Hospital Risk Management

The Risk Management (RM) Department is dedicated to reducing our members’  exposure to loss with expert hospital, physician, and medical group practice analysis and ongoing risk management consultative support. We concentrate on improving patient safety throughout the health care delivery system using an enterprise risk management approach. Our dedicated RM staffs in our Seattle, Portland, and Spokane offices are well situated to provide risk management services to members throughout our three-state operating region.

The RM/Education Committee supports our RM activities and is composed of physicians who serve in a wide range of specialties, practice settings, and geographic regions. The committee meets regularly to develop RM strategies and programs aimed at improving health care quality and reducing professional liability loss. Their guidance, in tandem with the contributions of highly knowledgeable experts and state-of-the art data collection systems, affords us the ability to design and deliver unparalleled risk management support for our members.

Facility Support
Our on-site consultation service is one of the distinctive benefits of membership in Physicians Insurance. We regularly meet with facility personnel, including the executive team, administrators, physicians, risk managers, and other clinic staff  to build relationships and develop proactive risk management service plans. Upon request, we conduct in-depth risk assessments, followed by ongoing assistance with implementing any recommended system enhancements and providing tailored staff education.

Telephone consultation is another cornerstone of our service. Members receive personalized assistance from seasoned risk management professionals during business hours, Monday through Friday, via our toll-free phone lines. We also invite members to ask questions at any time via e-mail and our Web site. Consultations range from short telephone conversations to in-person follow-up meetings with facility staff, with additional research on regulatory issues as necessary. Analysis of these consultations forms the basis of Web site postings, publications, and educational opportunities for our membership.

Our members appreciate this kind of personalized service and simple access to a host of educational and practice management tools. Comments on evaluation forms frequently cite these tools as a significant value-added bonus.

Continuing Education
Physicians Insurance is accredited by the Washington State Medical Association CME Accreditation Committee to provide Category 1 continuing medical education to physicians. We are one of the few CME providers in Washington State to have received an exemplary rating, the highest level of accreditation, and to have maintained our exemplary status since 2002.

The strength of our continuing education program is due to our commitment to strong member support. We do not charge a registration fee to our members, nor do we accept commercial support. Members of our RM/Education Committee are closely involved in course development and evaluation. Seminar faculty familiar with regional and practice setting differences address the issues pertinent to the particular health care community throughout our membership area.

The goal of our CME program reflects the company’s mission to improve the quality of patient care and reduce medical professional liability risks. We aim to initiate improvements in competence, performance, and patient outcomes through a variety of learning activities.

Washington State Mandates: Washington State law requires all physicians to undergo risk management training every three years as a condition of renewal of liability insurance coverage. Effective January 1, 2011, the Washington State Nursing Care Quality Assurance Commission requires nurses to complete 531 hours of active practice, 45 hours of continuing education along with a self-assessment and reflections of individual professional practice every 3 years. Our education programs are designed to help providers meet these requirements. In addition, our computerized attendance records are keyed into a process that tracks participation in training activities and provides written documentation of compliance with the laws. For insured physicians, we are able to monitor their compliance with the law and advise physicians well in advance of their deadline, and list their options for compliance. 

CME Delivery Methodology

Seminars: We offer daytime and evening seminars throughout our geographic coverage area to our members. Basic and topical risk management issues are offered such as:

• Scope of practice
• Compliance issues: HIPAA, HITECH, and EMTALA
• Team communication skills
• Optimizing patient engagement
• Effective documentation
• Disclosure and apology training
• Provider wellness

Seminars also cover clinical topics such as diagnosis of cancer, chronic pain management, and other relevant topics to health care providers.

E-Learning: Members can obtain self-directed, relevant continuing education  through our e-learning program, accessible through the Physicians Insurance Web site.

Self-study programs: Various formats for self-study courses allow our members to obtain Category 1 CME in the time and location of their choosing. Self-study courses are currently available for anesthesiologists, emergency physicians, obstetrical practitioners, primary care physicians, and medical office and facility staff.

Special Presentations: By special request, we provide customized presenta¬tions to clinics, facilities, hospital medical staff programs such as grand rounds, specialty societies, universities and colleges, and other state and national health care organizations.

Webcasts and Webinars: At periodic intervals during the year, we offer Webcasts and Webinars. These learning sessions provide educational options for members in rural communities to participate from anywhere that they have an Internet connection.

CME Course Curriculum Examples

Performance Improvement: Our members are invited to participate in performance improvement projects. We offer a three-stage performance improvement process for patient care that involves:

• an initial chart review to identify gaps between current and expected performance
• a facilitated group discussion and use of documentation tools to close the gaps
• a second chart review to show both individual and group improvement

During this activity, patient documentation--including handoffs and follow-up activities--is reviewed, and suggestions for improvement are made, if necessary.   

Currently, we also have available performance improvement projects specific to the clinical arena such as potentially life-threatening presentations of chest pain and the management and treatment of the chronic pain patient. Physicians and hospital staff will find these projects informative and helpful. These projects are accredited for Category 1 CME.  

Patient Safety Assessment Tool: Patient Safety Assessment for Every Medical Practice (Patient SAFE Medical Practice) is a clinic-based performance improvement project designed to advance patient safety by implementing proven risk management systems. The survey designed for this project incorporates ten documentation and practice standards to evaluate a clinic’s or facility’s system processes. Research has shown that providers who have scored high on compliance of these standards have had fewer medical professional liability claims.

Disclosure and Apology Communication Training Program: Our AdVerse Event Response Team Training (AVERT) Program incorporates a variety of multimedia and experiential techniques to teach skills involved in the delivery of a compassionate and empathetic apology. Targeted to clinical and administrative staff, the 2.5 hour program covers each step beginning with immediate response, and moving through incident investigation, corrective action, documentation, and support for patients, their families, and the health care team after an adverse event. Evaluations from members attending the seminar show that they are more confident in:

• their ability to manage a bad outcome
• making use of outside resources for personal mental, emotional, and professional support
• realizing that apologizing after a medical mistake increases patient trust

Airway Management: Decision Making in Airway Management is a DVD self-study course developed in response to survey data that identified airway problems as the most challenging risk management issue for anesthesiologists and emergency physicians. The course is presented by Will Rosenblatt, MD, professor of anesthesiology at Yale University and past president of the Society for Airway Management.

Reducing Obstetrics Exposure: To address growing concerns of this specialty, the RM team offers on-site simulation training in high-risk procedures, and two Category 1-certified self-study courses; Updates in Electronic Fetal Monitoring, presented by internationally recognized obstetrical leader Gary Hankins, MD, is available as an on-demand Webinar. Delivering Patient Safety is a DVD course adapted from a live presentation by Steven L. Clark, MD, medical director of the Hospital Corporation of America's 163-hospital system.

Weight Management Communication: Opening Pandora’s Box: A Collaborative Approach to Reducing Obesity-Related Liability helps providers examine and overcome the barriers to communication about weight management. It features original video-recorded vignettes that demonstrate effective patient-interview techniques. Collaborative management among multiple providers is also emphasized. Course materials include a facility assessment of obesity-related liability and a BMI poster to encourage dialogue with patients.

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