We identified 16 risk management practices that health centers are likely to conduct to reduce medical malpractice claims and ensure patient safety. We identified these practices based on interviews with health centers, Federal officials, and other key stakeholders; a review of relevant statutes, regulations, and policies; and a review of pertinent literature regarding risk management in health care settings. Ten of these 16 risk management practices are explicitly required either by statute or by HRSA regulation or policy (as designated by an asterisk). The Joint Commission requires all 16 of these practices.

·        Active quality improvement program*: Internal efforts to improve the quality of care. These efforts may include reviewing clinical outcome data and conducting long-term projects aimed at improving clinical care, among others.

·        Appropriate use of clinical protocols*: Established guidelines for providing clinical care that health care practitioners use. These guidelines may be developed by professional organizations or by the health center’s clinical staff.

·        Clear communication with patients*: Patients have a voice in determining their care and receiving information about their care in a way that they can comprehend. This includes providing translation services when necessary.

·        Clear communication with providers: Health care providers receive clear communication from the health center’s leadership about their roles and responsibilities and they communicate clearly with one another.

·        Comprehensive patient medical records*: These records document the care provided to the patient at the health center. They can be either paper or electronic.

·        Credentialing of health care professionals*: The process of verifying that health care providers meet all required educational and licensing requirements. The health center or a third party may conduct this activity.

·        Documentation of informed consent: Patients are adequately informed about risks and benefits of their treatment.

·        Formal patient grievance mechanism*: A system to collect, analyze and address complaints received from patients and/or staff.

·        Internal incident reporting system: A system to collect and analyze information on adverse events that occur within the health center resulting from inappropriate care.

·        Ongoing peer review of patient cases: The review of medical records or patient cases by health care professionals, either within the health center or as outside consultants, to ensure that appropriate care was provided.

·        Onsite assessment of risks and risk management practices: A process to assess the potential risks of the health center and the health center’s activities to reduce its risks. This assessment can be done by the health center or by outside consultants.

·        Patient tracking system: A formal system, either electronic or paper, to ensure that key patient information, such as test results, missed appointments, and care at different health care institutions, is not overlooked.

·        Privileging of health care professionals*: The process of verifying, on a routine basis, that practitioners have the appropriate clinical competencies and the ability to perform clinical procedures effectively.

·        Regular patient satisfaction survey*: A survey to assess patient satisfaction with the level of service and clinical care that they received.

·        Regular staff training on risk management*: Staff receive either onsite or offsite training on topics related to risk management.

·        Up-to-date policies and procedures on risk management*: Written documents that explicitly describe
·        A health center’s operations and processes related to risk management.
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