Taking action to meet needs

As ASHRM enters its 25^th year of service to the health care risk management profession, the society is reaching a critical stage. Both the organization and the profession have seen tremendous changes over the past quarter-century and continued change is certain.

The time has come to examine the relationships among ASHRM’s board of directors, members and the public. That’s why ASHRM has retained a research firm to gauge the alignment of current and future expectations of the ASHRM board of directors and the membership.

A multi-phased research approach began during the summer with an online membership survey. The survey yielded the empirical results necessary to help the board of directors develop strategic plans that can take ASHRM to its 30^th anniversary as an even stronger organization.

Results of the survey will be communicated to members in this and future issues of the Forum. As an introduction to this continuing report, here are some needs expressed by members in the survey results and the ways in which ASHRM leadership is responding to those needs.

     What members said: Three-quarters of members indicated they would participate in a patient safety-focused curriculum if one were developed by ASHRM. Some of the comments included “Provide more information and/or formal classes, starting with the basics” and “My resources are limited. It would be nice if patient safety programs could be concentrated at a specific time so if risk managers wanted to immerse themselves, they could.”

     ASHRM action: Working from recommendations of the ASHRM National Advisory Council on Patient Safety, ASHRM has completed its work on the ASHRM Patient Safety Curriculum©. The first of the three-part curriculum was unveiled Oct. 15 and 16 in Orlando. To view the agenda, visit www.ashrm.org (Education, Special Programs). Starting in 2005, Session I – Basic Principles of Patient Safety will be presented with Session II – Advanced Principles of Patient Safety and Session III – Strategies for Improving Patient Safety. Details will be announced soon.

     What members said: Members most frequently cited online study as the preferred method of keeping current in the field. In fact, an overwhelming number – 83 percent – chose Internet-based study as the educational delivery method for ASHRM to place greater emphasis in the future. Additionally, when asked to identify the most pressing professional development needs, many of the 591 respondents mentioned risk financing. Commented one: “Since I have a strong clinical risk management background, my primary professional development need would be risk financing.”

     ASHRM action: ASHRM has completed the development of its first online education program, titled “Risk Financing for Risk Managers.” The five-module program consists of “Health Care Risk Financing Fundamentals,” “Principles & Practices of Insurance,” “Submissions & Renewals,” “Alternatives in Risk Financing” and “Enterprise Risk Financing.” Refer to future ASHRM publications and the Web site for details about registering for this course.

     What members said: Most members indicated an interest in establishing practice groups, or “interest networks,” for patient safety (80 percent) and risk financing/claims management (62 percent). Members provided distinct ideas about what should be included with the establishment of any such network: electronic newsletters (85 percent) and tailored educational offerings (71 percent) were cited most frequently as necessary elements.

     ASHRM action: ASHRM is launching two health care risk management specialization practice groups – one in Patient Safety and one in Risk Financing and Claims Management. These ASHRM Interest Networks are the result of two years of thoughtful work. When fully operational in 2005, the ASHRM Interest Networks will deliver specialized content and networking opportunities to risk managers in specific domains. Initially, the content is being featured on dedicated Web pages, through electronic newsletters and in educational programs that feature unique and cutting-edge concepts of interest to specialized managers of risk and general practitioners. All ASHRM members were sent free introductory e-newsletters for each interest network in October.

     What members said: The professional development of members is ASHRM’s greatest strength, with 91 percent of the membership believing ASHRM provides quality professional development programs. And while 90 percent of the membership expressed pride in ASHRM, they would like to see more industry leadership on their behalf. Within risk management, ASHRM has high name recognition but in other health care arenas, ASHRM’s name recognition could be stronger. Many responses to the question “How should ASHRM respond to emerging changes in risk management?” centered on the need for ASHRM to “be the leader” in gaining and regaining public trust in safe and trusted health care.

     ASHRM action: ASHRM has promoted its name and brand within risk management during its first 25 years. Now, ASHRM leadership is determined to be more collaborative in cultivating name recognition and brand awareness within the overall health care environment and beyond. An excellent way to accomplish this is through collaborations with other respected health care industry leaders such as the National Patient Safety Foundation (NPSF). Last spring, ASHRM initiated an education event in conjunction with NPSF’s Annual Patient Safety Congress. ASHRM plans to build on this success with another NPSF “post-Congress” event in May.

