RISK MANAGEMENT

FENIDA RUSWANTI S

MAGISTER MANAGEMEN
UNIVERSITAS PADJADJARAN
 HISTORICALLY, SAFETY PROGRAMS & MEASURING THE
QUALITY OF CLINICAL SERVICES WERE SEPARATE
CONTROL ACTIVITIES
USUALLY LIMITED TO ACUTE CARE HOSPITAL

1970 : CONCEPT OF RISK MANAGEMENT (RM)

INCLUDED PROACTIVELY MANAGING RISK

A COMPREHENSIVE RM PROGRAM INCLUDES

IDENTIFYING : CONTROLLING AND
FINANCING RISKS OF ALL TYPES
 INHERENT IN RM IS
PREVENTING RISK AND
MINIMIZING THE EFFECT
OF UNTOWARD EVENTS,
SHOULD THEY OCCUR
FACTORS CAUSED THESE CHANGES :
INTERNAL :
HSO MANAGERS INCREASINGLY RECOGNIZED THEIR ETHICAL DUTY
TO PROVIDE A SAFE ENVIRONMENT FOR PATIENTS, STAFF &
VSITORS AND HIGH-QUALITY CLINICAL SERVICES

EXTERNAL :
THE INCREASING LITIGIOUSNESS IN SOCIETY AND COURT
DECISIONS THAT PUT GREATER LEGAL LIABLITY ON THE HSO
LAWS (OCCUPATIONAL SAFETY AND HEALTH ACT), WHICH
MANDATED THE STUDY OF HAZARDS IN ACUTE CARE HOSPITALS
THE REQUIREMENTS OF PRIVATE ORGANIZATIONS AND PUBLIC
BODIES WHICH INCREASINGLY THE QUALITY OF SERVICES AND
MANAGING RISK
THERE ARE OPERATIONAL LINKAGES
BETWEEN THE RISK MANAGEMENT
FUNCTIONS RELATED TO THE CLINICAL
ASPECTS OF PATIENT CARE AND SAFETY
AND QUALITY ASSESSMENT AND
IMPROVEMENT FUNCTION
RELATIONSHIP BETWEEN RM & QA

1. Common data base

2. Identification of problem leading
to adverse events
3. Patients focus
4. Continuous monitoring systems
RM QA 5. Information analysis
6. Clinical & managerial expertise
7. Staff education
8. Financial support
9. Governing board accountability
 RM IS COORDINATED THROUGH AN
INTERDICIPLINARY COMMITTEE, TIPICALY
CHAIRED BY THE RISK MANAGER.
THE COMMITTEE DEVELOPS POLICY &
PROVIDES GENERAL OVERSIGHT
TO INCLUDE MEMBERS OF PROFESSIONAL
STAFF ORGANIZATION COMMITTES AND
HAVE MORE CLINICAL ORIENTATION
 THE RISK MANAGER
TIPICALLY, RISK MANAGER HAVE
BACKGROUNDS IN SECURITY, SAFETY, AND
LOSS PREVETION
EXPERIENCE IN LAW ENFORCEMENT AND
INVESTIGATIVE TECHNIQUES ( NOT UNUSUAL)
FULL OR PART TIME
MASTERS DEGREES IN HEALTH SERVICES
MANAGEMENT
 THE DUTIES OF RISK
MANAGER
IDENTIFYING AND ANALYZING RISKS
DEVELOPING, IMPLEMENTING AND MONITORING THE
INSURANCE PROGRAM
MAINTAINING AND DISTRIBUTING A RM MANUAL
REVIEWING EXISTING AND PROPOSED CONTRACTS &
AGREEMENTS & CONSULTING WITH LEGAL COUNSEL
SUPERVISING CLAIMS REPORTING
 THE DUTIES OF RISK
MANAGER
(continued)
ASSISTING IN ADJUSTING LOSSES
DEVELOPING AND MAINTAINING REPORTING &
ANALYSIS SYSTEMS FOR RISK AND LOSS
ATTENDING & GIVING SEMINARS THAT WILL
IMPROVED PERSONAL AND ORGANIZATIONAL RM
SKILLS
FINANCIAL MANAGEMENT RESPONSIBILITIES, SUC AS
EVALUATING EQUIPMENT PURCHASE AGREEMENTS
AND JOINT VENTURE CONTRACTS
 PRINCIPLES OF MANAGING
RISK
THE STEPS IN MANAGING RISKS INCLUDE :
IDENTIFYING
EVALUATING
ELIMINATING RISK
REDUCING
TRANSFERRING
 SEVERAL WAYS TO IDENTIFY
RISK
THE MOST COMMON IS TO COLLECT AND AGGREGATE
DATA ABOUT PROBLEMS SO THAT PATTERNS
BECOME FOCI FOR ACTION

MANAGING RISK IS NOT ONLY REACTIVE, IT SHOULD

CONCENTRATE ON ELIMINATING, REDUCING AND
TRASFERRING RISK
EVALUATING RISK :
REVIEWING AND CATEGORIZING INFORMATION
ABOUT PROBLEMS OVER TIME
SHOULD BE PROSPECTIVE, BECAUSE IT IS KNOWN,
ACTUARIALLY, THAT CERTAIN TYPES OF PROBLEMS
WILL OCCUR OR
HAVE PARTICULAR PROBABILITY OF OCCURRING
PROSPECTIVE, RETROSPECTIVE & CONCURRENT
EFFORTS CAN USE EVALUATING TECHNIQUES SUCH AS
COST BENEFIT , COST EFFECTIVENESSANALYSES TO
TO SELECT THE BEST COURSE OF ACTION
EVALUATIVE EFFORTS :
AID IN THE IDENTIFYING STRATEGIES TO ELIMINATE,
REDUCES OR TRANSFER RISK
SAFETY INSPECTION AND AUDITS OF VARIOUS
ACTIVITIES AND FUNCTIONS ( RANGING FROM
FINANCIAL TO FIRE PROTECTION) OF THE HSO ARE
WAYS TO PROSPECTIVELY IDENTIFY PROBLEMS
AREA
 ELIMINATING OR REDUCING RISK
(OR BOTH) CAN BE ACHIEVED IN
MANY WAYS :

SPONSORING EDUCATION & AWARENESS PROGRAMS FOR

STAFF

MODIFYING PHYSICAL PLANT AND STRUCTURE

ENHANCING THE CREDENTIALING PROCESS AND
REVIEW OF CLINICAL STAFF ACTIVITIES
IMPROVING PROCESSES AND PROCEDURES
INITIATING MATERIAL MANAGEMENT SYSTEMS
IMPROVING PATIENT AND STAFF RELATIONS
HIRING QUALIFIED PERSONNEL IN APPROPRIATE
IIT IS PREFERABLE TO ELIMINATE
RISK BUT FOR MANY
TYPES OF RISK THIS MAY BE
IMPOSSIBLE
THEREFORE THE EMPHASIS MUST
BE ON MINIMIZING RISK