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CONCURRENT SESSIONS
Friday, Oct. 3 | Saturday, Oct. 4 | Sunday, Oct. 5
FRIDAY, OCT. 3
9:15-10:15 A.M.
FR-01
Achieving Top Performance from Outside Counsel
Here’s a unique approach to a familiar topic: In-house counsel and outside counsel join together to identify a succinct way to select outside counsel, an objective evaluation of the effectiveness of outside counsel and the secrets to making the relationship a rewarding one for all parties. The presentation is in a panel format and includes templates attendees can use to develop their own forms.
Objectives: Apply objective criteria to the selection of outside counsel. Evaluate outside counsel using an assessment method developed by Baylor Health Care System. Identify qualities that promote the best legal representation.
Katherine Laws, JD, CPHRM
Steed Flagg LLP, Rockwall, TX
Beth Huntington, BSN, MSN, JD
Baylor Health Care System, Dallas
FR-02
Cyber and Privacy Liability for Healthcare Organizations
Privacy and security breaches that make headlines remind healthcare organizations that, as technology evolves, they must adapt risk management plans to include ever-present cyber risks. Faculty discusses assessing and quantifying risk, comparing coverage options for healthcare to limit liability, and addresses the impact of recent litigation on the cyber risk insurance market, the FTC, HIPAA security and public notification legislation, and effective incident response plans.
Objectives: Differentiate current coverage for cyber liability with PL, GL and property programs and gaps that need coverage from a different insurance source: cyber product. Analyze HCO cyber risks, specific controls for these risks and insurance products available for first- and third-party exposures including those to the organization, patients and providers. Utilize the information provide to develop an enterprise-wide risk minimization program for cyber risk in collaboration with the CIO and other key leaders.
Michael Klaschka, BS
William McDonough, MPAH, ARM, FASHRM
Integro Insurance Brokers, Boston
Toby Merrill, BA
ACE USA, Boston
FR-03
Physician Involvement in Risk and Safety: Strategies and Rewards
Children’s Memorial Hospital (CMH) is a free-standing tertiary care hospital in an unfriendly med-mal jurisdiction. CMH reorganized its risk/safety structure in 2005 to have direct physician oversight of risk and safety, and can now report success in this strategy.
Objectives: Identify ways to engage physicians and hospital leadership in becoming more involved with patient safety and risk. Recognize the benefits of having physicians directly involved with claims management. Recognize the benefits of having physicians who are involved in risk and safety be part of the risk financing strategy.
Tetsu Uejima, MD, CPHRM
Children’s Memorial Hospital, Chicago
FR-04
Avoiding EMTALA Liability When Sending or Accepting Patient Transfers
Patient transfers are high-risk medical-legal encounters for hospitals and physicians. Federal law (EMTALA) compounds those risks because it controls most aspects of patient transfers. Furthermore, the number of transfers is increasing exponentially, particularly to referral centers, due to difficulty in maintaining specialty on-call coverage for hospital EDs. This session provides methods, tools and forms to transfer patients in compliance with the law. It also teaches when transfers must be accepted and when they may be rejected so as to avoid regulatory and civil liability for failure to accept appropriate transfers required by EMTALA.
Objectives: Understand methods and tools to affect appropriate patient transfers in compliance with EMTALA. Know when to accept or reject patient transfers according to EMTALA and understand regulatory and civil liability for failure to accept appropriate transfers under the law. Recognize legal responsibilities of on-call physicians related to accepting patients in transfer.
Robert Bitterman, MD, JD, FACEP
Emergency Physicians Insurance Co., Harbor Springs, MI
FR-05
Handle with Care: Management of Behavioral Health Patients in the ED
This session reviews safety data related to the management of behavioral health patients in the ED, highlights the significant patient safety issues, and provides intervention strategies to reduce risk of harm in the ED.
Objectives: Describe current data regarding the care and management of patients with a primary behavioral health diagnosis in the ED. Discuss risk issues related to patient safety of behavioral health patients in the ED. Discuss appropriate risk treatment to reduce the likelihood of harm to self and others when managing behavioral health patients in the ED.
Bernard Katz, MC, PC
Newton Centre, MA
Carol Burkhart, RN, MS, CNP
Marsh Risk Consulting, Denver
FR-06
Turning Your Medication Data Into Answers: Help Improve Performance By Reducing Risk, Improving Safety and Decreasing Cost
Automated dispensing cabinets and smart infusion pumps generate utilization and clinical data that can help identify potential patient safety risk points and populate a continuous quality improvement plan. Template reports, dashboards and critical questions, which organizations can use to gain insight and to follow trends in medication ordering, dispensing and administration, are discussed. Methods to set criteria limits for overrides, controlled substance triggers and identification of subsets of adverse drug events are explained.
