Other Useful NetLinks Handbook Contents Introduction Risk management Insurance program Legal system Medical records Incident reporting Physician-patient Informed consent Infectious disease Confidentiality Patient's rights Risk Home Page

What is risk management? Risk management is a planned and systematic process to reduce and/or eliminate the probability that losses will occur in a specific setting. It consists of three distinct, yet interrelated areas: 1) risk identification and loss prevention; 2) loss reduction; and 3) risk financing. To be most effective in the hospital setting, risk management involves a multidisciplinary and proactive approach. The first component involves those activities related to risk identification and loss prevention. Generally, these activities include the identification and correction of situations or problems which may give rise to events or incidents of potential liability for the hospital, its employees, physicians and other health care providers. These activities are vital to successful risk management since in most cases, the cost of preventing a liability claim is far less than the cost of resolving the claim after it occurs. Loss prevention activities also consist of the planning and presentation of regular educational programs to clinical and administrative departments which includes: orientation of new employees including medical staff, residents and nurses; continuing education in the form of in-service programs regarding medical-legal and risk management related subjects; and special seminars or conferences for target audiences in response to particular risk management problems. The second component involves loss reduction activities. Loss reduction includes those steps which are taken after an event or incident occurs that are aimed at minimizing the adverse impact, financial or otherwise, of such an event or incident on the patient, the hospital and its staff. These loss reduction activities are multifaceted and, depending on the facts and circumstances of the particular occurrence, include involvement and input from a number of the medical and administrative staff throughout the hospital. The foundation of an effective loss reduction program includes procedures that identify and respond as soon as reasonably possible to incidents which occur. In this way any adverse impact potentially resulting from the incident can be best minimized. These activities include the hospital's management of professional and general liability claims reported under its insurance program. The third component is risk financing, which involves the mechanisms utilized to ensure that there are adequate financial resources available to cover any potential liability situations, and includes the procurement of adequate liability insurance coverage at reasonable premiums to cover such losses. To respond to this need, the medical center has developed a professional and general liability insurance program which provides coverage for "medical malpractice" and other types of negligence claims. Risk financing also involves the effective negotiation and use of indemnity provisions in hospital contracts to transfer liability risks to other parties whenever possible. The hospital's risk management program primarily is administered by the Office of Legal Affairs in the areas of loss reduction and loss prevention. However, risk management at the hospital is a coordinated effort integrating many administrative and clinical departments throughout the hospital. In particular, the hospital's Patient Relations and its Quality Assurance Departments work closely with the Office of Legal Affairs in the hospital's overall risk management effort.   Risk management at Yale-New Haven Hospital The risk management program at all Yale-New Haven Hospital ("YNHH") facilities is coordinated through the Office of Legal Affairs and Risk Management, which is located in the Clinic Building, Room 230, Ext. 5-2291. The Director of Legal Affairs is responsible for the activities the department and the YNHH risk management program. The department has a staff of three attorneys who handle a wide range of issues on behalf of YNHH including answering questions about patient consents, DNR orders, withdrawal of treatment issues, business transactions, contract negotiations, leases and regulatory matters. The attorneys are available to speak at inservices, at Grand Rounds and other educational programs on topics of interest to departments. The Office of Legal Affairs is responsible for managing and investigating the professional and general liability claims that are made against the medical center facilities, its employees and insured physicians. Members of the office staff are available for individual consultation on risk management and liability issues. The Office of Legal Affairs is also responsible for managing certain insurance policies that have been secured by YNHH and its insured physicians. Staff members assist physicians and others with questions concerning insurance coverage, premium payments and proof of insurance. The attorneys in the department are available via telephone to answer hospital/patient related legal questions Monday through Friday, 8:30 a.m. to 5:00 p.m. An attorney from the department is always on-call after hours and on weekends and can be reached by beeper through the YNHH page operator, at 5-3111.