Hospital board members have a fiduciary duty to the organization and community they serve. In collaboration with the medical staff, the board needs to have a reasonable understanding of the overall quality of healthcare services provided to patients, as well as an understanding of how things are handled when mistakes are made.
The board and hospital leaders are charged with implementing a patient safety program that has rigorous quality monitoring and improvement activities. In addition to routine quality, patient safety and risk management reports from senior leaders, the board should receive regular reports on liability claim trends and results.
Understanding this data can:
- Personalize the nature and cost of adverse events;
- Determine whether medical malpractice claims are resolved in a way that’s consistent with the reputation, vision and goals of the organization;
- Enhance understanding of how claim payments impact the bottom line
- Support ongoing patient safety efforts.
Asking three questions can help unlock the right approach to evaluating your hospital’s claims management program, and help identify strengths and improvement opportunities.
Today, we’ll begin a 3-part series by tackling the first question:
QUESTION #1: Why should I evaluate my organization’s liability claims management program?
ANSWER: It’s your duty and it impacts your hospital’s mission.
First, the board fulfills key governance responsibilities when liability claims are assessed, and this information also helps the management team analyze insurance costs, risk controls, adverse event trends, and deployment of resources for ongoing patient safety and clinical risk management activities.
The reputation of the hospital is also at risk in certain high-profile claims, so that knowing claims outcomes and processes ensures consistency in the way the hospital presents itself to the public and eliminates surprises when reporters call after a verdict or settlement.
Second, the assessment helps to validate the organization’s financial viability to meet expected claims costs, particularly for hospitals or systems that self-insure or have large deductibles exposed on each claim.
Third, appropriate claims policies and procedures to manage financial obligations are confirmed. Identifying contributing factors that resulted in liability claims being made – and implementing appropriate corrective actions – can reduce the potential for such future claims.
Finally, the claims function directly connects with ongoing safety and improvement efforts to eliminate errors in clinical processes or with providers that result in injuries. Thus, claims management information is wholly intertwined with any hospital’s core mission of providing safe, high-quality patient care, and increasing patient satisfaction.
This post appeared first at Action for Better Healthcare.