Objectives: Identify the universe of data that can be obtained from automated dispensing cabinets and smart infusion pumps. Define key organizational risk points such as controlled substance proactive diversion monitoring, overrides of medications without pharmacist review, triggers for high risk intravenous medications and potential adverse drug events. Describe methods to obtain data, analyze activities and improve performance and outcomes.
Patricia Kienle, R.Ph., MPA, FASHP
Cardinal Health, Laflin, PA
Thomas Utech, Pharm.D.
Carol Leighton, MR.Pharm.S.
Cardinal Health, San Diego
FR-07
Aon/ASHRM Hospital Professional Liability Benchmark Analysis
This session recaps some highlights of the 2008 Aon/ASHRM Hospital Professional Liability Benchmark report. Key findings include trends in frequency, severity and loss costs. The authors look at underlying drivers including patient safety and claims management.
Objectives: Identify trends in hospital professional liability. Compare current results to prior reports to highlight changes in the underlying environment. Learn how patient safety initiatives are affecting loss costs.
Gregory Larcher, FCAS, MAAA
Kristin Monopolis
Aon, Millersville, MD
FR-08
Is the Designed Built Environment Safe for Patients?
Providers are increasingly sensitive to the risks posed to patients by a variety of care system components. Some hazards are subtle and hard to identify, particularly those in the physical environment in which care is conducted. Unfortunately, there is little reliable research on this subject and there are differing opinions among design practitioners as to the nature and severity of building environment hazards. This presentation explores how design can affect safety.
Objectives: Recognize hazards associated with the designed physical environment. Learn how to research information regarding design process and issues to avoid or minimize building hazards into new facilities. Share pertinent information with design professionals which will improve compliance with regulatory requirements and enhance building safety.
A. Ray Pentecost III, Dr.PH., AIA, ACHA
Clark Nexsen, Norfolk, VA
Kenneth Dickerman, AIA, ACHA, FHFI
Jacksonville, FL
FR-22
Note: This session was originally scheduled for Friday, 3-4 p.m., but has been rescheduled to Friday, 9:15-10:15 a.m.
Clinical Conflict Resolution Between Nurses and Physicians During Labor and Birth
This session presents highlights of results from new research on how nurses handle clinical conflicts with physicians during labor and birth and the implications for perinatal patient safety and professional liability: Clinical conflict resolution does not always result in actions consistent with national standards and guidelines. Confidence in administrative support may be a key factor in empowering nurses to resolve disagreements in patients’ best interests, while medical hierarchy, disruptive clinician behavior, fear and intimidation are significant barriers.
Objectives: List common sources of clinical conflict between nurses and physicians during labor and birth. Review strategies to empower nurses to pursue resolution of clinical disagreements that are good for patients and minimize risk of professional liability.
Kathleen Rice Simpson, Ph.D., RNC, FAAN
St. John’s Mercy Medical Center, St. Louis
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FRIDAY, OCT. 3
1:15-2:45 P.M. LEARNING LABS
Structured interactive sessions for sharing best practices.
FR-09
A multimedia experiential approach demonstrates the AdVerse Event Response Team (AVERT) training program for physicians and other providers. The program focuses on delivering a compassionate and effective apology following an adverse event, managing the impact of an event on personal and professional lives, and integrating physician peer support into the culture. The session reviews protocols, types of apologies, elements of effective apologies and documentation. Self-care and self-management techniques are discussed to support providers after an adverse event.
Objectives: Via the speakers’ AVERT training program, understand the value of an apology, when an apology is necessary, types of apologies, and elements of an effective apology. Appreciate and understand listening skills and verbal and nonverbal communication that support effective apology. Appreciate and understand the caregiver’s emotional and physical response to an adverse event and self-care techniques that support well-being
Patricia McCotter, RN, JD, CPC, CPHRM
Ron Hofeldt, MD
Physicians Insurance, Seattle
FR-10
Data To Drive Action: A Risk Management Tool
This session explores concepts of data mining, and specifically how to turn data into action for financial loss control, performance improvement, risk management, regulatory compliance and reimbursement. Trends toward pay for performance, transparency and the lack of reimbursement for “errors deemed preventable” are explored. Clinical risk management principles and case studies incorporate interactive group learning.
Objectives: Identify concepts related to data mining. Identify methods for data collection and analysis of risk management information. Discuss the risk management role in using data to improve the risk profile.
