General Purpose of Job:
The Clinical Risk Manager implements the Clinical Risk Management Program at Driscoll Children’s Hospital Corpus Christi (DCHCC) to protect the interests of the hospital and patients. The Clinical Risk Manager identifies the most advantageous methods of correcting, reducing, or eliminating identifiable risks that may adversely affect patients, visitors, and employees or the quality of care provided to patients in our facility, as well as reduce the cost of risk to the system. This position serves as the DCHCC Risk Manager and Patient Safety Officer working with the Driscoll Children’s Hospital Legal and Operational Risk Management Departments.
Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employee will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.
Clinical Risk Management
- Develop, implement and lead a robust and proactive clinical risk management program to support DCH mission and vision.
- Conduct clinical risk assessments and analysis of complex organizational systems and facilitates development of corrective action plans, with an emphasis on intervention.
- Evaluate the effectiveness of risk reduction plans.
- Perform thorough investigations and participate in Root Cause Analyses of significant events.
- Work closely with Environment of Care (EOC), Hospital & Patient Safety regulatory criteria and other risk initiatives.
- Assist with patient grievances and complaints when needed.
- Assist with The Joint Commission process.
- Interact with internal and external customers regarding patient safety culture/concerns while observing for hazard risk reduction opportunities through active rounding, service recovery and other strategies.
- Assist with planning and executing patient safety and educational activities by local teams and/or departments.
- Facilitate or participate in events or situations that require Root Cause Analysis (RCA), Process Improvement (PI) or Failure Modes and Effects Analysis (FMEA).
- Propose, recommend and implement solutions and resolutions to risk-related issues and events; following up on the implementation and impact of proposed solutions and resolutions.
- Participate in multidisciplinary teams, standing work groups, councils and committees for the purpose of evaluating and improving organizational risk.
- Participate in patient safety rounds and risk focused tracer activity.
- Monitor product recalls, FDA warnings and coordinate response by responsible parties/departments.
- Coordinate disclosures and communications with patients/families related to patient events and unexpected outcomes.
- Assist with or coordinate post-mortem conferences.
- Remain available to staff to answer questions related to policies, consents, and risk-related inquiries.
- Ensure compliance with mandatory reporting to local, state, federal and regulatory agencies as it relates to patient safety.
- Performs other duties as assigned.
Data Management and Incident Reporting Analysis
- Review event reporting system and analyze entries to address risk, patient safety or quality concerns.
- Identify trends and actively collaborate with involved local individuals and/or departments.
- Use data from event reporting database for trending and analysis of incidents.
- Review results of concurrent chart review based on predetermined criteria and incident report summary.
- Analyzes incidents/occurrences and identifies patterns as evidence for decision-making.
- Recommend actions and evaluate effectiveness of actions taken.
- Determine necessity of evidence retention and directs procedures for special handling.
- Analyze, investigate, and trend incidents related to patients, employees, and visitors. Analyze incidents/occurrences and identify patterns as evidence for decision-making.
- Prepare and report information to the Legal Department as appropriate.
Claims Management:
- Identify occurrences that are potentially compensable events and work with clinical staff to obtain appropriate documentation.
- Work with patients/families and visitors where appropriate to resolve outstanding issues within the guidelines approved by the Legal Department.
- As part of legal team, investigate incidents that could lead to professional/general liability claims.
- Participate in the management and support of professional liability litigation, including coordination of discovery responses and development of case strategies where appropriate, and provides documentation for defense counsel along with associated discovery, deposition and witness scheduling, etc.
Risk Management Program Administration:
- Develop and implement policies and procedures to ensure all patients receive a high level of care.
- Provide advice on proposed policies and consent issues.
- Operate within departmental budget guidelines and evaluates and proposes cost-saving alternatives.
- Assist in collaboration with internal stakeholders and insurance brokers, including completing applications.
- Recommend and review applicable policies, procedures and operational plans.
- Perform clerical support activities
Education and/or Experience:
- Minimum 1-5 years of experience in a healthcare clinical field or Risk Management.
- Associate's degree or equivalent from two-year college or technical school in nursing or allied health care field.
- Possesses an advanced understanding of the healthcare industry and risk management, Texas laws regulating hospitals and health systems, Medicare Conditions of Participation, Joint Commission standards
- Strong clinical skills.
- Strong data analysis, trending and risk assessment skills. Demonstrated ability to communicate effectively both verbally and in writing.
- Demonstrated leadership ability in relating to healthcare and management professionals.
- Hospital or Healthcare Risk Management certification, preferred or obtained within 1-3 years of hire.