Powerpoint
Drakejosh
riskmanagementpowerpoint.pptxOut-Patient Physical therapy risk management
Grand Canyon University
Joshua Garcia
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Objectives
Risk management rationale
Risk management support
Risk management implementation
Risk management challenges
Risk management evaluation
Risk management opportunities
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Risk management goals
Improve quality care and safety
Identify risks that affect the business and care.
Practice within the scope of practice
Implement risk management strategy
Review
Risk management role is to improve quality care, safety and identify risks that affect the business such as scope of practice, documentation, patient relationship, and interventions, and malpractice.
“A situation involving exposure to danger where a probability or threat of damage, injury, liability, loss, or any other negative occurrence that is caused by external or internal vulnerabilities exist and that may be avoided through preemptive action.” (Chugh, 2015).
“Work within the physical therapist scope of practice and professional competence; Document only the intervention and avoid comments related to "secondary gain" or its origin. Avoid expansion of services at the individual patient's/client's request unless approved by appropriate referral sources and an additional examination/evaluation is performed.” (Anonymous, 2011)
Implement strategies in areas that are prone to non compliance, safety and care that will affect the patient, health care professional and the business.
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Rationale
Health care professional competence
Continuing education
Competence with care
Competence with practice standards
It is important to perform continuing education in or to maintain your licensure.
The accrediting body of CMS is important in maintaining compliance especially with documentation, safety, accreditation of a therapist, medical records and practicing of a therapist .
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Support
Standard practice in Physical Therapy
Continuing education
Inservice training
Physical therapy plan to risk management is “According to the Guide to Physical Therapist Practice, the elements of patient/client management include examination, evaluation, diagnosis, prognosis, and intervention.” (Anonymous, 2011).
“Identifying the most efficient and effective learning activities is essential to enable the profession to assimilate research findings and enhance clinical expertise to maximize patient outcomes.” (Leahy, Chipchase, & Blackstock, 2017).
Inservice training is imperative to identify the most effective and safest approach.
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Professional negligence
Improper management of treatment
Improper use of physical agents
Improper therapeutic exercise
Improper manual therapy
Inservice training will decrease the chances of malpractice in the most common types of interventions listed above.
Many different types of injuries can occur from improper training such as: falls, burns, improper assessments, ligament/tendon damage, dislocation etc.
Continuing education and practicing within the scope of practice is imperative.
“The implementation of best practices can help improve patient outcomes” (Pozgar, 2014 ).
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implementation
Provide Inservice training to all health care professionals
Evidence based practice
Common issues pertaining to safety
Compliance issues with governing agencies
“Effective risk management requires identification of litigation-prone areas and implementation of preventive or corrective actions throughout a facility.” (Weinberg & Levine, 2005).
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Risk applications
Quality indicators (QI)
Questionnaires
Reviews
Safety protocols and standards
Environment safety
Implementation of these risk applications can be useful in creating a positive risk management strategy. This can help provide feedback and area that are prone to non compliance and safety issues.
“We must collect data and identify sources of error and root causes in order to understand the nature and outcome of error and make appropriate practice changes to mitigate error and improve patient safety.” (King & Anderson, 2010).
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Challenges
Opposition in approach to care
Opposition to manual techniques and intervention
Transition to care and documentation requirements
“Physical therapists performing patient/client interventions should ensure that their methods are accepted, safe, justifiable, and comply with the standards of care (see Guide to Physical Therapist Practice).” (Anonymous, 2011).
“In an effort to properly train and use support personnel in physical therapy, the American Physical Therapy Association (APTA) has differentiated training and function of PTs, PTAs, and therapy aides (Bashi and Domholdt 1993) and promulgated guidelines on delegation of responsibilities.” (Resnik & Hart, 2006).
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Evaluation
Maintain scope of practice standards
Implement new innovations following governing agencies
Build a staff comprised of health care professionals who are like minded
“Experience and change in circumstances will necessitate changes in the plan and contribute information to allow different decisions to be made depending on the risk being faced.” (Anonymous, 2010).
The risk management plan meets the organizations, short term, long term and end goals which is to provide optimal safe care, sure privacy, and meet standards of governing bodies. This risk managements maintains the scope of practice .
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opportunities
Improvement in documentation
Documentation to follow strict guidelines by CMS.
“Documentation must be learned and practiced much in the same way as clinical skills. Physical therapists need to adopt good habits of documentation and become aware of their legal obligations incidental to patient care.” (Kolber & Lucado, 2005 ).
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Documentation
Documentation are legal records
Documentation is evidence on what is being performed
Accuracy and complete documentation is required
It is important to document on every patient that attends physical therapy.
Make sure the patient has consented to the treatment that will be provided every day
Document accurately and specifically on what is being performed
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Checklist to success
Work within the scope of practice
Maintain skills following the standard of practice
Continuing education and competence
Be professional
Properly document
Protect patient confidentiality
These are the keys to maintaining compliance and following the risk management strategy.
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References
Chugh, N. (2015). Risk Identification, Assessment and Management in Healthcare Sector. ASCI Journal of Management, 44(2), 36–44. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=119119051&site=eds-live&scope=site.
Developing a Risk Management Plan. (2010). Retrrieved from https://www.usaid.gov/sites/default/files/documents/1864/Developing-a-Risk-Management-Plan.pdf.
King, J & Anderson, C. Patient Safety and Physiotherapy: What Does It Mean for Your Clinical Practice? (2010). 62 (3) pp. 172-175. doi: 10.3138/physio.62.3.172. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909853/#!po=65.0000
Occupational Health Physical Therapy: Legal and Risk Management Issues Guidelines. 2011. Retrievedfrom https://www.orthopt.org/uploads/content_files/OHSIG_Guidelines/OHSIG_guidelines_2/OCCUPATIONAL_HEALTH_in_PT_LEGAL_RISK_MGT.pdf
Weinberg, A & Levine J. 2005. Clinical Areas of Liability: Risk Management Concerns in Long-Term Care. Annals of Long Term Care, 13 (1). Retrieved from https://www.managedhealthcareconnect.com/article/3564.
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