how the Avian Flu will have an impact on your healthcare organization. The discussion will cover some of the difficult issues healthcare organizations will face in the event of a pandemic event including, human resource issues, internal emergency preparedness plans and risk financing. Healthcare risk managers will learn more about their role in pandemic preparedness, understand the implications of human resource issues and explore risk financing options.
Session Level: Experienced
Dalena Barrett, BSN, RHD, CPHRM
Marsh Risk Consulting
Nashville, TN
Keith Becker
Marsh USA, Inc.
Atlanta, GA
Jim Reynolds, MD
Mercer Human Resource Consulting
Melissa Updike, CPHRM
Marsh Risk Consulting
Louisville, KY
10-11:30 a.m.
TUES-01
Nursing Liability: An Analysis of Claims
Registered nurses, nurse midwives, CRNAs and nurse practitioners are feeling the affects of escalating litigation. This synopsis of closed claims will highlight primary allegations, injuries, frequency and severity. Results of a 2005 Nurse Practitioner Claims Study will be presented.
Objectives: Discuss the current litigation environment for registered nurses and advanced practice nurses. Identify primary allegations associated with lawsuits involving nurses and advanced practice nurses. Identify successful strategies to mitigate the risk of lawsuits and to defend claims.
Session Level: Experienced
June Leigh, RN, MS, ARM, CPHRM
Nancy Lagorio, RN, MS, CCLA
CNA HealthPro
Chicago, IL
TUES-02
Emerging Catastrophe Risks: Post 9/11, Post Katrina, Post Blaster
A panel discusses types of catastrophic events that may affect a hospital, including natural disasters, terrorism and security breaches of electronic medical records.
Objectives: Review previous incidents as a framework for the types of incidents hospitals may encounter. Provide examples of successes and failures in response to such incidents. Outline steps to mitigate such risks in an integrated approach to crisis management.
Session Level: Experienced
Pamela Haughawout, CPCU, ARM, RPLU
Lawrence Likar, Ph.D., JD
Matthew Kelly, BA
Hilb Rogal & Hobbs
Boston, MA
TUES-03
Enterprise Risk Management Models and Implementation Panel
Panelists present ERM models and discuss implementation. An overview of models and processes as well as the consultant’s role in developing an ERM program will be described. Viewpoints from organizations that have developed programs will be shared along with the steps in the process. Information will be provided on a simple but effective framework.
Objectives: Understand ERM and its value and application in health care organizations. Gain knowledge about the learning experiences of organizations during implementation of ERM programs. Avoid complicating strategies.
Session Level: Experienced
Cindy Magners, RN, MEd, MPA, CPHRM
Children’s Healthcare of Atlanta
Atlanta
Michael Chagares
Mercer Oliver Wyman
Washington, D.C.
Mitch Melfi, JD
Catholic Health Initiatives
Erlanger, KY
John Phelps, CPCU, ARM
Blue Cross Blue Shield of Florida
Jacksonville, FL
TUES-04
Strange Bedfellows: Vendor Relationships in the Operating Room
Sales representatives (vendors) are commonly allowed into the OR to assist in the use of new devices or techniques. This session tells how one facility’s risk managers, partnering with sourcing and materials management departments, influenced a network-wide shift in vendor interactions to create safer ORs for patient care, control costs and comply with federal regulations.
Objectives: Understand the scope of risk management issues related to the practice of allowing and encouraging vendor interaction in the OR. Examine how collaborating with non-traditional partners in assuring safe care can be an effective risk management strategy. Examine policies and procedural changes that serve to increase patient safe environments.
Session Level: Experienced
Mary Gutman, RN, CPHRM, FASHRM
Premier Health Partners
Dayton, OH
Bobbie Gerhart, RN, MS, FACHE
Miami Valley Hospital
Dayton, OH
TUES-05
Maximizing Mandatory Risk Management Education: Two Interactive Approaches
This session outlines the development of a mandatory specialty-specific program to address error prevention and disclosure using both instructor-led and online formats. The structure of the program allows for the physician to participate in discussion and a variety of interactive exercises drawn from a real case set in primary care, surgery or pediatrics area.
