Inside This Issue
Click here for a .PDF version of this document
Return to Archives
Nashville Conference Provides 'Grand Opportunity'
Nearly 2,000 registered attendees took advantage of a “Grand Ole Opportunity” to network and learn more about current health care risk management issues Nov. 2-5 at ASHRM’s 23rd Annual Conference & Exhibition. The tropically landscaped Gaylord Opryland Hotel and Convention Center in Nashville provided a lush setting.
Keynote speakers Donna Shalala, former Secretary of the U.S. Department of Health and Human Services, and Atul Gawande, general surgeon at the Brigham and Women’s Hospital in Boston and staff writer for the New Yorker magazine, attracted standing-room crowds during general sessions. In addition, 48 concurrent education sessions led by a faculty of more than 50 health care industry leaders armed attendees with information to take away and apply at their own organizations.
At the annual business and recognition luncheon, ASHRM 2003 President Jane McCaffrey highlighted the past year’s successes and future challenges, and presented awards to members for their outstanding achievements in risk management.
Following are capsule reports on conference highlights.
Donna Shalala: Management tips from a leader
“I’m happy to be able to talk about something other than football,” Donna Shalala told her audience of risk managers with a smile.
Since June 2001, Shalala has served as president of the University of Miami, a sports powerhouse that also boasts a respected medical program. In fact, Shalala’s strategic vision for Miami hinges in large part on the development of its Jackson Memorial Medical Center and formation of a patient safety center.
Coming to Miami from Washington, where she served for eight years in the Clinton Administration as secretary of the Department of Health and Human Services, Shalala brought experience in managing the complex world of government and education. In Nashville, she shared her wealth of management tips with ASHRM.
· Build teams. “Change comes out of a group of people working together,” she said, adding that recognition and awards can be more effective when they are given to teams rather than to individuals.
· Instill loyalty through communication. During the Congressional battle that led to a brief government shutdown she stayed in touch with her HHS employees via reassuring letters “just to reach out and touch them,” sending them the simple message that she was thinking of them as the holidays neared.
· Open up meetings to everyone who wants to speak to an issue. In complex organizations, information is power, Shalala noted. And while many managers restrict information to protect their power they are actually hurting themselves because “the worst thing for a manager is not having all the information.”
· Make friends with the enemy. “Treat them with respect,” she advised, recalling how she made a point of calling on Republicans as well as Democrats when she first arrived in Washington.
· Do things that are measurable. “At the end of the year, you’ll know you’ve actually done something,” she said, also stressing the importance of having a clear strategy. One of Shalala’s goals at HHS was to improve the vaccination rate of children. To that end, she made health insurance more available and created a system to enable 90 percent of children to get shots they needed before starting school.
Also, Shalala talked about the issue of patient safety: “It’s a movement that’s starting to show up in polls. It’s a sleeper issue in the presidential campaign.”
In a Q&A session, Shalala responded to a query about whether she saw national tort reform passing. “Only if we can figure out what it is,” she replied, adding that she personally favored malpractice caps but believed that passage of tort reform would have to be preceded by campaign finance reform – a reference to money spent by the plaintiff’s bar.
While noting that everyone wants the best health care system, and the public knows there are problems with the current system, “We do not have a consensus on the solution,” Shalala said. “That is the challenge.”
Atul Gawande: Risk managers ‘in the gap’
Atul Gawande knows risk managers are on the front line of the battle against medical error.
“The risk manager is in the gap between what we aim for and promise in medicine, and what we actually do,” Gawande noted in his keynote remarks. “You can't understand medicine without understanding what goes wrong. That small percentage of things that go wrong governs everything we do.”
Gawande dealt with what he sees as the three causes of imperfection in medicine: error, uncertainty and mystery. The public often perceives errors as the result of incompetence, he said, while risk managers and other health care professionals see all three.
“[Yet] even knowing as much as we do, we believe there must be carelessness, malfeasance, indifference,” he added.
Sometimes, the cause of a misdiagnosis or unintended outcome might not be clear to the doctor. Gawande recounted the case of an 86-year-old woman he had treated. She was suffering from an abdominal aortic aneurysm that was about to burst, and he recommended immediate surgery. Afraid of complications and difficult rehabilitation, the woman refused surgery, to her family’s and Gawande’s chagrin. “Measuring her days in coffee spoons ...she went home understanding that she would die,” he recalled. Three weeks later when he called to check on the family, he was surprised to hear her answer the phone. One year later, she is still living on her own.
