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Report from Seattle: 'Safe & Sound'
"Safe & Sound in Seattle," ASHRM's 22nd Annual Conference & Exhibition, helped solidify ASHRM's established leadership position in the arena of patient safety. More than 45 educational events and 100 exhibits benefited greater than 2,200 attendees Sept. 29-Oct. 2.
President Monica Berry opened the conference by encouraging her audience to learn "new ways to approach common concerns and think about things differently." With the hard insurance market presenting new potential challenges to patient safety, she noted that "Safe & Sound" offered many opportunities to learn about safe care as well as sound business practices.
"My challenge to you," she said, "is to get the education you need so that you can have a conversation with your CEO or CFO about the insurance market - so you will increase the likelihood of being invited to the table to consider your insurance options for your next renewal and to better prepare yourself for understanding how the market can or will impact your organization."
She noted that ASHRM would continue to provide vital risk finance information in its publications and program offerings.
Speed bumps on the road
Turning to the topic of patient safety, Berry asked: "Have we [risk managers] made a significant impact on the reduction of harm to patients or medical errors? … If not, why not?"
She pointed to possible speed bumps on the road to patient safety. They include the "hierarchical structure of health care organizations," a "hamstrung" shift away from a punitive culture because the legal system and nursing and medicine boards are slow to change, and, until recently, a lack of evidenced-based knowledge.
To achieve a culture of safety at their facilities, risk managers must be educators, she said. They must learn how to foster the design of health care processes to reduce the potential for human error. Risk managers must also model "the benefits of sharing our mistakes as well as identifying the lessons learned in order to promote best practices."
Berry closed with challenging the conference attendees to participate in the upcoming grass roots advocacy campaign on patient safety legislation and to be a part of creating the future of risk management.
A year of accomplishments
At the Annual Business Meeting on Sept. 30, Berry summed up the year's accomplishments, including an all-time high of 4,460 members, four educational audio conferences on timely topics, seven modules of the Barton Certificate in Healthcare Risk Management Program, a redesign of the modules program (see details at www.ashrm.org / Education), five new publications, numerous advocacy initiatives including comment letters on health care legislation and participation in redrafting JCAHO hospital standards, and collaborations with other organizations such as the National Patient Safety Foundation.
She announced the formation of ASHRM's new Special Interest Group for patient safety, which will allow participating members to share information via an ASHRM listserv.
Berry recognized ASHRM's special achievers and introduced the new nominating committee and board members (see separate articles). She thanked outgoing board members Geri Amori, Kathleen Knoppe, Jeffrey Driver and Ellen Quinn - and all of ASHRM's 158 volunteers who served on task forces and committees.
Before formally turning over the gavel to incoming President Jane McCaffrey, Berry said, "This has been an incredible year for me, one in which I learned so much. … I cannot thank you enough for the experience."
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Tapes & CDs available
Tapes of educational programs presented at ASHRM's 2002 Annual Conference & Exhibition, "Safe & Sound in Seattle," are now available online. Audiotapes of most concurrent educational sessions and keynote presentations, plus videotapes of keynote presentations, can be purchased online.
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Outstanding members earn recognition
The Annual Conference & Exhibition provided a showcase for some of ASHRM's most outstanding members in 2002.
- Those who earned Certified Professional Healthcare Risk Manager status were recognized Sept. 30 at the annual business luncheon. As of Sept. 30, 357 members have passed the CPHRM exam (new achievers are listed in each issue of the Forum). More than 100 took the exam on the first day of the conference.
- Also recognized were members whose contributions to the profession qualified them for ASHRM Board approval as Fellows in the society. The 2002 FASHRM achievers are David Benjamin, David Hester, June Leigh, Wayne Merchant, Paul English Smith and Abraham Segres.
- Grena Porto was announced as winner of the Journal Author Excellence Award for her Fall 2001 article in the Journal of Healthcare Risk Management titled "Safety By Design: Ten Lessons from Human Factors Research."
2002 Board foresees grand opportunities
Earlier this year, members of ASHRM's 2002 Board of Directors were informally asked to identify key opportunities they thought the society might be wise to pursue. With "Grand Ole Opportunity" as the theme selected for the next Annual Conference & Exhibition Nov. 2-5, 2003, in Nashville, now seems like an opportune time to review highlights of the boardmembers' ideas:
[ASHRM could] develop a "model" response to incidents where risk management is portrayed in a negative or inappropriate manner by the media that would include the offer to provide education/consultation on risk management issues.
