Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management最新文献

{"title":"Case law update","authors":"Christopher J. Allman JD, CPHRM, DFASHRM, Maggie Neustadt JD, CPHRM, FASHRM","doi":"10.1002/jhrm.21588","DOIUrl":"10.1002/jhrm.21588","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 3","pages":"36-41"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haddon matrix model: Application to workplace violence in a hospital setting","authors":"Della J. Derscheid PhD, APRN-BC, MS, RN,&nbsp;Christopher Meyer BSN, RN,&nbsp;Judith E. Arnetz PhD, MPH, PT","doi":"10.1002/jhrm.21586","DOIUrl":"10.1002/jhrm.21586","url":null,"abstract":"<p>The aim of this study was to identify hospital-based workplace violence (WPV) risk factors with the Haddon Matrix Model (HMM) to determine its potential utility to conceptualize multiple risks for WPV events. This descriptive study utilized two independent convenience samples Data from behavioral emergencies (2014–2015) for patient violence (<i>N</i> = 192) and from health care staff (<i>N</i> = 380) 12-month violence survey responses (2015) in a Midwestern academic hospital were analyzed. Logistic regression examined patient features associated with physical violence. Survey questions pertained to employee, environment, and cultural factors associated with WPV; responses were examined with Chi-square and two-sample <i>t</i>-tests. Violence risk factors populated the 4 Haddon Matrix domains at pre-event time frames as Host (worker)-age/demographics, Agent (patient)-age/gender, Physical Environment-door/window structure, and Social Environment-worker safety. Risks at event time frames populated for Agent—behavior/delirium, and Physical Environment—event medication/patient identification. The Haddon Matrix identification of hospital violence risks indicates its utility as a comprehensive approach to workplace violence.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 3","pages":"26-35"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case law update","authors":"Christopher J. Allman JD, CPHRM, DFASHRM,&nbsp;Maggie Neustadt JD, CPHRM, FASHRM","doi":"10.1002/jhrm.21584","DOIUrl":"10.1002/jhrm.21584","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 2","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of patients on chronic prescription opioids at risk for opioid use disorder using pharmacy claims data","authors":"Aleesha Jantzen Pharm.D.,&nbsp;Scott Thomas Hall Pharm.D.,&nbsp;Benjamin Lai MB BCh BAO,&nbsp;Julie L. Cunningham Pharm.D.,&nbsp;Laura Odell Pharm.D., MPH","doi":"10.1002/jhrm.21585","DOIUrl":"10.1002/jhrm.21585","url":null,"abstract":"<p>Using pharmacy claims data from a single commercial health plan to identify opportunities for opioid use disorder (OUD) focused screening and interventions communicated via targeted prescriber messaging. Participants included members ≥18 years using more than 90 morphine milligram equivalents (MMED) daily based on all opioid claims, had &gt;1 paid claim for an opioid product, and had ≥90 days of total opioid therapy. Members were excluded with ≥1 claims for an oral chemotherapy agent (except methotrexate). Intervention was completed with a secure communication to the primary outpatient opioid prescriber that included resources for diagnosis, treatment, and best practices for opioid prescribing. The main outcome measure was any documented change to opioid use following the intervention. Seven hundred forty-five members were identified; a subset (<i>n</i> = 20) was further assessed, and all had identified OUD risk factors; providers were subsequently sent a communication. Sixteen providers acknowledged receipt and 11 patients (55%) had at least one documented intervention following communication receipt. Provision of targeted, evidence-based recommendations to providers for patients identified to be at risk of OUD from pharmacy claims data can result in increased recognition and intervention. Future efforts to explore feasibility of provider education detailing efforts and continued evaluation of efficacy are needed.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 2","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond error: A qualitative study of human factors in serious adverse events","authors":"Chenjerai Mujuru MBA,&nbsp;Carmelle Peisah MBBS, MD, FRANZCP","doi":"10.1002/jhrm.21583","DOIUrl":"10.1002/jhrm.21583","url":null,"abstract":"<p>The field of healthcare quality and safety has been informed by the study of Human Factors contributing to adverse events. Hitherto, much of the study of Human Factors has been focused on a narrow lens of human error, identifying cognitive-based or knowledge-based errors and cognitive processes such as loss of situational awareness contributing to error. While these factors are important, this narrow approach fails to consider the complexity of relational and systemic factors that also contribute to adverse events. We aimed to explore the relational and systemic human factors, including shared clinician attitudes and behavior, that contribute to serious adverse patient events in a public health setting. The study, set in a metropolitan local health district in New South Wales, Australia, was conducted using a retrospective qualitative multi-incident content analysis design. Serious adverse event reviews (SAER) over 6 months (2022–2023) were subject to qualitative content analysis until data saturation was reached. Data saturation reached at 20 reports. Emergent themes related to human factors in serious adverse events included: (i) delays and inertia—with a subtheme of inertia of ageism; (ii) “All-or-nothing” approach to end-of-life care and planning; (iii) communication lapses; and (iv) implementation gap between standards and practice. Error-based incidents accounted for only 35% of the serious adverse events examined. The sample studied involved mostly (65%) male patients, with a mean age of 69 (70% aged &gt;65), managed across the gamut of specialties, with the most common incident being the management of acutely deteriorating patients. In conclusion, there is more to Human Factors in adverse events than cognitive or knowledge-based error. While identifying and correcting errors is absolutely essential, we need adjunctive “soft measures” to address clinical attitudes, behaviors, and relationships in health care, particularly in increasingly complex, fraught, and stressful health care environments.