Should risk managers review all reports?
Question: I worry sometimes that I am not reviewing various types of business reports associated with my facility, but I’m not sure how to make sure that I have access to them without seeming overbearing. I suspect many risk management issues go unchecked simply because I do not see these documents. Should I be reviewing these items, and if so, how do I go about it?
Answer: Reviewing marketing proposals, joint venture agreements, charitable care agreements, and other such documents should be a regular part of a risk manager’s job, says Sandy Mahon, ARM, vice president of risk management and quality assessment for Program Beta in Alamo, CA. Mahon is working with the American Society for Healthcare Risk Management in Chicago to encourage risk managers to expand their duties beyond the "basic" risk management functions such as incident reports and managing medication errors.
"We’ve been viewed as being in charge of the body count, but we need to take a more proactive role in leading the troops," Mahon explains.
Getting yourself in the loop to review business reports and various documents is a good way to take initiative as a risk manager, Mahon says. Risk managers aren’t routinely asked to review such reports, she notes. Usually, the administration routes a report to the risk manager only when there are obvious risk management implications.
"That’s one of the big problems," she says. "If you’re not in the loop, you don’t even see most of the reports. That’s where you have problems you might not even know about until it’s too late."
Develop a wide range of skills
A better strategy is to convince hospital leaders that you should be included in all significant hospital transactions, especially because you will be able to spot risk management problems they would not. Getting yourself "a seat at the table" is easier said than done, but it can be accomplished if you develop your skills in finance, insurance, and other issues that dominate most high-level hospital discussions.
Once you convince your administrators that you have something to contribute, you should establish a policy that certain types of documents should always be sent to you for review. The documents you specify will differ from one facility to another and will depend on how much work you can handle. For starters, you should insist on seeing any contract or agreement with another party.
"This can be a problem if you can’t handle all you ask for, and you just create a bureaucratic bottleneck in your office," Mahon notes. "To get this to work at all, you have to be seen as credible in the organization. If you then let everything get backed up and you don’t have any real input, people will find a way around you."
Once you have access to all these documents, you will have to draw on the fundamentals of risk management to look for hidden problems. What is the exposure to your organization? Is the exposure insurable? Do you need to create loss control activities to manage the risk?
[For more information, contact Sandy Mahon, Vice President, Program BETA, 1443 Danville Blvd., Suite 200, Alamo, CA 94507. Telephone: (510) 838-6070.]
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