Monica Berry
ASHRM has the opportunity to increase its partnering with AHA and other organizations focusing on patient safety and quality. These initiatives must be addressed and ASHRM positioned to provide input using its expertise so that standards and regulations do not create legal nightmares. Another area of concern is risk financing. Organizations are continuing to feel the impact of a hard insurance market and members need to be provided with information on viable options.
Jane McCaffrey
Visits (high visibility) of Board members to the local chapters during their board meetings, asking the boards how they would like the Board to assist (mentoring, tax status, standing committee involvement, cosponsoring local educational programs, etc.) may be ways of breaking the ice.
Kathleen Knoppe
[ASHRM could] collaborate with other professional organizations that have similar vision and goals - AHIMA, NPSF, p4ps, ACIP, ASHE and others. … By working together, we strengthen our message and expand our universe of those we engage to make health care the safe and trusted vision we envision. Another opportunity we have is to be a resource on risk management for our international colleagues. … We can enhance safe and trustworthy health care throughout the world.
Geri Amori
[ASHRM should] promote more grassroots advocacy among our membership.
Jeffrey Driver
With the insurance market in a very unsettling state and patient safety being such a high priority, I can see ASHRM as an important vehicle to get out good, accurate and timely communication and education to assist members in being successful.
Michael Seitz
ASHRM has the opportunity to work with a number of organizations, such as the AHA, to promote the goals and objectives of risk management and further develop the reputation of ASHRM as a credible source of guidance and information on a national level.
Paul English Smith
We will provide superb professional development opportunities, including an enhanced certification program, a revised Risk Management Handbook and a new Patient Safety Leadership Fellowship and Scholarship initiative.
Ronni Solomon
[ASHRM could] sharpen both internal and external perception and focus on the patient-centered and preventative nature of health care risk management, and enhance the profile of the risk manager as a key member of the facility's administrative team.
Mark Cohen
We have the opportunity to collaborate more with other politically influential organizations such as CMS and NCCMERP.
Ellen Quinn
Keynoters provide unique, powerful insights
Eric Knox, the Annual Conference's opening keynote speaker on Sept. 30, provided a provocative presentation titled "Safety: A Project or a Way of Life." The former Director of Patient Safety at Children's Health Hospitals & Clinics in Minneapolis stressed the need for teamwork to create a culture of safety and preventing harm, starting at the top. "There really is only one 'patient safety officer,' and that's the Chief Operating Officer," he said.
Other key points:
- Three major root causes of error are 1. hierarchy ("we haven't yet learned how to introduce teamwork into the medical profession"), 2. the pressure to produce ("clinical work is a never-ending series of choices") and 3. the hazard of deafness ("new ideas must be welcomed" by management).
- Error is not the issue" that risk managers should focus on. "The issue is harm, injury or death." In the aviation industry, he noted, there are 100 million errors each year, yet only 25 result in accidents. Competent people make errors … the important thing is to learn from them.
- Counting incident reports does not improve care - they are just the tip of the iceberg. Look below the surface. Vital context can be found in the stories underlying the events.
- To create safety, "fix what you can, tell what you fixed and find someone to fix what you cannot."
Knox also addressed the value of disclosure, calling it "one piece of good patient communication" that may reduce liability. Done right by a properly trained staff, disclosure can be a positive experience, he said.
Peg C. Neuhauser, in her Oct. 1 presentation titled "Tribal Warfare in Health Care: Turning Turf Battles into Teamwork," capitalized on her and the audience's experiences dealing with other professional groups ("tribes") in the workplace and suggested techniques to head off conflict with other tribe members (e.g., IT staff members, doctors). Language sensitivity is a prime consideration: "When you sound tribal, you sound adversarial," she warned.
"One of the dangers of your work is that people think you only come to them when there is trouble," Neuhauser told the risk managers. She suggested a conversational problem-solving technique: Step 1 is to understand and show respect; Step 2 is to identify the point of disagreement. She noted that Step 1 is often skipped. But rather than skipping the first step and not acknowledging the other's values, "it's preferable to not have the conversation."
"When all else fails, use humor," she added.
Her comments were based on her book Tribal Warfare in Organizations: Turning Tribal Conflict into Negotiated Peace (published by HarperBusiness).
Mark Ackermann, Senior Vice President & Chief Corporate Services Officer at St. Vincent Catholic Medical Centers (SVCMC) in New York, closed the conference on Oct. 2 with a call to "be prepared." He shared lessons learned as leader of the trauma center closest to the World Trade Center, and emphasized that the level of disaster his facilities faced can happen anywhere.