Similarly, ASHRM believes that health care risk managers can reap tangible benefits by relating to successful risk management in other industries. A prime resource in this arena is the American Society for Quality (ASQ), and ASHRM will partner with ASQ in February for a Quality Institute that will bring together expert quality practitioners and innovative health care leaders to share expertise. Watch for details from ASHRM on both the NPSF and ASQ events.

The work ahead

ASHRM will continue to ensure that members are made aware of initiatives as they contribute to meeting the three goals of the updated ASHRM strategy map: 1) professional development, 2) advocacy and development, and 3) organizational development.

Of course, the ability of an organization such as ASHRM to sustain and grow the profession’s place in the world depends on the investment of talents and expertise by its members. Participating in an ASHRM work team can result in personal satisfaction as well as knowledge that the investment can help others appreciate the value of health care risk management. Survey data also indicated that members who are the most active participants in ASHRM projects are the most satisfied members.

Please take a few moments to read and complete the Call for Participation form enclosed with this issue of the Forum. The information also is available at www.ashrm.org   (Members Services, Calls/Notices). The deadline for responding is Nov. 19.

President-elect, new board commence terms Jan. 1

ASHRM’s president-elect and new members of the board of directors will begin their terms on Jan. 1 after being sworn into office Oct. 18 during the Annual Conference & Exhibition business luncheon in Orlando.

ASHRM members went to the electronic polls this summer to vote in the 2005 online elections. Peggy Martin, MEd, ARM, DFASHRM, senior risk management coordinator for Lifespan Risk Services in Providence, RI, was chosen president-elect. She will serve as president of ASHRM in 2006.

Also elected to three-year terms on the ASHRM board of directors were Mary Anne Hilliard, JD, BSN, CPHRM, chief risk counsel for Children's National Medical Center in Washington; Michelle Hoppes, RN, MS, AHRMQR, DFASHRM, president of the Risk Management and Patient Safety Institute, a division of MHA Insurance Co. in Lansing, MI; and David Stallings, MHA, CPHQ, FASHRM, director of risk management for Children's Hospital and Regional Medical Center in Seattle.

The new board members will join officers elected in 2003: Mary Ott, MS, RN, MS, FASHRM, CPHRM, director of risk management at Sisters of Mercy Health System in Chesterfield, MO; Dorothy Berry, RN, BSN, HRM, CPHRM, vice president of clinical risk management at GE ERC, Inc., in Arlington Heights, IL; June Leigh, CPHRM, RN, BSN, MS, FASHRM, ARM, director of risk management services at CNA HealthPro in Chicago; and Douglas Borg, MHA, ARM, CPHRM, director, medical center, risk management at Duke Health System in Durham, NC.

"ASHRM members will be well represented by this board," stated Pamela Popp, JD, MA, FASHRM, CPHRM, vice president of health care practice at McQueary Henry Bowles Troy, LLP. She will serve as president in 2005. "The diversity of experience among the board is highly representative of our membership as a whole. I am looking forward to leading ASHRM in its 25^th year with so many talented and accomplished colleagues."

Serving as past-president in 2005 will be Jeffrey Driver, JD, MBA, DFASHRM, chief risk officer and director of risk management at Stanford University Medical Center in Stanford, CA. "I am so pleased to see the succession of ASHRM is such capable hands," he said. "ASHRM is well positioned to continue serving managers of risk through our professional development and advocacy efforts."

ASHRM members also elected the nominating committee for 2005. Serving in this capacity will be Jane McCaffrey, DFASHRM, MHSA, director, safety and risk management at Self Regional Hospital in Greenwood, SC; Greg Terrell, CPHRM, MS, CSP, FASHRM, ARM, director of risk management at Children's Medical Center in Dallas; Mark Cohen, ARM, DFASHRM, CPHRM CPHQ, risk management consultant at Sutter Health in Sacramento, CA; Denise Peterson, RN, director of risk management and patient safety at Lowell General Hospital in Lowell, MA; Cynthia Siders, RN, MS, DFASHRM, CPHRM, senior clinical risk specialist at MHA Insurance Co. in Grand Forks, ND; Linda Jones, MHA, CPCU, risk management consultant at Riggs, Counselman et al in Towson, MD; and Korliss Ann “Korky” Schnitker, RNC, BSN, director of risk management at the Chicago Hospital Risk Pooling Program in Chicago.

