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Healthcare Risk Management – February 1, 2012

February 1, 2012

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  • Is your premium too high? You might be getting ripped off

    No one enjoys paying their hospital professional liability (HPL) premiums, but paying too much is even worse. Your premium might be too high if the insurer is loading based on a broad geographical area, and it's up to you to ask the right questions.
  • Probe load calculation, show your own data

    To avoid being overcharged on load premiums, you have to ask the right questions and provide the data showing why you deserve better than the typical load for your area.
  • Don't leave insurance to finance department

    Risk managers should have an active role in purchasing and managing insurance, says R. Stephen Trosty, JD, MHA, CPHRM, president of Risk Management Consulting in Haslett, MI, and a former insurance company executive.
  • More MD hires means more tail insurance

    Hospitals are bringing more self-employed physicians on board as employees, which can bring benefits to both parties, but it brings a potential problem for risk managers. What do you do about tail insurance?
  • Weigh tail options when hiring MDs

    Deciding who pays for a new physician's tail coverage usually hinges on who has the leverage in the hiring situation, says Mary Anne Hilliard, JD, BSN, CPHRM, chief risk counsel with Children's National Medical Center in Washington, DC, and president of the American Society for Healthcare Risk Management (ASHRM) in Chicago.
  • Identified fall risks can be used in prevention

    Investigators have identified factors that are associated with an increased risk of in-hospital falls after total hip or knee replacement surgery, and the findings can be useful to risk managers and fall prevention committees.
  • Comorbid conditions increase fall risk

    To study the risk of falls in patients undergoing orthopedic procedures, researchers at the Hospital for Special Surgery (HSS) turned to the Nationwide Inpatient Sample, sponsored by the Agency for Healthcare Research and Quality (AHRQ).
  • Target those most at risk of falls, but others too

    Fall prevention efforts usually target those thought most likely to fall, but does that leave the other patients at risk if no one is paying attention to their potential for falling? A special focus on high risk patients doesn't have to shortchange others, says Pamela E. Toto, PhD, OTR/L, BCG, FAOTA, an occupational therapist at the School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pennsylvania.
  • Volunteer program cuts falls 46%

    Some of the best ways to prevent falls require personal, hands-on attention to individual patients, but hospitals don't have enough staff to provide as much of that tending as they would like. One hospital has found that volunteers are eager to do the job, and it has cut falls by a whopping 46% as a result.
  • More rounding means better fall compliance

    Two years of the Fall Prevention -- Safety Monitor Volunteer Program at Hartford (CT) Hospital have yielded significant results, says Christine Waszynski, APRN, a geriatric nurse practitioner and clinical nurse specialist in the geriatrics program. (See the charts above and on p. 20.) In addition to reducing falls 46%, analysis of the bed check results shows these findings:
  • Clinical champion is a must for falls program

    Who wouldn't want to replicate a falls prevention program that cuts falls 46%? If you want the same results, here are some tips from Christine Waszynski, APRN, a geriatric nurse practitioner and clinical nurse specialist in the geriatrics program who works with the Fall Prevention-Safety Monitor Volunteer Program at Hartford (CT) Hospital:
  • Kaiser hospital fined for med storage error

    The California Department of Health has fined Kaiser Permanente South San Francisco Medical Center $50,000 for failing to follow "policies and procedures for the safe and effective administration of medication," in relation to improper refrigeration. Thousands of patients received the potentially dangerous medications over almost three years.
  • Failure to communicate test results adds risks

    Because clinical evaluation often depends on diagnostic tests, diagnostic physicians have a responsibility to notify referring clinicians when test results reveal urgent or unexpected findings. According to a report in the Journal of the American College of Radiology (JACR), the rapid growth of diagnostic testing appears to be placing physicians at greater risk for medical malpractice claims for test communication failures.
  • ED treatment delayed — 14-year-old could have been saved by surgery, family claims

    News: A 14-year-old boy was taken to a local hospital emergency department (ED) with complaints of sharp pain on the right side of his face and his right shoulder after being kicked in the head by his mother. The boy reported that his pain level was 10 on a scale of 1-10; however, the triage nurse indicated his was a "non-urgent" case.
  • $10 million settlement in toddler amputations

    News: A 2-year-old patient presented to the emergency department (ED) with a high fever, skin discoloration, and weakness. Despite her parent's numerous requests for treatment, the patient waited for five hours before being evaluated by medical staff. By the time she was evaluated, her condition had worsened. She was flown to another hospital, where she was diagnosed with septic shock.
  • Data breaches attributed to business associates increase

    Three scenarios that no hospital security or privacy officer wants to experience:
  • BA 'must haves' for privacy, security

    A hospital privacy and security compliance officer knows exactly what policies and programs within the organization are designed to protect patient information (PHI), but what should be expected of a business associate (BA)?
  • Study: Breaches of data up 32%

    The second annual benchmark study by Ponemon Institute in Traverse City, MI, sponsored by ID Experts, finds that the frequency of data breaches in healthcare organizations surveyed has increased by 32%.