Cases like this drew Gawande into the study of medical error. He writes about these cases as a way to explore issues not covered in textbooks as a staff writer at The New Yorker and in a book titled Complications: A Surgeon's Notes on an Imperfect Science.
Gawande stressed the importance of open and honest communication. The public understands that medicine will never be a perfect science, he said, but part of what they want and expect is information. “What they want to know is that we will never cease aiming for perfection,” he concluded.
Jane McCaffrey: ‘Advancing our vision’
ASHRM President Jane McCaffrey summed up her administration during the annual business and recognition luncheon meeting as one dedicated to “advancing our vision of safe and trusted patient-centered health care.”
“By focusing on our strategic goals of professional development, advocacy and representation, and operational effectiveness, we have served the divergent needs of our membership and participated on a national level with other organizations,” she stated.
Key ASHRM accomplishments for the year centered on:
· Barton Certificate Program in Healthcare Risk Management. “We launched the revamped format for the Barton Certificate Program in Healthcare Risk Management and more than 500 risk managers participated in an Essentials, Applications, or Advanced Forum Module this year.”
· New educational opportunities. In addition to developing four audio conferences and a National Healthcare Risk Management Week Webcast, ASHRM partnered with the American Healthcare Lawyers Association, the Healthcare Compliance Association, the Centers for Disease Control and Prevention, National Patient Safety Foundation, and Partnership for Patient Safety to bring members new professional development opportunities.
· Timely publications. Besides the 4th edition of the Risk Management Handbook for Health Care Organizations and the updated Certified Professional in Healthcare Risk Management (CPHRM) Examination Study Guide, ASHRM produced five monographs for www.ashrm.org (including two on disclosure, with a third to be released next month), a self-assessment tool for risk management programs, a risk management program development tool kit and a new “Pearls” booklet of risk management tips for physicians.
· Advocacy efforts. ASHRM joined the Coalition for Affordable and Reliable Healthcare (CARH) in 2003. “The focus of this group is to pass medical liability reform,” McCaffrey said. “And while this issue may appear to be off the congressional radar it is very much on our radar.” She also recapped meetings ASHRM held in March with Senators to encourage them to pass medical liability reform legislation and support patient safety legislation that provides for voluntary reporting of medical errors. “We will continue to track these issues on the Hill just as we continue to contribute the risk management perspective on regulatory issues,” she said, adding, “We continue to build upon our relationship with the Joint Commission by providing input on a number of advisory committees and task forces.”
· Chapter development. “Throughout the year our chapters offer numerous opportunities for professional development and networking,” McCaffrey said. “Their commitment to risk management at the grass roots is extraordinary and we look forward to continuing that bond.” She also welcomed members of the Central Pennsylvania Association for Healthcare Risk Management – the newest ASHRM chapter.
· Operational effectiveness. “Through hard work and by staying focused on our strategic goals, ASHRM had a very good year,” McCaffrey said. “We experienced growth in our membership numbers, increased participation in our educational programs, and managed our expenses very conservatively. The ability to manage our resources has allowed us to be innovative in the way we offer programs, publications and products.”
McCaffrey expressed gratitude to all 2003 committee, task force and special interest group volunteers who donated their time and expertise for ASHRM programs and products. “You have shown commitment, dedication, flexibility and enthusiasm for the projects you are involved in and I am honored to have this opportunity to thank each and every one of you, on behalf of the board of directors. We cannot do the work without you.”
The business meeting concluded with thanks to outgoing ASHRM board members Monica Berry (past-president), Mark Cohen, Mike Seitz, Paul English Smith and Ronni Solomon, and introduction of the 2004 board, including Jeff Driver (president), Jane McCaffrey (past-president), Pamela Popp (president-elect), Dorothy Berry, Joyce Benton, Doug Borg, June Leigh, Mary Marta, Mary Ott and Sherrill Peters. Driver also took the oath of office of president before accepting the gavel for 2004.
Members are honored for special efforts
The Annual Conference & Exhibition provided a showcase for some of ASHRM’s most outstanding members in 2003.
· Distinguished Service Award. Robert Bunting Jr. was recognized primarily for his work as editor of the CPHRM Examination Study Guide and co-leadership (with Joyce Benton) of CPHRM study sessions. In 2003, ASHRM passed the 500 mark for CPHRM achievers. “ASHRM and our profession have benefited greatly from his efforts,” President Jane McCaffrey noted.
· Fellows and Distinguished Fellows. Recognized for their leadership in ASHRM and the profession were Fellows Marie Conti, Mary Gutman, Gordon Hall, Melanie Osley, Julie Pike, James Robinson and David Stallings and Distinguished Fellows Michelle Hoppes, Carl Saltzman and Anne Irving.