Pearls booklet addresses nurses with focus on OR

Nurses do their jobs every day and night in an environment characterized by rapidly evolving technology, patient acuity and concerns about resources and liability. To help these critical front-line workers consistently deliver safe and trusted health care, ASHRM is offering a new booklet titled Risk Management Pearls for Nurses: Focus on the OR Setting.

ASHRM’s popular “Pearls” pocket guides cover risk management and legal issues that busy health care practitioners may encounter on a day-to-day basis. As the latest installment in the series, Risk Management Pearls for Nurses: Focus on the OR Setting is designed to:

• provide a handy reference to help promote patient safety;
• prevent malpractice suits in nurses’ particular settings; and
• improve defensibility in the event of a malpractice case.

Although many examples will be of particular interest to perioperative nurses in the OR, nurses in all settings can benefit from knowledge of principles put forth in this booklet.

Chapters examine:

• The roots of litigiousness – insights into why patients become plaintiffs
• Malpractice – issues centered on standards of care
• Insurance coverage –guidance on whether additional coverage is needed
• Managing risk in the OR – pointers based on claims statistics, policies and procedures, medication administration, equipment usage and more
• Communication – strategies for dealing with other departments, other caregivers and with patients and families, including “do not resuscitate” directives, informed consent documentation and disclosure
• Performance improvement – explanations of reporting tools driven by Joint Commission on Accreditation of Healthcare Organizations and others and suggestions on how nurses can be more active in PI.
• The final chapter spells out “what to do when things go wrong.”

Additionally, a back-cover tip card spells out when and how nurses can call on the support of their risk managers.

Risk Management Pearls for Nurses: Focus on the OR Setting is available in specially priced packs of five for cost-effective risk management outreach efforts as well in single copies.

Other titles in the “Pearls” series also are available for the following specialties: Physicians, Long-Term Care & Skilled Nursing Facilities, Medication Error Reduction and Obstetrics. For product details, visit www.ashrm.org (Members Services/Tools & Products) or call (800) 242-2626.

Experts to analyze birth injury risks

“The Experts Analyze Brain Damaged Baby Cases III,” scheduled for Nov. 11-13 in San Diego,

will bring together distinguished international authorities to discuss developments in maternal-fetal medicine, pediatric neurology, neonatology, placental pathology and pediatric neuroradiology.

Professor Peter Gluckman, director of the Liggins Institute in New Zealand, is a program keynote speaker. He will discuss results of a major international clinical trial conducted in 28 centers which showed that head cooling may reduce brain damage in certain oxygen-deprived newborn babies. Dr. James Hanson and Dr. Karin Nelson of the National Institutes of Health are also featured keynote speakers.

As part of the conference, ASHRM is coordinating an afternoon breakout session of particular interest to risk managers and claims management professionals involved with birth injury litigation and associated loss control and loss prevention strategies. During the three-hour session, Dr. Eric Knox will present "Integrating the Science of Safety With the Science of Brain Injury," Dr. Larry Veltman will address "A Protocol for the Management of the Sick Newborn," and a panel discussion will complete the session by discussing shoulder dystocia, negligent monitoring (EFM), oxytocin and chain of command issues.

In addition to ASHRM's session, separate sessions will be offered for plaintiff’s counsel and defense counsel. Trial lawyers will participate in panel discussions on how this medical information can be most effectively utilized by attorneys.

This will be the third such advanced level program to be jointly sponsored by the University of California, Davis, Health System Center for Perinatal Medicine and Law, and the American Bar Association, Tort Trial and Insurance Practice Section, Medicine and Law Committee.

For registration details and to view the current agenda for the ASHRM session, visit www.ashrm.org (Education, Special Programs)

In Memoriam

David E. Manoogian

David E. Manoogian, 60, a respected attorney and a friend to ASHRM, died Sept. 4 following a cardiac procedure.

