www.marsh.sk

Health Risk Management

29 October 2008, Sofia

Louis Coomans, CEO Eastern Europe

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1. Basic terms

2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority

4. Risk management in hospitals

5. Medical event IT reporting system

6. Marsh expertise

AGENDA

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11.. Basic terms Basic terms

2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority

4. Risk management in hospitals

5. Medical event IT reporting system

6. Marsh expertise

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Changing Perception

April 17th, 1906

...glad I've found at least some work at

the construction site. Times are tough and

it's one of the few safe jobs you can get

nowadays.

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Basic Terms

Risk

The combination of the probability of an appearance of a certain event and its consequences.

Risk management

The process through which an organisation continuously and methodically studies the risks of its activities in order to achieve a steady positive effect

The process of analyzing exposure to risk and determining how to best handle such exposure.

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1

10

100

1,000

10,000

100,000

1 10 100 1,000 10,000 100,000 1,000,000 10,000,000

Number of encounters per fatality

To

tal

liv

es

lo

st

pe

r y

ea

r

REGULATEDDANGEROUS ULTRA-SAFE

Healthcare

Mountain Climbing

Bungee Jumping

Driving

Chemical Manufacturing

Chartered Flights

ScheduledAirlines

European Railroads

Nuclear Power

Source: University of Miami Centre for Patient Safety 2005

How hazardous is healthcare?

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How does an incident come about?

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The Process of Risk management

Risk identification

Risk analysis

Risk quantification

Risk management

Risk transfer

Insurance Contractual

Risk reduction

Risk acceptance

Risk elimination

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The Process of Risk management

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Levels of Risk Management

EU, EC– Directives, recommendations (Recommendation (2006)7 of the Committee

of Ministers towards Member States for control of the patient safety and of prevention of adverse events in healthcare services

State- political– Laws, legislations, codes and acts

Regional – Municipality level– projects, programs

Company / Hospital – ?

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1. Basic terms

2. Council of Europe recommendations for patient safety2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority

4. Risk management in hospitals

5. Medical event IT reporting system

6. Marsh expertise

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Council of Europe

Recommendation Rec(2006)7 of the Committee of Ministers to member states on management of patient safety and prevention of adverse events in health care

Recognizing the need to promote open co-ordination of national and international regulations concerning research on patient safety, Council of Europe recommends that governments of member states, according to their competencies:

i. ensure that patient safety is the cornerstone of all relevant health policies, in particular policies to improve quality;

ii. develop a coherent and comprehensive patient-safety policy framework which makes patient safety a leadership and management priority;

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Council of Europe

iii. promote the development of a reporting system for patient-safety incidents in order to enhance patient safety by learning from such incidents; this system should include:

а) the proactive design of safe health-care systems ;

b) the reporting of patient-safety incidents, and learning from the incidents and from the reporting;

c) methods to standardise health-care processes ;

d) methods of risk identification and management ;

e) the development of standardised patient-safety indicators f) the content of training programmes and methods to implement a safety culture;

Risk management in healthcare organizations should be

compulsory and controlled.

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1. Basic terms

2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority3. Patient safety - European Commission priority

4. Risk management in hospitals

5. Medical event IT reporting system

6. Marsh expertise

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Patient safety – European Commission priority

Content missing?

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1. Basic terms

2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority

4. Risk management in hospitals4. Risk management in hospitals

5. Medical event IT reporting system

6. Marsh expertise

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Risk Management in Hospitals

Governance of Healthcare organizations. Healthcare Risk and Quality management.

Patient Safety and Clinical Risk Management

Service Continuity Management

Blood and Blood Products Supply Chain and Product Liability

Absence and Stress Management. Health and Safety

Clinical Trails and Medical Devices

Education and Training on Risk, Quality, Regulatory and Governance Issues

Professional liability for doctors, medical personnel. Professional liability for directors and management

Public, Private, Partnership Programmes for finance of new build. Construction Risk Advice and Audit

Financial Modeling and Design

Actuarial claims prediction and analysis

Property Management

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1. Basic terms

2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority

4. Risk management in hospitals

5. 5. Medical event IT reporting systemMedical event IT reporting system

6. Marsh expertise

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Medical event IT reporting system

Internet / intranet reporting

Consolidated incident, near miss, adverse events &

claims database

Analyse trends, patterns, themes

Implement change recommendations

Improve patient safety / quality of care

Bedside, ward,(home)

Centraladministration

Management &clinicalgovernance

Easy to use

Local input by hospital staff

Risk management reports

Anonymous data

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Medical event IT reporting systemsNational and regional systems

United KingdomUnited Kingdom – National Reporting & Learning System, Datex, STARS, Vanguard, etc

IrelandIreland – Clinical Indemnity Scheme

NetherlandsNetherlands – ‘Sneller Beter’ Safety Management System (VMS)

DenmarkDenmark – Incident Reporting System

United StatesUnited States – STARS, Doctor Quality, etc

Australia / TasmaniaAustralia / Tasmania – STARS

ItalyItaly – STARS

Sweden, Switzerland, Czech RepublicSweden, Switzerland, Czech Republic, etc*.

*Source: Council of Europe

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Installed medical event IT reportingBenefits – process

Supports evidence-based risk management framework and process

Process for prevention; i.e. root cause analysis / system failures

Monitor risk management recommendations

Can reduce rate of claims

Helps manage litigation costs

Supports accreditation and achievement of quality standards

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1. Basic terms

2. Council of Europe recommendations for patient safety

3. Patient safety - European Commission priority

4. Risk management in hospitals

5. Medical event IT reporting system

6. 6. Marsh expertiseMarsh expertise

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Marsh expertise

Largest Healthcare Risk and Insurance Advisor in the world

Dedicated Healthcare Practice with 600 colleagues globally

Clients served in more than 100 countries

US$1,000,000,000 in healthcare premiums annually

Serving +2,300 diverse healthcare clients worldwide

Providing risk management programmes to:

Providing insurance and risk management programmes to:– France - UK – Ireland (country) - Spain (region)– Australia - Italy (region)– US states, associations ) - Hong Kong (region)

Thank you for your attention!

&

Be healthy!

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