How to Stay Ahead in Healthcare Risk Management

June 16 to 20 is Healthcare Risk Management Week, a great time to look at healthcare risk managers and the important and strategic work they perform at their organizations.
There are several challenges facing risk managers today, says Jacque Mitchell, the 2014 American Society for Healthcare Risk Management President, and Risk Manager at Sentara Norfolk General Hospital, in Norfolk, Virginia. One of the biggest is moving from a claims world to an enterprise world; that is, not just managing patient safety, but evaluating the risk involved with offering new products and services, opening new locations and merging with other organizations.
“Risk managers have a lot of potential to add to those conversations,” says Mitchell. “They are expanding into other areas beyond the clinical role because of their unique skill sets.”
An Evolving Role
Other experts agree. “The evolving value-based/shared-savings reimbursement models that focus simultaneously on the appropriate use and quality of healthcare services are an emerging enterprise risk management issue,” says Cora Butler, JD, RN, CHC, Director of Commercial Operations for Primaris, a healthcare consulting firm based in Columbia, Missouri.
Butler, who specializes in risk management, says healthcare organizations are increasingly bringing their risk managers into discussions on financial, legal and strategic operations, and will continue to do so more frequently as time goes on.
Another new responsibility for risk managers is developing their new peers to meet rising demand. Most risk managers have been in the field for more than 10 years already. “Once you get into risk management, you don’t leave,” Butler says. “But we need a way to grow and mentor new ones.”
Having risk managers from a variety of backgrounds helps build perspective, she says. “I’m an RN, and that helps with the clinical piece,” but administrative, insurance or legal backgrounds are also useful to have on board.
Teamwork is Essential
Mitchell says one of the best ways to deal with the challenges is simply “get to know the people we work with.” By developing relationships and building trust, almost everyone in a healthcare organization can be a part of managing risk.
Working together is important, Butler says. “Increased collaboration and alignment of quality, performance improvement, patient safety and risk management within organizations to drive the change and improvement initiatives necessary to succeed in this shifting environment is essential.”
Always Keep Learning
Continuing education and professional networking are also key, Mitchell says. She follows listservs and reads journals to keep up with the latest trends. And with networking, “risk managers are unique in that I can talk to any risk manager in any area and they can help me or I can help them,” even competitors.
Risk managers sometimes get a bad rap, Mitchell says. “It’s hard. People hear ‘risk management’ and because of stereotypes they might see on TV, they think we’re there to hide and put up legal obstacles.” Instead, she said, risk managers are patient advocates. “We believe that you take care of the patients, and your reputation will follow.”
Mitchell says she loves the work. “Most risk managers love their jobs, even though we talk about how hard we work. Most of us love variety and challenge. We have the big picture that others don’t have.”