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RISK MANAGEMENT & GOVERNANCE

RISK MANAGEMENT & GOVERNANCE. Michael Gorton – Russell Kennedy ACHSE – 3 March 2004. The context. Rise in claims September 11 Collapse of HIH/UMP Under funding of MDO’s Fear Financial incentives for risk management. The Government Response. UMP support (and levy) Tort law reform

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RISK MANAGEMENT & GOVERNANCE

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  1. RISK MANAGEMENT & GOVERNANCE Michael Gorton – Russell Kennedy ACHSE – 3 March 2004

  2. The context • Rise in claims • September 11 • Collapse of HIH/UMP • Under funding of MDO’s • Fear • Financial incentives for risk management

  3. The Government Response • UMP support (and levy) • Tort law reform • Risk management (safety & quality)

  4. Tort Law Reform • Proportionate liability • Caps and thresholds • Open disclosure • Limitation period for claims • Definition of negligence (IPP) • Abolish exemplary damages • Good Samaritan • Structured settlements

  5. Liability Entity Individuals Vicarious liability Accountability Delegation Reporting Risk Management Legal risk Financial risk Business risk Compliance Governance & Management

  6. Towards a governance culture • Organisational culture (open) • Staff knowledge, beliefs and values • System design • Resources • Management model

  7. Key Governance Issues • Identification of and compliance with standards • Recognise opportunity cost • Getting it right • Doing it wrong

  8. Key Governance Issues • Levels of delegation • Systems of Accountability and Reporting Regimes • Policies • Quality of care and service • Safety (including emergency) • Legal risks • Education and training • Notice requirements/Compliance Checklist/Sign-off • Incident Monitoring/Complaint Handling

  9. Medical Governance • MAC • Credentialling • Clinical Risk Committee • QA • Complaints analysis • Incident data

  10. Vicarious Liability • Employees • Agents • Privatised services/facilities

  11. Informed Consent • Not a form • Doctor certification • Information sheets • Checklist • Records/notes

  12. Communication and Prevention • Studies of patients complaints and why they complain, indicate that some of the following factors are relevant • They have not received an explanation which they can understand and accept • They believe their treatment has been negligent or below standard (whether, in fact, it has or not) • They have not been treated with consideration or sympathy or courtesy

  13. Communication and Prevention • They have sought information, but have not received an explanation, or their reasonable requests have not been met • They have been discharged before they fully recovered (or they thought they had fully recovered), or discharged without proper explanation or follow up • They are chronic complainers

  14. Avoiding Liability • Good care and service • Protocols and procedures • COMMUNICATION!! • Complaint handling procedures – timely, sensitive, communicative • NOTES AND RECORDS • Insurance

  15. Risk Management and Governance Michael Gorton Russell Kennedy Solicitors PO Box 5146AA, Melbourne Tel: 03 9609 1625 Fax: 03 9609 1825 Email: mgorton@rk.com.au

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