Hospital Risk Management - A Philippine Perspective
69
-
Upload
reynaldo-joson -
Category
Healthcare
-
view
20 -
download
3
Transcript of Hospital Risk Management - A Philippine Perspective
Hospital Risk Management – A Philippine Perspective
(ROJoson’s Thoughts, Perceptions, Opinions, and Recommendations)[TPORs]
Reynaldo O. Joson, MD, MHA, MHPEd, MSc SurgNovember 14, 2012
ROJoson’s Disclosures and Disclaimers
A student, still a student in Hospital Risk Management (HRM)!
2012
Assistant Medical Director, MDH
SVP- Corp Affairs, MDH
Disaster Programs - MDH, OMMC, DOH & WHO
Quality & Safety Programs - MDH, OMMC, PCS
ACI Workshop on Risk Management – Nov. 14-16, 2012
2008 2010
Concept of HRM - MDH
20051989
Ms. Patricia McKernan
Hospital Risk Management – A Philippine Perspective
(ROJoson’s Thoughts, Perceptions, Opinions, and Recommendations)[TPORs]
Anecdotal Experiences in HRM30 years in medical practice
23 years in hospital administration
Hopefully
HELPFUL to ALL!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
framework for Filipino participants
to add – to refineduring the ACI
Workshop!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
assist Canadian facilitator in
understanding PH situation
during the ACI Workshop!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Backgrounder
What is “RISK”?
What is Hospital Risk Management (HRM)?
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What is “RISK”?
Risk is a probability or threat of a damage, injury, liability, loss, or other negative
occurrence that is caused by external or internal vulnerabilities, and
that may be neutralized through preemptive action.
http://www.businessdictionary.com/definition/risk.html
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What is Hospital Risk Management (HRM)?
Hospital risk management (HRM) is a system or program that
manages the “risks” of a hospital.
•Department Risk Management •Disaster Risk Management•Patient Treatment Risk Management (Benefit-Risk; Medical Malpractice Risk Management)•Others
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What are the general goals of HRM?
• Prevent and mitigate all potential risks• Be prepared in terms of response and recovery
in case the risks become real• Control resulting damage, injury, liability,
loss, or other negative occurrence to a minimum level
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What are the general goals of HRM?
• Avoid loss of and disability inPeople (patients, visitors, staff) in the hospitalResources of hospitalBusiness of hospital (business discontinuity)
• Avoid complaints related to risk occurrence and consequences!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What are the preventive goals of HRM?
• Promote safety for ALL patients, visitors, and staff in the hospital
• Provide effective assistance and management during emergencies (disasters)
• Prevent controllable deaths and disabilities • Prevent and control losses (business, finances,
properties, and infrastructure).
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What are the ultimate goals of HRM?
SUSTAINABILITY OF THE HOSPITAL AS LONG AS POSSIBLE
(target: 100 years)
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
What are the ultimate goals of HRM?
SUSTAINABILITY OF THE HOSPITAL AS LONG AS POSSIBLE
(target: 100 years)
Sustainable structure-wiseSustainable financial-wiseSustainable service-wise
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Sustainable structure-wise goal of HRM?
Sustainable structure-wise
Will NOT collapse NOT be burnedNOT be flooded
NOT be destroyed by whatever hazards and will continue to operate its business as long as
possible (target: 100 years).
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Sustainable financial-wise goal of HRM?
Sustainable financial-wise
Will NOT go bankrupt
Will have positive income and will continue to operate its business as long as
possible (target: 100 years).
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Sustainable service-wise goal of HRM?
Sustainable service-wise
Will continue to provide adequate and quality services
expected of a hospital for as long as possible, both during crisis and non-crisis situations
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Quality parameters of an excellent HRM?
• Systematically and comprehensively formulated (with document)
• With full support and commitment of top management and ALL staff
• ALL staff of the hospitals trained and educated on program
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Quality parameters of an excellent HRM?
• With testing or exercises done regularly and at planned intervals and as needed
• Being reviewed regularly at planned intervals and as needed
• Has been tried and tested and has achieved its formulated goals and objectives and specified targets
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Basic processes in Hospital Risk Management?