Objectives: Describe at least three methods of making educational programs interactive. Describe two teaching modalities to motivate learners to make behavioral changes. Name five advantages and disadvantages of the use of e-learning in health care.
Session Level: Essentials
Geri Donohue, MSN, RN, ARM
Marjorie Thomas, MPA, FASHRM, ARM, RPLU
Christine Quinn, MPA, BSN, RN, FASHRM
Administrators for the Profession
Manhasset, NY
TUES-06
Health Care Privacy and Security Risks:It’s Not Just About HIPAA! Integrated Risk Management and Risk Transfer Strategies
Privacy issues related to financial information, identity theft, outsourcing and the performance of patient-related functions through public and private networks have revealed inadequate insurance programs, ineffective contract negotiations and limited risk management strategies. This session identifies key technology and privacy risks, updates health care risk managers on the new legal environment, and outlines risk transfer and risk control technology strategies.
Objectives: Identify risks in health care technology systems, including privacy, network security, identity theft, Web site risk and related liabilities. Develop strategies for technology and privacy exposures to protect organizations and boards, with emphasis on tying technology risks to integrated risk management objectives. Evaluate health care risk transfer products, conduct a gap/overlap coverage analysis with traditional insurance policies, and strengthen contract terms and requirements related to technology and outsourced risks.
Session Level: Experienced
Janet Hale, ARM
Jardine Lloyd Thompson
Houston
Judith Camp, ARM
Triad Hospitals
Plano, TX
Emily Freeman, ARM, AU
JLT Risk Solutions
London, England
Lori Nugent
Cozen O'Conner
Chicago
TUES-07
XXXL Risk: Risk Management in a Bariatric Population
A bariatric surgeon and nurse and health care risk manager address risk issues and risk management interventions in the care and treatment of obese patients. Topics include equipment and environmental accommodations, physician and health care staff training, patient selection and informed consent, and employee and patient safety interventions. A medical malpractice insurance executive addresses how high-risk characteristics of bariatric surgery procedures affect professional liability claims and insurance premiums.
Objectives: Discuss three risk management issues and interventions in health care delivery for the morbidly obese. Describe major liability risks and risk reduction interventions in a bariatric surgery program. Identify two liability issues in the informed consent process for the bariatric surgery patient and family.
Session Level: Experienced
Diane Valley, RN, MS, AHRMQR
Spectrum Health
Randal Baker, MD
Michigan Medical PC
Grand Rapids, MI
Cal Mulder
Michigan Professional Insurance Exchange
Grand Rapids, MI
TUESDAY, Oct. 31
1:15–2:45 p.m.
TUES-08
Interactive Mini-Trial
Through direct and cross-exam, presenters act as co-counsel and judge to illustrate litigation issues at their endpoint: a jury trial, with jury verdict interrogatories filled out by attendees after deliberation. The ultimate effects of good and bad risk management practices (covering reporting unanticipated outcomes, sentinel event root cause analysis, credentialing, compliance, etc.) are revealed in real time.
Objectives: Identify components of a medical liability trial and the roles of witnesses, counsel, trial judge and jury. Identify and analyze how good risk management practices make a difference in the courtroom. Identify and analyze how bad risk management practices are exploited in the courtroom to create liability and/or enhance damages.
Session Level: Essentials
Stephen Ryan, JD
Kathleen McGrath, JD
Daniel Sherry, JD
Marshall, Dennehey, Warner, Coleman & Goggin
King of Prussia, PA
TUES-09
Enterprise Risk Management and the ‘C’ Suite
ERM is gaining attention in the “C” suite as a way to benefit from risk and opportunity and add value to an organization. As more health care organizations elevate the risk manager to the chief risk officer position, this presentation explores the evolution of ERM and the process for developing and implementing an ERM program. The two presenters approach the topic from not-for-profit and for-profit CRO perspectives.
