Journal of Healthcare Risk Management : the Journal of the American Society for Healthcare Risk Management

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Delivery of healthcare is a complex interaction of patients, healthcare providers, nurses, ambulatory practices, and hospitals. As the model of health care transitioned, free standing physician practices and hospitals have coalesced to form networks of ambulatory practices and hospitals. This change in the model of healthcare delivery presented challenges to provide safe, quality, cost-effective care for patients, with potentially increased risk to an organization. The development and imbedding of comprehensive safety strategies are imperative to the foundation of this model...

Occupational burnout has become widespread. The syndrome can be especially harmful in health care settings, affecting clinicians, organizational effectiveness, and patient safety. Certain approaches have proven helpful in some cases in combatting the syndrome. The coronavirus pandemic presented physicians with unique challenges, which appeared to have magnified work stress This national survey specifically explored interventions used by health care leaders to reduce burnout and whether these interventions proved effective during a pandemic...

Hospitals seeking to understand patient safety strengths and vulnerabilities in the context of mergers/acquisitions benefit more from a third-party perspective than from a limited internal process. A well-structured and highly-inclusive risk assessment-involving a broad cross-section of interviews-can be key to a successful transition of optimal health care safety during organizational changes.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Many health care workers are subject to violence at work on a frequent basis. This article will define different types of violence in the workplace and outline the current scope of the issue. There are a myriad of laws and regulations that apply including OSHA, Joint Commission, state and potentially new federal legislation. Violence in the health care workplace is an exceedingly complex issue that is well suited to enterprise risk management (ERM) solutions. A sample framework for an ERM solution will be explored...

"Pro re nata" (PRN) or "as needed" medicine administration and usage is a relatively neglected area in medication management (pharmacotherapy/pharmaceutical care) which contributes to error-prone use of medications and is unsafe for patients. In this case, we report the incident of diclofenac toxicity in a 51-year-old woman due to a prescription of 100 mg diclofenac suppositories PRN, or as needed, for postoperative pain control without explanation of the maximum daily dose (150 mg daily), which led to arbitrary consumption of 3 g of diclofenac over 5 days (600 mg daily) by the patient, and subsequent development of metabolic acidosis, acute kidney injury, and sudden cardiac arrest...

Leapfrog Hospital Safety Grades and Magnet designation are two publicly available measures that serve as proxies for health care quality and safety. We examine whether hospitals with a better rating in one Leapfrog safety measure also have favorable ratings in other Leapfrog safety measures and whether Magnet-designated hospitals have better Leapfrog safety scores related to outcomes, processes, and structures than non-Magnet hospitals. Our study found that hospital-associated infections (HAIs) were not strongly correlated with one another, but Leapfrog safety process and structural measures were significantly and strongly correlated with one another, suggesting hospitals that invest in processes/structures to improve quality tend to do so across many dimensions...

Collaboration among physicians and nurses is vital and has shown to lead to better patient care and improve outcomes. Our study surveyed two groups of Labor and Delivery nurses in two regionally similar community hospitals in midwestern United States: one group from a new Obstetrics and Gynecology (OB/GYN) residency program (n = 49) and another from an established (legacy) OB/GYN residency program (n = 49). The survey asked nurses from the hospital with new and legacy residency program about preparedness for working with residents, perceptions of nurse-resident-patient relationships, collaboration and opinions about how resident physicians impact patient safety...

A recent medication error at Vanderbilt University Medical Center contributed to the death of a patient. The ensuing criminal indictment of the administering nurse has shaken the medical community. This has led to clinical staff questioning whether they can disclose patient safety incidents without fear of criminal prosecution. However, because of the publicity of this case, hospitals can benefit from the lessons learned and mitigate the risk of this and similar events at their facilities. To uncover the most impactful and relevant safety recommendations, the Vanderbilt case is examined from a systems investigation perspective using the available public information gathered from media reports, the Tennessee Bureau of Investigation report, and Vanderbilt's corrective action plan submitted to CMS...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

It has been estimated that medical errors are the third highest-ranking cause of death in the United States. A patient safety culture has been touted for many years as best practice to reduce medical error. While there is a general agreement of its importance, it has remained elusive for many. This study sought to learn how strengthening leadership skills within a health care organization could catalyze patient safety culture improvement. The research asked the following to gain an appreciation for that question: How does a leader ensure consistency in policies, practices, and protocols to create a patient safety culture? What attitudes, beliefs, and collective efficacy are needed to produce a patient safety culture? What leadership characteristics are needed to create a patient safety culture? The research participants were the employees who make up the patient safety department in a large academic health care system...

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The United States Department of Labor's Occupational Safety and Health Administration (OSHA) defines workplace violence (WPV) as any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. OSHA recognizes that WPV ranges from threats and verbal abuse to physical assaults and even homicide. There are no OSHA standards specifically related to WPV however the General Duty Clause, Section 5(a)(1) of the OSHA Act of 1970, requires employers to provide a workplace that is free of conditions that could cause death or serious harm to employees...

In the world of health care litigation it has become clear that medical malpractice cases now contain two claims-one on the medicine and one on the electronic health record (EHR). Two years of contentious discovery motions over the production of a complete copy of the EHR and audit trail in a case involving the delivery of a baby recently resulted in a nightmare scenario for a large health care system: sanctions in the form of an order entering judgment of liability in favor of the patient. The order was entered before depositions on the medicine were ever held...

Social factors that affect health are called social determinants. Social determinants may also carry risk, known as social risk. Management and patient safety professionals understand health care and enterprise risk. Social risk may add a new dimension for some. Social risks are probably amenable to the strategies patient safety and risk management professionals already employ, such as enterprise risk management, a culture of safety, and just culture. A large body of evidence suggests that social risks, particularly literacy and discrimination, strongly affect patient safety and well-being...