In an age where customer experience reigns supreme, the healthcare industry is beginning to view processes and outcomes through a similar lens. Hospitals and healthcare systems are businesses. Patients are customers. And customers must have a positive experience in order to continue using the services of a business. Patient experience is a term often applied broadly to initiatives such as reducing hospital stay length and readmission rates, cutting down incidences of patient safety events, and ensuring patients feel seen and heard.
In an effort to get a hold of this new way of thinking, hospitals are adding patient experience leaders to their staff and also considering the myriad sources that impact the patient experience. Risk managers and patient safety professionals have a unique opportunity to champion patient experience efforts for their organizations. Here are four areas of focus for improving the patient experience with the help of risk management best practices.
1. Get the whole organization involved and invested
With a far-reaching goal like improving patient experience, healthcare organizations will see greater success when they establish a targeted strategy and communicate that strategy clearly across all departments. In many cases, it may make sense to establish an enterprise risk management (ERM) program to make headway. As mentioned in GRC: Where to start? Productive healthcare ERM tools, “Healthcare ERM establishes a standardized framework for identifying risk across an organization, encourages cross-departmental collaboration, and shifts hospitals from a reactive clinical risk program to a proactive holistic risk management program.”
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Before organizations can begin implementing an enterprise risk management (ERM) program, they must get buy-in from leadership. But in order for leadership to feel comfortable buying into a program, they must have sufficient evidence that it will make a difference for the organization’s overall goals.
There’s a solution to this catch-22. By having the right conversations and showing results from smaller-scale initiatives, organizations can demonstrate the value of an ERM program to leadership—and do so without the same time, effort, and resources required for a full-scale ERM operation.
Start the old-fashioned way
The right technology can be instrumental in demonstrating ERM program successes. However, before using technology to prove the benefits of an ERM program, risk managers can begin influencing leadership through small, in-person conversations.
“One of the biggest buy-in methods for a successful strategy is talk,” writes Darius Delon, AVP of risk services for Mount Royal University, in the article Putting Strategy into Risk Management. “One person at a time, one hour at a time, one advocate at a time. People will not buy-in to ERM just because they read something you put in front of them or heard at a large forum. Talk to them, work with them, get small wins…”
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In TPAs and automation, part 1: Humanizing customer service, we looked at ways in which the use of features available in integrated claims management software—automation tools, push-reporting, and online portals—can help improve the level of service provided to clients and claimants. The automation and self-service features of a claims management software solution also have roles to play in another business-critical area for TPAs and organizations self-administering claims: recruiting, hiring, and retaining top talent.
Challenges to hiring and keeping qualified claims professionals
As is the case across most industries, a combination of baby boomers reaching retirement age and a strong economy continues to make it difficult for businesses in the property/casualty insurance industry to find qualified candidates. According to the Insurance Journal article Insurance Industry Facing Competitive Labor Market, the industry’s unemployment rate of 1.7% is even lower than the reported national average of 3.9%. Even so, the article points to the fact that, as of its April 2019 publication date, the “need for technology, claims and sales/marketing staff is expected to grow the greatest in the next 12 months.”
Beyond the challenge of finding qualified candidates to fill open claims department positions is the issue of employee retention. A 2018 CompData Survey shows that total turnover among organizations in the insurance industry stood at 12.8%. Although lower than the average for all industries (19.3%), this rate has trended upward in recent years.
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In “Bad Decision Family,” a classic sketch from the 16th season of Saturday Night Live, guest host Tom Hanks, playing the father of the family, joins his wife (Jan Hooks) and children (Julia Sweeney, Mike Myers) at the kitchen table for “leftover night.” Hanks has just retrieved milk from the refrigerator. Upon taking a seat, he drinks directly from the carton. “Oh! Oh, geez!” he cries out in disgust. “How old is that milk? It is really bad!” Hooks asks to see for herself, and reacts similarly after taking a sip. To a mixture of laughter and moans from the live audience, Sweeney and Myers eagerly follow suit. As the sketch continues, each member of the family takes turns joining in on bad decision after bad decision: sniffing a plate of bad fish, sitting on a sharp nail, and testing out a broken staircase to the basement, to name just a few.
The sketch works because it illustrates our tendency as human beings to willingly opt-in for experiences that are guaranteed to be less than optimal. This phenomenon holds true when it comes to the performance of risk management information system (RMIS) software and support.
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Supply chain management has always come with a wide range of risks—from capacity issues to operational disruption to inheriting the risks of a supplier. Recently, raw material shortages, climate change, and trade wars have come to the forefront of concerns. Regardless of a company’s size or the proximity of its suppliers, it’s likely to feel the impact of global risks like these. Risk managers are taking note. In Lockton’s 2018 Risk Management Survey, supply risk was among the top issues risk managers wanted to discuss more within their organizations.
As supply chains become more complex, so does the management of related risks. Manual management techniques or legacy technology previously used in performing the job may not work for addressing today’s challenges. “To make the best decisions, managers need access to real-time data about their supply chain, but the limitations of legacy technologies can thwart the goal of end-to-end transparency,” states the Harvard Business Review article The Death of Supply Chain Management.