Objectives: Describe basic components of three ERM models in the industry. Articulate the process for developing and implementing an ERM program in not-for-profit and for-profit health care organizations. Discuss the unique challenges associated with effective health care ERM programs.
Session Level: Experienced
Peggy Nakamura, RN, MBA, JD, DFASHRM, CPHRM
Adventist Health
Roseville, CA
Sheila Hagg-Rickert, JD, MHA, MBA, CPCU, DFASHRM, CPHRM
Sun Healthcare Group
Irvine, CA
TUES-10
A Grievance Is Not Just a Complaint
Regulatory agencies frequently investigate complaints from patients who state that a health care organization has failed to address their concerns. This session focuses on how to handle patient grievances to meet federal regulatory requirements, boost customer satisfaction and improve performance. Special considerations include patient rights, prior knowledge/punitive damages, hidden risks/potential claims, and how to expand management team accountability for mandatory written follow-up to patient grievances.
Objectives: Understand the difference between complaints and grievances. Learn how to structure a grievance policy and establish a committee to monitor grievance processes. Learn tips to engage management team with preparing written responses to resolve grievances.
Session Level: Essentials
Regina Vukson, RN, CPHQ, CPHRM
Optima Healthcare Insurance Services
Sanger, CA
Jean Turvey, RN
Wesley Medical Center
Halstead, KS
TUES-11
Regulatory, Legislative and Case Law Update
Repeat of MON-11.
TUES-12
Preventing Multiple Medication Incidents: Strategy To Minimize Harm for Your System
This session considers how to track medication incidents and inform other institutions and governmental entities. Additionally, this session discusses how the Patient Safety and Quality Improvement Act of 2005 can help in sharing information among other institutions to protect confidentiality. Finally, this session discusses how to best communicate medication incidents throughout a hospital. The goal for hospital systems is a strategy (including committee structure) to prevent harm and reduce legal liability.
Objectives: Design a strategy to minimize harm caused by medication errors. Use the Patient Safety Act to report medication errors to other institutions and keep information confidential. Provide a proactive plan for addressing medication incidents.
Session Level: Experienced
Amy Nilsen, JD
Connelly Baker Wotring & Jackson
Houston
Ellen Quinn, RN, ARM, FASHRM, CPHRM
Christus Health System
Houston
TUES-13
2006 Hospital Liability Benchmark Results
This session highlights findings of the latest Aon/ASHRM Hospital Professional Liability Benchmark Analysis. Results include trends in claim counts, average size of loss and overall liability costs. (The survey will be available for purchase at the ASHRM onsite bookstore.)
Objectives: Understand the latest trends in liability costs. Compare liability costs by type of hospital system and by state. Understand the key drivers of liability cost trends.
Session Level: Experienced
Greg Larcher, FCAS, MAAA
Aon Healthcare
Columbia, MD
Erik Johnson, FCAS, MAAA
Aon Risk Consultants, Inc.
Columbia, MD
TUES-14
Developing a Risk Management Program for Small and Rural Facilities
In a forum-type discussion moderated by the risk manager of a 50-bed rural hospital, small/rural facilities can share best practices in developing a viable risk management program with limited resources. The moderator uses Chapter 4 of the Risk Management Handbook for Health Care Organizations (4th ed.) to focus the discussion on the elements of a good risk management program.
Objectives: Understand the key elements of an effective risk management program. Gain the understanding of ways to establish an effective risk management program in small/rural setting. Identify resources outside an organization that can augment risk management resources.
Session Level: Essentials
Bradley Howell, CPHRM
Madison Memorial Hospital
Rexburg, ID
TUESDAY, Oct. 31
3-4 p.m.
