Bültmann & Gerriets
Risk Management Handbook for Health Care Organizations
von American Society for Healthcare Risk Management (ASHRM)
Verlag: John Wiley & Sons
Reihe: Jossey-Bass Public Health
Reihe: Jossey-Bass Public Health/Health Services Text
E-Book / EPUB
Kopierschutz: ePub mit Wasserzeichen

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ISBN: 978-0-470-44371-2
Auflage: 5., Student Edition
Erschienen am 27.03.2009
Sprache: Englisch

Preis: 108,99 €

Klappentext
Biografische Anmerkung
Inhaltsverzeichnis

Risk Management Handbook for Health Care Organizations, Student Edition

This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available.

American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.



ROBERTA CARROLL, ARM, MBA, CPCU, CPHRM, is senior vice president of Aon Healthcare based in Tampa, Florida.



Exhibits, Figures, Tables, and, Photos ix


The Contributors xiii


Preface xxvii


About the Book xxix


ONE Development of a Risk Management Program 1


Learning Objectives 1


Risk Management Program Development 3


Key Structural Elements of the Risk Management Program 4


Scope of the Risk Management Program 8


The Risk Management Process 13


Evolution of the Risk Management Program 21


Selecting an Appropriate Risk Management Program Structure 22


Assessing Areas of the Organization That Need Risk Management 23


Key Components for Getting Started 26


Writing a Risk Management Program Plan 27


Achieving Program Acceptance 27


TWO The Health Care Risk Management Professional 31


Learning Objectives 31


The Risk Manager's Job: Functional Areas of Responsibility 33


Health Care Risk Management across a Spectrum of Settings 53


Required Skills for the Successful Health Care Risk Management Professional 76


Risk Management Ethics 77


A Profile of the Health Care Risk Management Professional 78


Education and Professional Recognition Programs 78


THREE Patient Safety and the Risk Management Professional 87


Learning Objectives 87


The Scope of Medical Errors 89


Seeking Solutions: What Are the Causes of Medical Errors? 91


FOUR Health Care Legal Concepts 115


Learning Objectives 115


Legal Issues Common to All Health Care Providers 116


Legal Issues Related to Specific Health Care Providers 134


FIVE Governance of the Health Care Organization 157


Learning Objectives 157


Essential Responsibilities of the Hospital Board 159


Basic Legal Duties of Health Care Trustees 160


Lessons from the Panel on the Nonprofit Sector 162


Federal Sentencing Guidelines for Organizations 165


The Sarbanes-Oxley Act of 2002 167


The Volunteer Protection Act of 1997 169


Risk Management and the Board 170


The Medical Staff, Risk Management, and the Board 175


SIX Early Warning Systems for the Identification of Organizational Risks 181


Learning Objectives 181


Early Identification of Exposure to Loss 182


Food and Drug Administration 206


Institute for Safe Medication Practices, United States


Pharmacopeia, and National Coordinating Council for Medication Error Reporting and Prevention 208


Medical Event Reporting System-Transfusion Medicine 212


Intensive Care Unit Safety Reporting System 212


Pittsburgh Regional Healthcare Initiative 212


Other Voluntary Programs 212


Standardizing a Patient Safety Taxonomy:


The National Quality Forum 213


Protecting Sensitive Information 213


SEVEN the Risk Management Professional and Medication Safety 219


Learning Objectives 219


Latent and Active Failures 220


Systems Thinking 221


Risk Management: A Prioritizing Approach 252


Eight Ethics in Patient Care 261


Learning Objectives 261


Ethical Principles and Moral Obligations 263


Research 263


Institutional Review Boards 266


Patient Self-Determination Act 275


"Do Not Resuscitate": Withholding or Withdrawing Treatment 277


NINE Documentation and The Medical Record 287


Learning Objectives 287


Documentation 291


Record Retention 310


Release of Records 310


Ownership of Medical Records 311


Medical Record Audits 312


Documentation and Risk Management 313


Emerging Risk Exposures 320


The Risk Management Professional's Role 321


TEN Statutes, Standards, and Regulations 327


Learning Objectives 327


Patient Care 328


Medicare Modernization Act 331


Medical Staff 332


Life Safety Code 350


Federal Health Insurance Laws and Regulations 354


Tort Reform 357


Policy and Procedure Manuals 359


Case Law 360


ELEVEN Basic Claims Administration 367


Learning Objectives 367


The Claims Environment 368


The Claims Process 369


The Risk Management Professional's Responsibilities 371


Regulatory Reporting of Claims 378


TWELVE Introduction to Risk Financing 381


Learning Objectives 381


Risk Financing in the Context of the Risk Management Process 384


Risk Retention 384


THIRTEEN Insurance: Basic Principles and Coverages 395


Learning Objectives 395


Definition of Insurance 396


Specific Types of Insurance for the Health Care Industry 408


FOURTEEN Information Technologies and Risk Management 427


Learning Objectives 427


Risk Management Information Needs 430


Risk Management Information Systems 431


Using Information Systems to Generate Reports 432


Integrating Risk Management, Quality Assurance, and Patient Safety 433


Electronic Mail 434


Internet- and Web-Based Technology 435


Personal Health Record 435


Electronic Health Records and Systems 436


Clinical Information Systems and "Smart" Technologies 437


Infrastructure Technology 440


Point-of-Care Technology 442


Telemedicine 442


Appendix 14.1: IT Glossary for Risk Managers 447


FIFTEEN Risk Management Metrics 451


Learning Objectives 451


Benchmarking Defined 453


Claims 456


Measuring Change 459


Developing New Metrics 461


SIXTEEN Acreditation, Licensure, Certification, and Surveying Bodies 467


Learning Objectives 467


The Consumer Era of Health Care 468


What the Health Care Risk Management Professional Needs to Know 469


Mandatory Surveying Bodies 471


Voluntary Surveying Bodies 475


URAC 489


Appendix 16.1: Accreditation and Licensure Organizations, Surveying Bodies, and Government Agencies 501


SEVENTEEN Emergency Management 503


Learning Objectives 503


The Steps of Emergency Management 505


Prevention 506


Planning and Preparation 511


Implementation and Response 525


Recovery 526


Recommended Web Sites 528


EIGHTEEN Occupational Safety, Health, and Environmental Impairment 529


Learning Objectives 529


Administrative Procedure Act 530


Administrative Enforcement 532


Specific Occupational Safety and Health Issues 535


APPENDIX A A RISK MANAGEMENT PROGRAM (EXAMPLE) 543


APPENDIX B REQUEST FOR RECORDS form (EXAMPLE) 549


APPENDIX C A GUIDE TO MEDICAL TERMINOLOGY 551


GLOSSARY 565


INDEX 623


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