Jeanie Taylor, RN, MHA
Michelle Hoppes, RN, MS, DFASHRM
Patient Safety & Risk Solutions, Auburn, CA
FR-11
Improving Risk Manager Performance with Lean Process Analysis and Quality Improvement Tools
Skilled risk managers can quickly identify waste and risks in inefficient clinical processes. Yet they may not be as readily able to identify waste and inefficiency in their own actions. Goals of this session are to: 1) illustrate the negative impact of waste on risk management activities; 2) introduce lean process analysis techniques and quality/process improvement tools; and 3) through case discussion, identify how these techniques and tools can improve risk manager performance. By identifying and removing waste, risk managers have new strategies to manage time, effort and accuracy.
Objectives: Identify how lean process analysis techniques can boost efficiencies and consistency in risk management. Through a case study, see how lean process tools can improve an electronic incident reporting system, cut average report entry time and advance successful first-time report submission.
Amit Prachand
Kristopher Goetz
Stephen Pavkovic, RN, MPH, JD
Northwestern Memorial Hospital, Chicago
FR-12
Leadership 101: Setting the Tone for the Team
In rapidly changing times, management skills are not enough; what’s needed is leadership. This session can help participants develop the skills they need to become real leaders in their organizations.
Objectives: Identify principles and techniques of leadership. Understand the role of power and influence in leadership situations. Examine leadership styles, situations and strategies. Integrate self-assessment into an effective leadership style. Recognize alternative styles of leadership.
Jane Boucher, CSP, LLC
Reno, NV
FR-13
Risk Managers as Disclosure Coaches: Practical Challenges and Effective Strategies
Risk managers increasingly must serve as disclosure coaches, even without formal training. This session covers barriers to disclosure coaching, such as resistance from workers and disagreements about disclosure content. After a presentation of coaching models that highlight effective strategies, sessions participants may practice disclosure coaching skills and receive constructive feedback.
Objectives: Describe common barriers risk managers are likely to experience as disclosure coaches and effective strategies for overcoming these barriers. List common coaching models and the pros/cons of applying each model to specific disclosure situations. Demonstrate coaching skills for successful disclosure of medical errors.
Marcia Rhodes, BA
Thomas Gallagher, MD
University of Washington, Seattle
FR-14
Case Law, Legislative & Regulatory Update
Annual update summarizes recent appellate cases, new laws and regulations of particular interest or importance for healthcare risk managers.
Objectives: Learn about recent court decisions that affect the practice of risk management or provide guidance for risk managers. Recognize trends and contemporary issues that are receiving attention of legislators. Identify new rules or requirements applicable to local risk management practices.
Dan Groszkruger, JD, MPH, DFASHRM, CPHRM
Tri-City Medical Center, Oceanside, CA
John West, JD, MHA, DFASHRM, CPHRM
AIG, Atlanta
FR-15
Closing Swiss Cheese Holes: Using In-Situ Simulation To Correct Latent Errors
High fidelity simulation (HFS) has been used as a training tool in many industries. Recently, Stanford University Medical Center Risk Management sponsored a pioneering project that utilizes in-situ HFS for systems probes in high risk/high loss areas to uncover accidents waiting to happen so that they may be proactively addressed and avoided. In this session, Stanford University Medical Center researchers preview for the first time some qualitative findings from its pilot study and share a process for setting up an HFS in-situ systems probe in various healthcare settings, from small to large.
Objectives: Recount the utilization of HFS in healthcare from past to present. Relay benefits of utilizing in-situ HFS to conduct high risk/high loss systems probes to uncover latent error. Articulate a step-wise process to set-up a HFS in-situ program.
Jeffrey Driver, JD
Geoffrey Lighthall, Ph.D., MD
Stanford University Medical Center
Palo Alto, CA
FR-16
Determining Optimum Risk Retention Levels and Risk Financing Vehicles
This presentation describes the steps for deciding what risks a healthcare provider should retain, and to what extent. It focuses on determining the risk appetite and capacity to take on risk as well as the rewards for doing so. Once participants see how to select risk retention levels, the speakers will discuss various vehicles and the benefits and drawbacks of each as a risk financing tool. This covers a variety of options such as captive insurance companies, protected cell companies, balance sheet funding, et al.
Objectives: Learn how to determine how much risk should be retained by an organization. Calculate risk tolerance and determine risk appetite. Choose the most appropriate vehicle for financing retained risk.
Scott Gemmell
Marsh, Bermuda
Neil Horner, LLM
Attride-Stirling & Woloniecki, Bermuda
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FRIDAY, OCT. 3
3-4 P.M.
FR-17
Lost Limbs, Botched Biopsies and Tossed Tissue: Pathology and Forensic Risk Management
Special risks of pathology functions, performance of autopsies and practice of forensic medicine are often overlooked in a general risk management program. This session describes the unique risks, discusses lawsuits and reviews the increase in claims. Participants are given tools to begin a successful risk management program in these areas (and are entertained in the process).