TUES-15
Overreaching Discovery Requests: Defending Patient and Employee Privacy
Risk managers are often faced with a plaintiff’s overreaching discovery requests for a hospital’s personnel records and the medical records of other patients. Fighting such discovery tactics requires an understanding of information contained in these two different types of records and how the law protects that information. Defending against such requests requires that a risk manager understand how to translate state and federal laws into practical, daily procedures that strengthen the arguments against discovery.
Objectives: Identify information to be stored in an employee’s personnel record and patients’ medical records. Understand how state and federal laws protect the information in these records. Learn procedures to combat overreaching discovery requests for these types of records.
Session Level: Experienced
Andrew McCumber, JD
McCumber Inclan
Tampa, FL
TUES-16
Don’t Fall Into the ‘Pit’: Avoiding Allegations of Oxytocin Misuse
When there is an adverse labor and delivery outcome and a lawsuit, allegations of improper use of oxytocin are common components of the suit. This session reviews the pharmacology and safe use of oxytocin. It addresses a protocol for safe administration, the risks of using it with patients undergoing a trial of labor after prior cesarean birth and the management of induction and augmentation of labor, with attention to avoiding and managing tachysystole and hyperstimulation.
Objectives: Understand how oxytocin works. State the risks of using oxytocin with women who have had cesarean deliveries. Develop a protocol for safe use of oxytocin.
Session Level: Experienced
Larry Veltman, MD
St. Vincent Medical Center
Portland, OR
TUES-17
Risk Management in Senior Housing: CCRCs, Assisted Living, Independent Living and Skilled Facilities
The senior housing world poses unique risk exposures yet can borrow risk management techniques similar to those used in hospitals. Claims and litigation trends seen in various senior housing venues are presented here along with techniques and models for risk managing a multi-state operation.
Objectives: Understand current claim trends seen in senior housing. Develop a risk management program suitable for a multi-state operation. Customize tools and checklists to improve a risk management program.
Session Level: Essentials
Mary Lynn Curran, RN, MS, FASHRM, CPHRM
Thilman Filippini
Chicago
TUES-18
Compassionate Risk Management: Patients at the End of Life
This session looks at enterprise risk management as it pertains to patients at the end of life. Their unique legal and regulatory challenges include privacy issues, unconsented touching, pain relief, termination of life support, surrogate decision-making and religious demands. A sample risk management policy unique to this patient population is presented.
Objectives: Identify risk management needs of end-of-life and terminally ill patients. Integrate the ERM concept with end-of-life patients. Implement appropriate risk management strategies.
Session Level: Essentials
Wanda Hurr, RN, JD, CPHRM
PIC Wisconsin
Madison, WI
TUES-19
Creating and Improving a Highly Reliable Diagnostic Process in an Integrated Health Care Delivery System
Delays and failures of diagnosis account for many medical malpractice claims. Diagnostic errors are difficult to recognize because multiple contributors occur over a long period. Kaiser Permanente developed an initiative to reduce the incidence of diagnostic errors by infusing high reliability principles. The initiative involves 1) developing a conceptual model to understand the diagnostic process and failure modes, 2) identifying solutions that prevent these failure modes from occurring, which includes “diagnosing misdiagnosing,” and 3) implementing an organization communication and practice transfer strategy.
Objectives: Understand a conceptual model that shows how diagnostic errors occur. Identify approaches to prevent diagnostic failure modes from occurring. Implement an organization communication strategy addressing diagnostic errors and potential solutions.
Session Level: Essentials
Doug Bonacum, MBA, CSP, CPHQ, CPHRM
Kaiser Permanente
Oakland, CA
TUES-20
Establish or Redesign a Hybrid Customized Captive for Effectiveness
This session provides insight into designing or redesigning a captive for optimal effectiveness in the changing corporate and health care environment. The speakers utilize a case study from the Stanford University Hospitals and School of Medicine to illustrate a methodology to establish or redesign a hybrid customized captive with the goal of optimizing effectiveness while maintaining composure in a dynamic business climate.