"I hope you understand," he said over big-screen images of 9/11, "there will be a next time. ...We are at war." He described SVCMC's emergency drills, employee training, communication plans, media handling plans, and special patient information guidelines.
He proceeded chronologically from the moment of first impact, 8:46 a.m. St. Vincents' disaster plan was activated at 8:55 a.m. with ER patients moved to make room for WTC casualties, extra supplies ordered and triage teams set up. Refuting the reports that hospitals handled few survivors, Ackermann said 400 patients arrived for care in the first hour; 1,400 people with injuries arrived in the coming days. Counseling for more than 15,000 continues to this day.
Aside from the patients, "Thousands of family and friends arrived at the hospital or called in an effort to locate loved ones, and we broke nearly every HIPAA rule," Ackermann declared to his applauding audience. "Shame on us if we can't provide a loved one with information," he said, calling for revision of HIPAA rules so they are appropriate for disaster situations.
He also called for:
- a national registry of doctors so that volunteers who show up at a hospital during a crisis can be readily confirmed as MDs
- a "strong, full-time public health office" in every county to ensure sharing of resources
- quicker release of federal aid. SVCMC spent and lost revenue totaling more than $25 million, and did not receive help from the government until late September.
A member of the audience drew some laughs when he asked Ackermann whether SVCMC had been sued for any emergency care. "No, not at this time," he drolly replied.
Ackermann brought his presentation to a powerful conclusion with more images of his hospital - photos of staff (everyone from nutritionists to MDs) standing together outside awaiting the arrival of victims, empty stretchers that were never used, hand-lettered notes on St. Vincents' Wall of Hope and Remembrance - underscored by the Alan Jackson song "Where Were You (When the World Stopped Turning)."
Washington wins chapter award
The 2002 Chapter Recognition Program contest drew strong entries from the Kentucky Society Healthcare Risk Management, Southern California Association for Healthcare Risk Management and Washington Health Care Risk Management Society.
The Washington chapter won the top award for the work of its Legislative Committee, which tracks pending and new federal and state legislation and conveys information about these bills to its members. Of particular note was the committee's response to Washington's "Newborn Safety Act."
ASHRM President Monica Berry congratulated the chapters for their outstanding work and thanked them for sharing their experiences.
The Washington chapter's first-place abstract submission can be viewed at http://www.hospitalconnect.com/ashrm/chapters/chapters.html
$18,000 scholarship deadline is Dec. 1
Consistent with its support of patient safety initiatives, ASHRM is a partner in the Patient Safety Leadership Fellowship. The intensive, yearlong experience for committed senior professionals is designed to provide tools to develop and implement strategies to improve patient safety.
The fellowship is offered by the American Hospital Association's Health Forum and the National Patient Safety Foundation in partnership with the American Organization of Nurse Executives, the Health Research and Educational Trust, and ASHRM.
ASHRM has committed $18,000 toward a scholarship to be awarded to an ASHRM member who meets the criteria of the Patient Safety Leadership Fellowship and who has a commitment to - and leadership in - the health care risk management profession. The deadline for applications is Dec. 1.
The following scholarship criteria will be applied by the ASHRM Fellowship Scholarship Task Force:
- Candidates must be FASHRM eligible: five years of membership in ASHRM.
- Candidates must be willing to have their Action Learning Project published: Prepare an ASHRM Journal article or monograph within six months of Fellowship completion
Or
Prepare an ASHRM Forum article within six months of Fellowship completion if project is ongoing
And
Present their Action Learning Project at the 2004 ASHRM Annual Conference (Oct. 17-20 in Orlando).
- Candidates must contribute to ASHRM:
Participate in post-fellowship ASHRM mentoring relationship
And
Participate in Health Forum alumni activities.
To request an application for the Patient Safety Leadership Fellowship, contact ASHRM at (312) 422-3980 or download a PDF of the brochure and application at http://www.hospitalconnect.com/healthforum/hfeducation/images/PSL2_Brochure.pdf
To be considered for the ASHRM scholarship, members must indicate their interest on their application and return it to the Health Forum at the address on the application. Candidates must meet criteria established by the Health Forum to be accepted as a Fellow. Meeting the ASHRM scholarship criteria does not guarantee acceptance as a Fellow.
Redesigned modules keyed to experience
The redesigned Barton Certificate in Healthcare Risk Management Program is based on experience levels to better meet the needs of health care risk managers and others interested in building a solid foundation in health care risk management.