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 2","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Servant leadership","authors":"Robert F. Bunting Jr. PhD, MSA, CPHRM, CPHQ, MT(ASCP), DFASHRM, DSA","doi":"10.1002/jhrm.21582","DOIUrl":"10.1002/jhrm.21582","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 2","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment tool items for addressing physician-patient communication and reducing health care risk factors across multiple enterprise risk management domains","authors":"Rawan Narwal-Kasmani MD, FACP,&nbsp;Julie M. Stausmire MSN, APRN-CNS,&nbsp;Kathleen A. McCarthy MA, BSN, CHSE,&nbsp;Nancy Buderer MS,&nbsp;Amanda Gutek BS,&nbsp;Charla A. Ulrich DNP, MOD, CPHQ, CPPS, CIC","doi":"10.1002/jhrm.21581","DOIUrl":"10.1002/jhrm.21581","url":null,"abstract":"<p>Expertise in physician-patient communication is a primary outcome measure for physicians. We evaluated residents’ communication behaviors with clinic patients following an educational intervention as measured by the Communication Assessment Tool (CAT). Thirty-five internal medicine residents were assessed by patients using the CAT for 3 months before and after the educational intervention. The intervention included a simulated, videotaped patient encounter, mock CAT, and preceptor coaching during video review. The primary outcome was the percentage of CAT items receiving an “excellent” rating from patients before and after the intervention. Research results were compared to previously published CAT studies. Within-resident improvement in the percentage of excellent ratings was small with median changes between 0 and 3 percentage points. Compared to previously published studies, similar results were found for the highest and lowest-scored communication items. Many clinical encounters are time-limited, and physicians do not pursue time-consuming conversations that could reduce health care risk. This data and other published studies suggest seven communication items taking the most time to complete (i.e., shared decision-making) were items demonstrating little or no improvement. This study identified clinical performance risk factors applicable to the Enterprise Risk Management Framework that could impact complication and readmission rates if addressed by changes in physician-patient communication.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 1","pages":"24-33"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership and the high reliability transformation: A qualitative study at Truman VA medical center","authors":"Chelsea Leonard PhD,&nbsp;Heather Gilmartin NP, PhD,&nbsp;Leigh Starr MHA, FACHE,&nbsp;Timothy Anderson RN, BS","doi":"10.1002/jhrm.21580","DOIUrl":"10.1002/jhrm.21580","url":null,"abstract":"<p>The Department of Veterans Affairs (VA) has committed to becoming a High Reliability Organization (HRO). The Truman VA Medical Center (VAMC) successfully implemented and sustained foundational HRO elements over a period with several changes in facility executive leadership. We interviewed current and past leaders at Truman to understand how they retained fidelity to the HRO transformation. We conducted 16 interviews with 14 leaders involved in the HRO transformation and identified three themes related to the Truman HRO transformation: (1) Leadership visibly drove culture change through intentional communication and modeling HRO principles; (2) Leadership deferred to frontline expertise and empowered staff to make changes and to fail; (3) Hiring the right team members for the organizational culture and investing in training can support HRO principles and values. Our findings highlight key actions for leaders in the context of HROs: regularly communicate the significance of HRO, demonstrate behavior consistent with what they hope to see from staff, celebrate failure, allocate time and resources to the creation of hiring frameworks that identify employee skillsets conducive to HRO principles, and substantial and recurring investments in employee development. Importantly, successive executive leaders at Truman VAMC modeled these skills to promote and sustain the HRO transformation.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 1","pages":"17-23"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social inflation and health care risk management","authors":"Sue Boisvert BSN, MHSA, CPPS, CPHRM, DFASHRM,&nbsp;Jim Lynch FCAS, MAAA,&nbsp;David Moore FCAS, MAAA, CERA","doi":"10.1002/jhrm.21578","DOIUrl":"10.1002/jhrm.21578","url":null,"abstract":"<p>This paper examines the concept of social inflation as it affects medical malpractice insurance claims, a phenomenon that warrants monitoring by risk managers in health care. The authors define social inflation as the growth in the cost of insurance claims that exceeds general inflation. The authors use data aggregated from insurance company Annual Statements and from a national database of malpractice reports to estimate that social inflation added $2.4 billion to $3.5 billion to booked losses over the 10 years ending in 2021, which is between 8% and 11% of total losses. The authors’ approach is to show growth in loss development factors, a metric that property/casualty actuaries use to estimate claim costs. This approach is explained in detail. The paper concludes with commentary on how risk managers can incorporate consideration of social inflation in their overall assessment of risk.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 1","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case law update","authors":"Christopher J. Allman JD, CPHRM, DFASHRM,&nbsp;Maggie Neustadt JD, CPHRM, FASHRM","doi":"10.1002/jhrm.21579","DOIUrl":"10.1002/jhrm.21579","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"44 1","pages":"34-40"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}