Objectives: Learn the possibilities of covering wholly owned subsidiaries, joint ventures or affiliated parties in various captive models. Identify potential partners and understand their roles and synergies. Design a corporate governance structure in line with modern requirements. Understand the unlocked potential of a captive as an alternative risk finance vehicle.
Session Level: Experienced
Jeff Driver, Esq.
Stanford University Medical Indemnity and Trust Insurance Co.
Stanford, CA
TUES-21
New Restraint Reduction Techniques in Psychiatric Treatment Programs
Facilities with psychiatric programs face numerous challenges in managing the risk of aggressive patients because restraint episodes can lead to patient and staff injuries and lawsuits This session airs new strategies to reduce restraint episodes while ensuring patient and staff safety. It demonstrates how these techniques can help change a culture of restraint as the first choice for control to a culture of collaboration. Patient involvement is highlighted to show how patients can learn to identify escalating behaviors and rehearse self-de-escalation skills in advance.
Objectives: Identify innovative techniques that have been used in restraint reduction strategies. Describe the importance of a culture of safety, patient collaboration and earlier intervention in the aggression cycle with regards to usage of restraints and restraint reduction techniques. Recognize best practices from patient safety, performance improvement and other areas.
Session Level: Essentials
Greg Timmons, RN, MA, JD, CPHRM
AIG Consultants
San Francisco
TUES-22
Beyond Theory: Practical Applications for Reducing Risk in the Physician Office Practice
This session reviews risk reduction strategies for the physician office practice and provides sample tools and practical applications. Information is based on claims analysis with identification of trends in medical malpractice claims and 20 years of experience with physician office appraisals. The presenter covers primary care, pediatrics, cardiology, obstetrics and gynecology and psychiatry. High-risk areas include tracking and follow-up systems, phone communication, medications, informed consent/refusal, communication and documentation.
Objectives: Develop strategies to minimize risks associated with the physician office regarding patient communication, informed consent and documentation. Identify tools for tracking and follow-up and medication processes. Recognize the important role the phone plays in patient care and satisfaction and how to document patient calls.
Session Level: Essentials
Anne Huben-Kearney, RN, MPA, CPHQ
ProMutual Group
North Haven, CT
8:30-9:30 a.m.
WED-01
Analysis of Triggers in Alleged Medical Malpractice
The presenter identifies six triggers that lead to medical malpractice allegations: 1) system errors, 2) documentation and communication, 2) the medical model, 3) “own worst enemy,” 4) poor decisions and 5) rare diseases. Video interviews and case vignettes explore these triggers and strategies to reduce risk and improve patient care.
Objectives: Identify potential system errors. Assess medical model for potential risks. Improve documentation and communication.
Session Level: Essentials
Scott Cooper, MD
Evanston Northwestern Healthcare
Highland Park, IL
WED-02
Risk Assessment: A Complement to Enterprise Risk Management
Enhancing quality, decreasing variability, ensuring patient safety, promoting communication and adequate documentation while supporting team efforts are all initiatives touching health care risk management professionals. This session highlights how a risk assessment can support an organization’s ERM program by offering actionable initiatives and solutions to identified areas of concern
Objectives: Understand risk assessment. Evaluate and prioritize risk initiatives. Understand what it takes to implement the initiatives recommended.
Session Level: Experienced
Roberta Carroll, CPCU, MBA, CPHQ, CPHRM
Aon Risk Services
Odessa, FL
WED-03
Patient Safety Organizations: Ins, Outs and Roundabouts of Protecting Patient Safety Data
The Patient Safety and Quality Improvement Act of 2005 establishes a new vehicle for collection, analysis and sharing of patient safety data. This session explores the mechanics of a patient safety organization and the benefits and operational risks. Benefits of using a PSO to collect patient safety include confidentiality, protection from disclosure and other protections for health care organizations, providers and reporters. However, operational issues must be weighed. This discussion provides insight into how to set up a PSO to maximize benefits and avoid or reduce operational risks.