The revised modules are 2 1/2 days each, and the Essentials and Applications Modules will be given sequentially at least once a year.
The Essentials Module (geared toward 0-2 years risk management experience; cannot be waived) is the educational foundation for the new risk manager. The agenda topics are designed to give the risk manager the basic building blocks to survive in this challenging profession.
The Applications Module (1-5 years experience) is a more in-depth discussion of health care risk management topics.
The Advanced Forum (5+ years experience) is designed for a small group of seasoned risk managers to focus on critical thinking and analysis of hot topics in risk management. The forum consists of interactive sessions led by past and present leaders of ASHRM and other nationally recognized experts.
Modules participants who have completed two or three of any of the five prior modules of the Barton Certificate in Healthcare Risk Management Program by the end of 2002 only need the Advanced Forum to obtain a certificate of completion. Those participants who have completed any one of the prior modules will need both the Applications Module and Advanced Forum. Participants who have completed modules II-V may obtain their certificate with no additional modules required.
There is a five-year timeframe for completion of all modules requirements to obtain the certificate of completion. Modules content is pertinent to CPHRM exam topics so that participants may be better prepared for the exam. The Risk Management Handbook for Healthcare Organizations (3rd edition) is the textbook for the modules program. To purchase a copy, call (800) AHA-2626 or visit the AHA Online Store, www.ahaonlinestore.com.
2003 dates and locations
March 17-21
Wyndham US Grant Hotel, San Diego, CA
Essentials Module presented concurrently with Advanced Forum first 2½ days followed by Applications Module. Earlybird discount registration deadline: Feb. 13; regular registration deadline: March 3.
June 2-6
Doubletree Guest Suites, Chicago, IL
Essentials Module presented concurrently with Advanced Forum first 2½ days, followed by Applications Module. Earlybird discount registration deadline: May 2; regular registration deadline: May 19.
Oct. 30-Nov. 1
Gaylord Opryland Resort and Convention Center, Nashville, TN
Essentials Module presented 2½ days in advance of the 2003 ASHRM Annual Conference & Exhibition, Grand Ole Opportunity. (No Advanced Forum or Applications Module.) Registration deadlines TBA.
Fees
Essentials Module
member earlybird/regular: $575/$625;
nonmember earlybird/regular: $675/$725
Applications Module
member earlybird/regular: $575/$625;
nonmember earlybird/regular: $675/$725
Advanced Forum
member earlybird/regular: $675/$725;
nonmember earlybird/regular: $775/$825
Hotel room rates
San Diego - $139 single/double per night
Chicago - $150 single/double per night
Nashville - TBA
Reminder: Dues rise in January
Membership in ASHRM brings many benefits that help risk management professionals:
- Achieve full potential;
- Stay on top of key issues;
- Learn from the experts;
- Solve everyday problems;
- Grow professionally;
- Get involved in national level advocacy; and
- Network with the best.
To continue and enhance these benefits, ASHRM membership dues will increase effective Jan. 1, 2003. This small increase of $30 represents the first dues increase since Jan. 1, 1998. The increased rate will not take effect until billings in 2003.
The new rates are $140 for regular membership, $85 for retired/student membership.
ASHRM will continue its dedication to top-notch education, first-rate publications, accessible networking opportunities, national level advocacy, professional development and peer recognition, and the many other membership benefits.
ASHRM's educational programs offer unique opportunities to learn the latest techniques from the authorities in health care risk management. The annual conference, Barton Certificate in Healthcare Risk Management (modules), audio conferences and other special programs are deliberately and thoughtfully designed to meet informational and educational needs and offer the richest opportunities for networking with more than 4,300 health care risk managers.
Dues enable ASHRM members to stay informed and on top of key issues with the quarterly Journal of Healthcare Risk Management, bimonthly Forum newsletter, weekly e-News: This Week at ASHRM and the ASHRM Web site. Professional development is of paramount concern and ASHRM membership facilitates networking with colleagues through special interest groups, searchable membership directory and more.
For more information on ASHRM membership, visit the "Join ASHRM" section of the web site at the top of the home page.
'Pearls' guide tackles long-term care issues
As long-term care and skilled nursing facilities face increasing legal pressures, it's important for all staff members to help risk managers avoid potential costly litigation.
"Risk Management Pearls for Long-Term Care & Skilled Nursing Facilities" is the latest pocket guide created by ASHRM's Pearls Task Force. The handy, easy-to-read format makes it ideal for sharing with everyone at your facility.
