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.