Objectives: Identify trends and increased liability in pathology claims. Develop a risk management program to quantify potential risk in the areas of forensic medicine, autopsy negligence and general pathology. Use a tool kit to assist in the development of a risk management program/function in pathology, forensic medicine and autopsy functions.
Wanda Daylin Hurr, RN, JD, CPHRM
Risk Management Consultant, Madison, WI
FR-18
Innovative Risk Management Program Design for Long-Term Care
Creating a robust risk management program in long-term care can test the skills of the risk professional who must navigate particular clinical, corporate, regulatory and legal challenges. This presentation addresses the multiple facets of a long-term care risk management program and highlights corporate boundaries and the expanded impact of regulatory determinations, quality assurance and performance improvement efforts, governing body involvement and clinical performance.
Objectives: Identify the elements of a long-term care risk management program and discuss the risk manager’s role in risk aversion activities in long-term care. Identify the characteristics of a comprehensive litigation management program. Identify practical tools to identify and manage actual or potential risks
Kimberli Poppe-Smart, RN, JD, CPHRM
Laura Sitar
Wroten & Associates
Irvine, CA
FR-19
From Novice to ‘Nerves of Steel’: Negotiating Skills for the Healthcare Manager
Every day is a new negotiation. This session teaches the nervous novice how to be a savvy negotiator for both the current risk management career role and the future.
Objectives: Identify methods for preparing for a negotiation. Recognize the qualities of a good negotiator. Understand challenges and roadblocks to negotiations.
Melanie Osley, RN, BS, BSN, MBA, CPHQ, DFASHRM, CPHRM
RNs/Risk Networking Solutions LLC, Bolton, CT
FR-20
Managing New Risks in Consent to Treatment
Common questions regarding consent to treatment have given way to new consent issues involving organ procurement, transplantation, definition of death, corporate liability, breach of contract, pay-for-performance, shared decision-making and revised Interpretive Guidelines from CMS. This session highlights new consent risks, offering practical strategies to address these concerns. Consent document requirements are covered in the discussion. Tools for consent are presented.
Objectives: Identify new risk exposures in the informed consent process. Describe possible consequences of new consent to treatment risk exposures. Describe strategies to manage risks stemming from new development involving consent to treatment.
Fay Rozovsky, JD, MPH, DFASHRM
The Rozovsky Group Inc., Bloomfield, CT
FR-21
Compliance Updates: Transparency in Vendor and Physician Relationships
This session provides a regulatory and compliance update focused on emerging trends related to provider relationships with life sciences vendors and physicians. Overall trend analyses cover the federal and state governments’ focus on Medicaid fraud, as well as the trend toward increased transparency in financial relationships.
Objectives: Understand legal and compliance risks associated with vendor and physician relationships. Identify emerging compliance trends and their associated risk. Understand increased focus on Medicaid compliance.
Jeff Layne, JD, MPH
Fulbright & Jaworski LLP, Austin, TX
FR-22
Clinical Conflict Resolution Between Nurses and Physicians During Labor and Birth
Note: This session has been rescheduled to Friday, Oct. 3, 9:15-10:15 a.m. See above.
FR-23
Disruptive Clinician Behavior Strategies and Solutions
Disruptive clinician behavior is a threat to patient safety that makes headlines. This session considers creative solutions developed and implemented by healthcare organizations to deal with this risk.
Objectives: Identify three actions that healthcare organizations can take to prevent disruptive clinician behavior from harming patients. Explain why solutions must go beyond policies and training to behavioral management strategies. Identify alternatives to discipline which may prove helpful in managing disruptive behavior.
Grena Porto, RN, MS, ARM, CPHRM
Marsh USA Inc., Philadelphia
Jana Deen, CPHRM
Catholic Health Partners, Cincinnati
FR-24
Whose Captive Is It Anyway? Surviving and Thriving without a TPA
Many captive programs contract with a TPA to manage claims and litigation. A thriving captive requires direct involvement in the management of the claims, oversight of the underwriting process for new insureds and new programs, and a close tie between loss prevention and the claims function. This session shows how one Risk Management and Insurance Department dealt with the transition from three wholly owned captives to one captive with three separate cells (segregated account companies). Operational issues in dealing with claims, adding physician insureds, underwriting, reporting, loss runs, etc., are shared. Interactions with the actuary, the excess insurer and the broker are discussed as well.
Objectives: Understand financial and strategic objectives of a captive program. Describe how managing claims and litigation management can be enhanced in-house as opposed to using a TPA. Discuss risk management competencies and resources (technology and human) necessary to manage a captive.
Erin Eldridge, RN, BS, MBA
Mary Gutman, RN, MS, DFASHRM, CPHRM
Premier Health Partners, Dayton, OH
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