• Risk identification and assessment
• Formulation of strategies and action plans to prevent, mitigate risks and to respond and recover from the consequences of unavoidable risk occurrence
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
RISK IDENTIFICATION RISKS commonly encountered in Philippine hospitals?
Risk for •business non-sustainability•natural disasters (earthquake, flood, tsunamis, fire, etc.)•man-made disasters (fire, felony, bomb threat, terrorism, etc.)•technology-related disasters•biological disasters
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
RISK IDENTIFICATION RISKS commonly encountered in Philippine hospitals?
Risk for •medico-legal suits (arising from patient care)•non-medico-legal suits (not arising from patient care, such as workforce legal suits)•aging (unsettled) account receivables•tarnished corporate or hospital reputation
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
RISK ASSESSMENT / EVALUATIONRISKS commonly encountered in Philippine hospitals?
Risk assessment - likelihood of occurrence of identified risks and impact when they occur.
Utility of risk assessment - more on prioritization
ALL risks identified must have preventive, mitigation, preparedness, response, and recovery plans!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
RISK ASSESSMENT and PRIORITIZATION RISKS commonly encountered in Philippine hospitals?
Risk for •business non-sustainability (financial viability)•aging (unsettled) account receivables•medico-legal suits (arising from patient care)•technology-related disasters•natural disasters (earthquake, flood, tsunamis, fire, etc.)
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
RISK ASSESSMENT and PRIORITIZATION RISKS commonly encountered in Philippine hospitals?
Risk for •tarnished corporate or hospital reputation•man-made disasters (fire, felony, bomb threat, terrorism, etc.)•non-medico-legal suits (not arising from patient care, such as workforce legal suits)•biological disasters
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Basic processes in Hospital Risk Management?
• Risk identification and assessment
• Formulation of strategies and action plans to prevent, mitigate risks and to respond and recover from the consequences of unavoidable risk occurrence
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
• Email survey – 18 questions – hospital administrators
• Interview – hospital administrators, MHA co-faculty at UP – CPH
• Personal observations in PH hospitals
• ACI participants (today)
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
Overall, we have a structured, comprehensive and effective hospital risk management program.
25% 25% 50% 0 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a structured risk identification process.
25% 38% 38% 0 0
We keep track of newly perceived and actual risks and add them to the list of hospital risks.
38% 25% 25% 0 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a structured risk assessment process.
38% 25% 38% 0 0
We prioritize our preparations for risk preparedness based on the risk assessment process.
50% 13% 25% 13% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have preparedness programs for all identified hospital risks.
25% 38% 25% 13% 0
We have a structured risk reduction system.
38% 13% 50% 0 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a structured risk control system (response and recovery program during risk occurrence).
25% 50% 25% 0 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a risk financing program like liability and general insurances.
38% 25% 25% 13% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a medical malpractice insurance for the hospital.
75% 0 0 25% 0
We have medical malpractice insurance for our healthcare professionals.
75% 0 0 25% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a comprehensive fire insurance for our properties and capital resources.
13% 0 13% 75% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have a multisectoral taskforce / committee in charge of the hospital risk management program.
25% 13% 38% 25% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have an integrated hospital risk management program where all risks are interconnected as indicated during planning and exercises.
0 38% 38% 13% 13%
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have documented policies and procedures on hospital risk management.
0 50% 25% 25% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
Our documented policies and procedures on hospital risk management are being reviewed at least at planned intervals.
25% 25% 38% 13% 0
We conduct regular exercises on our risk preparedness program.
13% 38% 13% 38% 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH Hospital Risk Management
None / not being done yet
Beginning Expanding Consistent Advanced
We have the full commitment and support from the top management for our hospital risk management program.
0 25% 25% 50% 0
Overall, we have a structured, comprehensive and effective hospital risk management program.
25% 25% 50% 0 0
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Most, if not all, Philippine hospitals are aware of, concerned with, and are on guard against their occurrence of the nine (9) general categories of risks.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Majority of the Philippine hospitals do not have a systematic approach even for each general risk category including the specific risks under the general category.