Using the right technology, risk management teams and supply chain teams can take control. A fully integrated risk management information system (RMIS) with built-in automation and data analytics can help eliminate manual labor, increase efficiency, and allow for more accurate predictions. Ultimately, this can save companies money, and aid in avoiding supply disruptions that could take a business under or severely damage its reputation. (Read more about the far-reaching consequences of reputational damage due to supply chain failures.)
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Risk management in healthcare has especially high stakes. In addition to risks related to operations, finances, and reputation, healthcare organizations must consider those that can be a matter of life or death. Hospitals and health systems work tirelessly to ensure the health and safety of their patients. The right healthcare risk management software will help them achieve that goal.
No matter what an organization hopes to improve—from claims management to incident reporting to clinical rounding—an integrated healthcare risk management information system (RMIS) offers the right solutions for improving patient well-being and finding organization-wide success. Read more about the many aspects of risk management in healthcare.
- Patient Safety & Quality
- Claims & Insurance
- Healthcare Enterprise Risk Management (ERM)
Patient Safety & Quality
Medical error is the third-leading cause of death in the United States. This includes process errors, planning errors, and failures to act. With the right reporting and workflow tools, integrated healthcare risk management software eliminates human error and allows clinicians to work in lockstep to provide better patient care.
To effectively address adverse events and near misses, hospital risk managers need an informed understanding of what constitutes such incidents. This starts with having the technology to efficiently report them. Integrated data tools—such as data surveillance, patient safety event reporting, and enterprise-wide near miss/unsafe condition reporting—that contain simplified forms with clear instructions make data collection efficient and straightforward.
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Enterprise risk management (ERM) programs require focused planning and commitment from a range of stakeholders within an organization. However, even organizations with the best intentions can see ERM efforts fall to the wayside as more pressing day-to-day issues take precedence.
In the article Leveraging Technology To Drive Sustainable ERM Initiatives, Origami Risk’s Josh Newsum discusses the powerful role of risk management technology in keeping ERM initiatives on track, as well as how organizations can achieve the best results, regardless of where they are in the process.
Read the article in Risk Management →
As the hospital burnout crisis continues to make headlines, healthcare organizations are in need not only of solutions that address the consequences of burnout, but also strategies for preventing burnout in the first place. As discussed in part 1 of this series, the right healthcare risk management technology can play a role in efforts to ensure physicians are more fully engaged. Physicians who feel connected to the core purpose of their work are less likely to burn out, and more likely provide quality patient care.
Another approach to addressing clinician burnout is the establishment of an organization-wide plan to monitor, analyze, and, ultimately, prevent the condition from occurring. Efforts to mitigate burnout will likely come from many directions within an organization, but to streamline the process and get everyone on the same page, a logical but perhaps unexpected place to start is with the hospital risk management team. Healthcare risk managers can play a crucial role in successfully preventing burnout by viewing burnout like the other risks they manage, developing a healthcare enterprise risk management (ERM) framework, and leveraging the technology they already work with on a daily basis.
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Increased rates of accident severity. Rising claim costs. Insurance coverage that is either more expensive or harder to secure. As risk managers grapple with these and other fleet management challenges, measures such as a renewed focus on training and driver safety, an improved understanding of the cause of accidents that lead to claims, and the ability to pull together a complete and accurate list of fleet exposure values are essential components in reducing fleet-related costs.
Given the range of departments and the number of people typically involved in the management of fleet vehicles, implementing and measuring the efficacy of such initiatives is easier said than done. By extension, the number of software systems, spreadsheets, and paper-based processes an organization uses to capture and store fleet-related data can make it difficult to monitor progress, identify trends, and report on successes. By consolidating this data in a central location that is linked to claims, policies, certifications, training records, and more, a RMIS can help better manage the risks associated with a commercial fleet.
#1 A RMIS can consolidate all fleet vehicle data
Data silos are an all-too-common issue for many organizations. This can hold especially true for those with an extensive fleet of vehicles, whether owned or leased, that directly employ or contract with drivers.
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Those working in the healthcare industry are no strangers to constant change. A healthcare risk management program and the right technology can help to effectively monitor risk across specialties and improve patient safety. Origami Risk’s Bill Schwacke spoke to Future of Personal Health about the intersection of risk management and the healthcare industry.
Risk management software is used in various industries. How is it applied to healthcare?
Risk management software is at the center of a healthcare organization’s approach to risk, safety, claims, and insurance. The software can define the provider’s approach to risk by linking, organizing, and distributing data from independent, critical functions to provide an organizational view of risk.
Can you elaborate on the correlation between patient safety and risk management software?
Patient safety and risk management software are often linked due to the nature of the data involved. While they often work independently, there are insights that can be discovered when linked together. These insights can improve quality of care and reduce claims/insurance costs for the organization.
Read the full article in Future of Personal Health.