An active member of ASHRM and the Maryland Society for Healthcare Risk Management, Mr. Manoogian dedicated his professional life to litigating health related issues dear to the interests of health care risk managers. He defended traditional medical malpractice cases as well as HMOs and managed care entities, hospitals, long term care and other health care. He litigated issues in federal court, including those involving ERISA, EMTALA, RICO, the ADA, COBRA, HCQIA, HIPAA and other federal statutes. He was also a published author whose risk management expertise was featured in a number of books. 

While based in Washington, D.C., with Bonner Kiernan Trebach & Crociata, Mr. Manoogian lectured widely. Topics included legal aspects of medical documentation, physician communication, employment risks, healthcare litigation trends, and ERISA defenses, application and developments. He served as faculty for ASHRM’s Annual Conference & Exhibition.

Mr. Manoogian is survived by his wife, Mary, a son, daughter and grandson.

Betty Harlow Breeden

Betty Harlow Breeden, an ASHRM Fellow and founding member and two-time president of the Virginia Chapter of ASHRM, died Oct. 9, 2003. Ms. Breeden developed the first risk management program at the University of Virginia Medical Center in 1979 and served as director until retirement in 1994.

Ms. Breeden lectured and wrote extensively on risk management issues and was credited for playing a vital role in the training of many of the risk management professionals throughout Virginia.

Members are encouraged to forward recent death notices to administrative assistant Shannon Grevas via e-mail: slong@aha.org. Submissions also must include an e-mail address and phone number that ASHRM may call on for any further information.

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 .

Congratulations to recent CPHRM achievers:

Marla R. Ashford, Phoenix

Glenda A. Bohan, Warwick, NY

Cleo Ann Burgard, Indianapolis

Raymond F. Carnevale, Rome, NY

Marsha Anne Caulkins, Morton Grove, IL

Stephen William Crawford, Coronado, CA

Elizabeth D. Fredrickson, Grand Rapids, MI

Ida A. Gonzales, Temple, TX

Carole A. Graham, Joplin, MO

Laurel Jeanne Grisbach, Frazier Park, CA

Geertje Anna Hill, Indianapolis

Johnnie M. Isphording, Pace, FL

Amelia D. Jordan, Calhoun, GA

Diane S. Kessler, Evansville, IN

Jacqueline A. Laing, Santa Fe, NM

Patricia M. McBride, Princeton, NJ

Gary Lee Miles, Port Charlotte, FL

Sharon A. Myers, Jeddah, Saudi Arabia

Ann F. Ripley, Buffalo, MN

Arlene H. Schilling, Chicago

Mary Pat Schwing, Louisville, KY

Christos Sierros, Miami Beach

Dawn M. Stahl, Cincinnati

Emma V. Truitt, Norfolk, VA

Margaret F. Turner, Richmond, VA

Rosemary Waitkus, Madison, WI

Robin Lynn Warmbrod, Mechanicsville, VA

Debra Kay Weber, Evanston, IL

The CPHRM designation is awarded based on participants meeting eligibility requirements and passing an examination. For details about the designation, download the CPHRM Candidate Handbook from the AHA Certification Center via www.ashrm.org (click on the CPHRM logo at the bottom of the page) or call (312) 422-3715.

Preparing for the CPHRM Exam

* The CPHRM Examination Study Guide (3^rd 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. Content was adapted from the Risk Management Handbook for Health Care Organizations (4^th Edition). Also, practice tests in the study guide correspond with the CPHRM content outline. The study guide is available for purchase via the AHA Online Store. Visit www.ashrm.org (Members Services, Tools & Products) or call (800) 242-2626 and request item 178836.

* A new online tool is available for preparing for the CPHRM Exam. Created by the AHA Certification Center (the people who created the exam), the Self-Assessment Exam (SAE) simulates the actual exam in format and content. The test offers rationales for correct and incorrect options, as well as several score reports that highlight the exam topics that they scored well in and those that need improvement. For details about the SAE, contact the AHA Certification Center at (312) 422-3713.