Objectives: Describe the purpose and organization of a PSO. Identify benefits of using a PSO to gather and protect patient safety data to improve patient safety and quality of care. Identify operational risks to peer review and other patient safety activities such as FMEA and RCA that result from using a PSO to gather patient safety data.
Session Level: Experienced
David Sine, CSP, ARM, CPHRM
Safety Logic Systems
Austin, TX
Chad Follmer, ARM
Marsh USA
Houston, TX
Brenda T. Strama, Esq.
Vinson & Elkins
Austin, TX
Mike Personett, CPHRM
Peminic, Inc
Princeton, NJ
WED-04
Against Medical Advice: When To Take ‘No’ for an Answer
Difficult consent issues related to providing acute medical care arise in the hospital setting, particularly the ED. Specific encounters, such as patients who leave before examination, patients who refuse emergency stabilizing care, suicidal patients refusing care or persons refusing police-requested blood alcohol draws, are discussed.
Objectives: Know when a patient can refuse emergency medical care and sign out against medical advice, and when health care providers must override a refusal. Understand the elements of “informed refusal” that are necessary before a patient can decline emergency care, and be able to document that in the medical record to avoid liability. Determine when minors can consent or refuse medical care on their own and when parents may not refuse care for their children.
Session Level: Experienced
Robert Bitterman, JD, MD, FASHRM
Bitterman Health Law Consulting Group
Charlotte, NC
WED-05
Measuring Safety from a Risk Perspective
This session introduces methods for demonstrating improvements in patient safety as viewed by a risk management professional. Participants can explore what the insurance markets want to see when they ask about patient safety and methods for demonstrating material reduction in events that lead to injury and malpractice liability.
Objectives: Describe methods for demonstrating improvements in patient safety. Identify patient safety improvements that resonate with excess insurance markets. Understand best practice as it relates to risk investigations that empower opportunities for risk-oriented patient safety metrics.
Session Level: Experienced
Mary Anne Hilliard, RN, JD
Raymond S. Sczudlo, Esq.
Children’s National Medical Center
Washington, D.C.
WED-06
The Analytic Process and the Importance of Your Data
Corporate risk finance programs are only as good as the data from which they are based. Many institutions have difficulty grasping the data needed to truly understand their risk exposures and loss costs. This session identifies key data components and explains how they are used to develop insurance premiums and fund retentions. This session also provides strategies for identifying data issues and bringing positive resolution to them.
Objectives: Identify key data components that underwriters and actuaries review to develop insurance premiums and funding estimates, including how underwriters view data and develop rating models. Develop the ability to understand the expected loss costs and the implications of those losses in terms of risk transfer and funding retention. Understand the importance of accurate internal data and the relationships among these data, the underwriting process and funding retention.
Session Level: Essentials
Lorraine Lewis, CIC, CISR
Jardine Lloyd Thompson
Houston
Sabrina Hart, FASHRM
Zurich
New York
John Mize, FCAS, MAAA
Towers Perrin
Atlanta
WED-07
Forgiveness and Fair Compensation: Ethical Considerations Following Medical Error
Health care organizations are being advised to disclose harm-causing errors promptly and truthfully, while data indicate that fewer malpractice suits are proceeding to jury trial. This presentation discusses significant moments that bear on justice: 1) apologizing for error and requesting forgiveness, and 2) determining what justice demands by way of “fair” compensation to an injured party.
Objectives: Characterize organizational challenges inherent in discussions that recommend that error disclosure conversations be transparent, contrite and forgiveness-seeking. List models or approaches to understanding fair compensation in the aftermath of harm-causing medical error. Discuss how ethical dimensions of risk management are affected by an interest in truthful and empathic disclosure of error and the consideration of fair compensation.
Session Level: Experienced
John Banja, Ph.D.
Ethics Center, Emory University
Atlanta
Nancy Berlinger, Ph.D., MDiv
Hastings Center
Garrison, NY
Go to the Annual Conference home page