· Journal Author Excellence Award. Robin Maley and Scott Kroll were recognized for their article "Coverage Procurement: Black & White Guidance for a Gray Process” published in Vol. 22 No. 4 of the Journal of Healthcare Risk Management.
· Special tribute was paid to editor Roberta Carroll and her contributors for work on the 1,400-page Risk Management Handbook for Health Care Organizations (4th edition) and to editor Robert Bunting Jr. and his contributors for the CPHRM Examination Study Guide (3rd edition). Both landmark publications made their debuts in Nashville at the on-site bookstore.
Conference session recordings are available
Tape and CD recordings of most education sessions and videos of all general sessions – including Donna Shalala’s and Atul Gawande’s as well as the Legislative, Regulatory & Case Law Update and motivational speaker Amanda Gore’s “Get a Life” program – are available online at www.ashrm.org (Annual Conference page). Extra copies of the proceeding CDs and books also are available on the Web site while supplies last.
Chapter Leaders
Georgia, Arizona chapters take top honors
The 2003 Chapter Recognition Awards were presented during ASHRM’s annual business meeting in Nashville.
The Arizona Society for Healthcare Risk Management won the overall award as well as the award in the category of chapters with 0-50 members for its surgical site verification project. The Georgia Society for Healthcare Risk Management took top honors in the category of chapters with 51-150 members with its project on medical malpractice liability tort reform in Georgia.
All chapters that submitted projects shared their experiences with other chapters in the Chapter Recognition Award display at the Annual Conference & Exhibition.
“Participation at the local level is important and ASHRM is fortunate to have so many strong chapters with committed members to plan and host local educational and networking events,” ASHRM President Jane McCaffrey said.
Winning chapter project highlights are featured in the Chapters home page of www.ashrm.org (lower right-hand corner).
Chapter leaders share program tips
More than 50 ASHRM chapter leaders and presenters gathered for the Chapter Leadership Workshop held before the start of the Annual Conference in Nashville.
Recruiting volunteers and planning educational sessions were among the topics covered. David Hester, chair of the Member Services Task Force, hosted the workshop, which began with a welcome by ASHRM President Jane McCaffrey, and an ASHRM update by Executive Director Elizabeth Summy.
ASHRM chapters are the first point of contact for many members and an effective way to get the word out about developments in risk management and patient safety, Summy said.
A focus of the workshop was planning and hosting a CPHRM exam study session. Robert Bean, past president of the Georgia chapter, shared insights he learned from planning a study session for his chapter, including how to market the event to members and how to negotiate with hotels. Be sure to read the fine print and get everything in writing, Bean said, or you may find yourself with unexpected charges.
Robert Bunting Jr. discussed the revised Certified Professional in Healthcare Risk Management (CPHRM) Examination Study Guide (3rd Edition), which he edited. ASHRM offers the Study Guide at a discount to chapters planning a CPHRM study session. Bunting presented a state-by-state examination of CPHRM certificants.
Sherry Maddox, president of the Kentucky chapter, covered general issues to consider when planning an educational meeting, including location, fees, speakers, registration and marketing. Having speaker bios, meeting agenda and objectives and other information prepared in advance is crucial for obtaining continuing education credits, Maddox said.
Volunteers are key to a chapter’s success, according to Curtis Nolen, a member of the Member Services Task Force, who offered some pointers on how to attract and motivate quality volunteers. His first point: Don’t forget to ask for help. A lot of volunteers get involved simply because they’re asked. Nolen also said that it’s important to understand why people volunteer and to reward them appropriately.
Several of the workshop presentations were available as handouts for chapter leaders. To obtain copies, contact Nancy Neff at nneff@aha.org. The 2003 Chapter Leadership Workshop was organized by ASHRM’s Member Services Task Force.
NEW CPHRMS
The Certified Professional in Healthcare Risk Management designation provides a credential based on a solid assessment that verifies a broad-based knowledge of risk management. Certification elevates professionals in an increasingly competitive marketplace. For details, call the AHA Certification Center at (312) 422-3715.