Examination, renewal fees to rise Jan. 1

The AHA-CC Board of Directors recently voted to increase CPHRM examination and renewal fees, effective Jan. 1. The fee will be $275 for ASHRM members and $345 for non-members. Renewal fees will increase to $135 for members and $175 for non-members. Candidates who apply in 2004 will pay the current fees of $225 for members and $295 for non-members, even if they do not test until 2005.

ASHRM Update

Member certified as security instructor

Denny Thomas, CPHRM, recently met the criteria of the U.S. Department of Homeland Security/Office for State and Local Government Coordination and Preparedness as a certified instructor through Homeland Security. The Office for Domestic Preparedness and the National Center for Biomedical Research and Training awarded the certificate.

Certification will allow Thomas to meet the certified instructor criteria for Homeland Security courses. A key component in preparedness activity is training hospital staff and leadership. Thomas is risk manager at Saint Joseph’s Hospital in Marshfield, WI.

Scholarship offered for Patient Safety Fellows

Sponsors of the Patient Safety Leadership Fellowship are seeking applications for the 2005-2006 program year. Participants in the yearlong program design and implement cost-effective models of health care delivery that advance patient safety and health outcomes. Applications are due Jan. 10, 2005, and Fellows will be selected in February. The Health Research and Educational Trust, Health Forum, AHA and National Patient Safety Foundation sponsor the program in partnership with ASHRM. For details and an application, visit www.healthforumfellowships.com. Additionally, ASHRM members may apply for a scholarship; visit www.ashrm.org (Members Services, Calls / Notices) for scholarship details.

ASHRM promotes FDA Web show

ASHRM is helping to promote an informational and educational tool called “FDA Patient Safety News.”  This monthly video/Web news show brings practical information on safeguarding patients and preventing medical errors directly from the FDA to risk managers.  Each show contains 6-8 stories covering drugs, biologics and medical devices.  It can be viewed at http://www.fda.gov/psn and via medical satellite television networks. The archive of stories that can be downloaded also continues to grow with each month’s broadcast.  For details about the program, contact Jay Crowley, the show’s executive producer at FDA, at psnews@fda.gov.

Compensation survey provides new data

The results in ASHRM's “2004 Compensation Survey for Healthcare Risk Management Professionals” provide a useful snapshot of the environment in which health care risk management professionals are working that can aid in decisions about employment and compensation arrangements. It includes exclusive data about risk management professionals, their jobs and how they are paid. Data from all 50 states, Puerto Rico and the Virgin Islands are captured in 27 tables and supported with essential analysis. Comparisons are drawn between results of this survey and previous ASHRM compensation surveys. “2004 Compensation Survey for Healthcare Risk Management Professionals” is available now through ASHRM’s Members Services/Tools & Products page at www.ashrm.org or via (800) 242-2626 – ask for item 178852.

New look for e-News

ASHRM recently redesigned the format of e-News to make it easier to read. Regular features include Clickable Calendar (with quick links to details on programs presented by ASHRM and its partners); Risk Management in the News; Legal, Regulatory & Compliance Update; Education Update; Chapters Update; and Risk Management Resources. E-news is transmitted every Friday morning to all current ASHRM members and prospects. Members who are not receiving e-News should contact ashrm@aha.org.

Sample pages posted

Sample pages and tables of content for many ASHRM products – including the new 2004 compensation survey results – are available on the ASHRM Products page. In the blue Members Services column on the right side of the home page, navigate down to the Tools & Products.

ON THE MOVE

Daniel P. Groszkruger to director of legal services, Tri-City Medical Center, Oceanside, CA.

Michael Lloyd to director of risk management, the Everett Clinic and the Sentinel Assurance Risk Retention Group, Everett, WA.

Jane McCaffrey to director, safety and risk management, Self Regional Hospital, Greenwood, SC.

Ellen Quinn to director of risk management and patient safety, Hospital Partners of America, Twelve Oaks Medical Center, Houston.

Patti Vail to senior risk management consultant for the Risk Management and Patient Safety Institute, a division of MHA Insurance Co., Lansing, MI.

Send notices to ashrm@aha.org. Contact details may be found in the ASHRM member directory at www.ashrm.org.