Without a systematic approach, it goes without saying, there is no system of deployment of risk preparedness programs.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Majority of the hospitals do not have well-documented preventive, mitigation, preparedness, response and recovery plans for the general risk categories and also the specific risks.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Majority of the hospitals do not have documented policies and procedures manual or primer; if there are, not disseminated to all staff; not exercised, reviewed and re-evaluated at planned intervals or as the need arises anytime.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Recommendations:
The management program must be documented and placed in a policies and procedures manual or primer, disseminated to all staff, exercised, reviewed and re-evaluated at planned intervals or as the need arises anytime.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
The manual can have the following simple outline:• Preface • Scope• Definitions • Program Management • Planning • Implementation • Exercises, evaluation and corrective action • Management Review
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
The manual can have the following simple outline:• Preface • Scope• Definitions • Program Management • Planning • Implementation • Exercises, evaluation and corrective action • Management Review
Hospital Risk Management Program Manual
Supplementary Manuals on Implementing Guidelines and
Instructions
(covering the 9 categories of common hospital risks)
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Regarding the maturity of the risk management program, majority, if not all, of the Philippine hospitals do not have an integrated system that encompasses all the general risk categories.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Recommendations:
Creation of multisectoral task force / committeeto align, coordinate, collaborate, and integrate all risk
preparedness programs of the hospital
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Recommendations:
Examples of multisectoral task forces / committees • Corporate Risk Management Committee• Safety Promotion and Disaster Preparedness Committee• Quality Management Committee
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Recommendations:
Examples of multisectoral task forces / committees • Corporate Risk Management Committee• Safety Promotion and Disaster Preparedness Committee• Quality Management Committee
Essentials:
Multisectoral in membership
Headed by a top / senior management representative
Aligning, coordinating, integrating all risk preparedness programs of
the entire hospital
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Medical Malpractice Insurances
Majority, if not all, of the PH hospitals do not have medical malpractice insurances for risk financing program.
For the few that have, they do not want to divulge.
Most physicians in PH also do not have medical malpractice insurances.
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
Medico-legal Suits (Medical Malpractice Suits)
NOT rampant yet in PH
NO medical malpractice law yet (the Medical Malpractice Act of 2002 still pending in Congress – encountering rough sailing)
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Survey on PH HRM – General and Summary Statements
To avoid medico-legal suits
All physicians must always take note of the goals in the management of all patients:
Resolution of the health problemLive patientNo complicationNo disabilitySatisfied patientNo medicolegal suit
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Critical steps to ensure success of HRM
• Securing of administrative commitment and support• Establishment and continual development of manual of
policies and procedures on risk management that include risk preparedness (prevention, mitigation, preparedness, response, and recovery plans)
• Regular conduct of risk control exercises
Critical Governance Factors
Leadership
Readiness in Risk Control
Training
Communication
Managership
“Manage” staff to get commitment and support to achieve goals!
Leaders may delegate
responsibilities and competencies to
managers.
But must know principles of risk
preparedness, esp. in managing
Incident Command!
Critical factors for readiness!
Leaders communicate with
managers and staff effectively and efficiently!
Timely!
Stress importance of risk
preparedness!
Provide directions!
Express commitment and
support!
Leaders support training of staff
for risk preparedness!
Undergo training to gain
competency, esp. in Incident Command!
To demonstrate engagement and
involvement!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
framework for Filipino participants
to add – to refineduring the ACI
Workshop!
Hospital Risk Management – A Philippine Perspective [ROJ – TPORs]
Contents
Overview of hospital risk management in Philippines
• Current status• Areas and opportunities for improvement• Recommendations in developing an
integrated sustainable hospital risk management based on Philippine environment and perspective
assist Canadian facilitator in
understanding PH situation
during the ACI Workshop!
Hospital Risk Management – A Philippine Perspective
(ROJoson’s Thoughts, Perceptions, Opinions, and Recommendations)[TPORs]
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
Email: [email protected]@yahoo.comCell No.: 09188040304
www.facebook.com/rjoson2001