Topics include resident care, resident safety, staff issues, environment of care, tracking & responding to occurrences, resident rights & responsibilities, documentation
surveys/surveyors issues and additional resources.
Sure to be a good investment, "Risk Management Pearls for Long-Term Care & Skilled Nursing Facilities" is available from the AHA Online Bookstore and at (800) AHA-2626. Item # 178558. Single copy, $15 for AHA members $20 for nonmembers; pack of five, $45 for members, $55 for non-members.
EMPLOYMENT OPPORTUNITIES
Risk Management Position
Bachelor's degree in health care administration or related field required, Master's degree preferred. This position requires 3-5 years of progressive management experience coupled with previous experience in hospital risk management. Qualified candidates, please call (800) 643-2609, ext. 13703 or (361) 881-6478 or write to: Human Resources Department, CHRISTUS Spohn Health System, 600 Elizabeth St., Corpus Christi, TX 78404. Jobline (361) 881-3752. Visit our Web site at: www.christusspohn.org. An Equal Opportunity Employer.
Director - Risk Management
SSM Health Care of Wisconsin is seeking an individual with substantial Risk Management experience to guide the Risk Management programs for our two acute care hospitals and two nursing homes. SSMHC/Wisconsin is a member of the SSM Health Care System, an integrated health care delivery network with facilities located in Missouri, Oklahoma, Illinois, and Wisconsin. Our Wisconsin hospitals have been awarded the top Wisconsin Quality Award for excellence, and St. Mary's Hospital, Madison, has achieved Magnet recognition for nursing. We offer the successful candidate an attractive compensation program at a desirable (Madison) location. Please send correspondence via e-mail to charles_zeisser@ssmhc.com or fax at (608) 259-5326.
Risk Manager
Plans, organizes, implements the organization-wide program of risk management, emphasizing prevention and loss control while managing organizational claims. Communicates with administration, medical leadership, affected departments, insurance carriers and legal counsel to implement appropriate actions. Works cooperatively with Quality Improvement in identification of cases with potential quality of care issues as well as for clinical risk issues. Bachelor of Nursing required. Licensure as an RN in the Commonwealth of Massachusetts required. Three (3) to five (5) years clinical experience required. Three (3) - five (5) years experience as a Risk Manager in an acute health care setting in a position responsible for JCAHO standards and OSHA regulations. Demonstrated proficiency in spreadsheet, database, word processing application as well as ability to aggregate, analyze and display data required. Send cover letter and resume to: Human Resource Department, 30 Locust Street, Northampton, MA 01061-5001; fax (413) 582-2951; or e-mail at Donna_Novak@cooley-dickinson.org. An Equal Opportunity Employer.
Clinical Risk Consultant
May be open for telecommute. Provide direct and indirect health care risk management consulting services to insured clients. Research, identify, develop new risk consulting products and services. Provide education modalities to increase awareness and promote reduction of risk. Work with underwriting staff to assess client level risk and share results. BA/BS req'd; MA/MS pref. RN/other practicing clinician licensure, CPHRM/other risk management designation pref. Five (5) to ten (10) years of clinical/administrative experience in a health care setting and clinical risk management req'd; Ten (10) plus years preferred. Please submit resume to opportunities@gecareers.com. In the subject line of the e-mail, please include GECERC/282392/WB459. An Equal Opportunity Employer.
Risk Management Consultant
AIG Consultants, Inc., Healthcare Management Division is seeking an experienced health care professional who can provide professional liability and workers' compensation risk management consulting services to insured clients. Consultants will be located within one of the following regional offices: San Francisco, Los Angeles or Dallas. BA/BS degree; 10 years' health care experience; 5 risk/quality/workers' compensation management. Work independently, assume responsibility, prioritize/plan workload, excellent verbal/written, computer literacy. (Travel.) E-mail: Dolores.Sheppard@aig.com or fax: (386) 673-0141.
How To Place Ads
Employment Opportunities ads should be limited to 100 words and must be paid in advance with a check payable to ASHRM. Mail typed copy with payment to ASHRM / American Hospital Association, One North Franklin, Chicago, IL 60606. Employers pay $100 (non-members of ASHRM or AHA pay $125). Job seekers pay $50 ($60 non-members.) Ads exceeding 100 words may be edited.
For additional employment opportunities, and to post a resume online, please visit CareerBuilder at http://www.careerbuilder.com/