Congratulations to recent CPHRM achievers:
Deborah Joan Azierski, Pine Bush, NY
Janet S. Bigelow, Sterling Heights, MI
Marie G. Brennan, Cranston, RI
Maurice A. Brownlee, Stone Mountain, GA
Susan Marie Carlson, Cambridge, MN
Debra Phillips Drew, Jacksonboro, SC
Elizabeth L. Enz, Mechanicsville, VA
Janet E. Frain, Sacramento, CA
Ann L. Grannan, Prospect, KY
Anna Herlik, Del Mar, CA
Ruth F. Hext, Cincinnati, OH
Barbara Ellen Hirsch, Rockville, MD
Kathy Rae Johnson, Duluth, MN
Leslie Kuipers, Denver, PA
Mark Littlewood, San Francisco
Sherry Denise Maddox, Louisville, KY
Karen Renee Mazzocco, Oakland, CA
Irene Daly McCall, Billings, MT
Patricia Anne McKinney, Mcloud, OK
Rebecca K. Mills, London, KY
Elaine Marie Moran, Hasbrouck, NJ
Janice Marie Netterfield, Bloomington, MN
Lori Ann O'Rourke, Oakland, CA
Janice Pankratz, Bloomington, MN
Edward Norman Porter, San Francisco
Judith L. Radovich, Sacramento, CA
Fredrick H. Schriever, Virginia Beach, VA
Robert W. Suddarth, Pulaski, VA
Debra Kay Warrington, San Angelo, TX
Michael S. Wiegel, Lake Villa, IL
The Certified Professional in Healthcare Risk Management designation is offered through the American Hospital Association Certification Center.
JUST RELEASED: Updated exam study guide
The newly released CPHRM Examination Study Guide (3rd Edition) covers exam content in a flexible format to meet the needs of anyone who has not yet purchased a Study Guide or does not plan to take a CPHRM Examination Preparation Session. Much of the content was adapted from the new Risk Management Handbook for Healthcare Organizations (4th Edition). Also, practice tests in the Study Guide correspond with the CPHRM content outline. Study Guide users generally review the material in the Study Guide, take the practice exams, and determine which areas they should review further by using the Risk Management Handbook.
The Study Guide is available for purchase via the AHA Online Store at an ASHRM member price of $50. Call (800) AHA-2626 and ask about item 178836.
CPHRM Prep Sessions – April 29 and Oct. 17, 2004
CPHRM Examination Preparation Sessions next year will be offered 9 a.m-3 p.m. CT April 29 at the Hotel InterContinental, 505 N. Michigan Ave., in Chicago, and 9 a.m-3 p.m. ET Oct. 17 at the Marriott World Center in Orlando (during the Annual Conference). Details will be announced soon.
Latest ‘Pearls’ aimed at physicians
ASHRM’s popular Pearls series continues to grow
“Risk Management Pearls for Physicians” is the latest pocket guide created by ASHRM to help medical practitioners minimize liability exposures they face on a daily basis.
Topics include communication, documentation, confidentiality, informed consent, insurance, withholding & withdrawing treatment, HIPAA, patient safety, records practices and more. The complete table of contents can be reviewed online at www.ashrm.org (click on the ASHRM Products link in the center column).
Price for ASHRM members is $15 for AHA members, $20 for non-members. Call (800) AHA-2626 and request item # 178563 (single copy) or # 178562 (five-packs).
The “Physicians” booklet joins the “Risk Management Pearls for Long-Term Care & Skilled Nursing Facilities,” “Risk Management Pearls for Medication Error Reduction” and “Risk Management Pearls for Obstetrics.” The format and five-pack quantity discount make them ideal for sharing with staff or clients.
Scholarship supports patient safety project
ASHRM is offering $18,000 in scholarship money to members for the Patient Safety Leadership Fellowship, a professional development program established by the Health Forum of the American Hospital Association, National Patient Safety Foundation, American Association of Nurse Executives, Health Research & Educational Trust and ASHRM.
The fellowship provides an intensive, 18-month learning experience to develop leadership skills and advance the science of patient safety in health care. Up to 40 fellows are brought together through on-site meetings and virtual conferences, allowing them to tap into a rich network of educational resources.
Scholarship winners are selected by an ASHRM task force on the basis several criteria including FASHRM eligibility and willingness to share their action learning project – the heart of the fellowship – with ASHRM members via articles in ASHRM publications or a presentation at the annual conference.
The fellowship and scholarship application deadline is Jan. 10, 2004. To request an application, contact ASHRM at (312) 422-3980 or download the application and other materials from www.healthforum.com. Interest in the ASHRM scholarship must be indicated on the application and returned to Health Forum at the address indicated on the application. Candidates must meet the criteria established by Health Forum to be accepted as a Fellow. Meeting the ASHRM criteria does not guarantee acceptance as a Fellow.
For information about the next class, call (415) 248-8416 or visit www.healthforum.com (“Education & Conferences”).
