Care and compassion


Care and compassion

‘Sharing and caring’ through enterprise risk management (ERM) was chosen as the over-riding theme of the 2014 ASHRM conference. Jacque Mitchell, the organization’s 2014 president, tells HRMR how this can be applied within the wider context of ERM.

The 2014 ASHRM conference chose compassion through enterprise risk management (ERM) as its central theme—this ethos flowing through more than 70 educational sessions. Working in risk management is a true vocation for many and, reflecting another big theme of the ASHRM event, the work of a risk manager takes courage, enduring strength and an inherent, unwavering compassion for patients and their safety.

But this idea of ‘sharing and caring’ must be examined in the context of the drive towards ERM, recognising that all healthcare workers, not just risk managers, play a vital role in patient safety.

By promoting a compassionate attitude across the healthcare continuum, ASHRM believes that the goal of zero preventable serious safety events will become more attainable.

“Everyone in healthcare should have compassion—people go into healthcare for the purpose of doing good,” says 2014 president Jacque Mitchell, who believes that risk manager have the potential to lead those in their organizations towards a more ‘sharing in the caring’ approach. 

“Risk managers can promote compassion by being compassionate—setting the example and expectation of compassionate care. Compassion needs to be demonstrated from the top down,” she says.

She believes the direct contact risk managers have with aggrieved patients gives them a special a role to play in leading all the staff in their organization towards a kinder attitude.

“Risk managers hear the stories from the patients directly. It helps if the healthcare providers can hear the stories and see the patients’ point of view.”

A knock-on effect of an ethos of compassion is that patients start to feel empowered and listened to—and this can even help pre-empt safety issues because patients are more likely to speak up if they perceive a problem.

“If patients feel that you are concerned and caring, they are more likely to be engaged and ask questions about their care,” says Mitchell.

She predicts that over the coming year risk managers will continue to lead their organizations in terms not only of patient safety, but also by promoting a more sympathetic, approachable manner. She adds that healthcare risk managers across the US are gearing up to take on the ERM model of healthcare, and that any developments will take place within this context. 

ERM has been a buzzword in healthcare for several years and is fast becoming essential to the work of risk managers. In fact, she says, many risk managers are already using an ERM approach without realizing it.

ERM requires risk managers to take a broader view of risk within their organizations, looking both within and beyond the clinical setting to identify potential issues that could harm the organization and managing those risks.

It is an ongoing, structured and analytical process that can and should involve everyone within the organization, at every level and within every unit. Rather than responding to risks after they cause problems, or simply avoiding risks, ERM is about identifying risks and pre-empting any problems that may arise.

It also ventures one step further: by viewing risks as either sources of capital or potential for losses, it recognizes that there are upside possibilities inherent in some risks, and that these can be exploited.

An ERM journey

It’s a subject close to ASHRM’s heart. The society has laid out its commitment in several white papers over the years including its latest published in 2014 called: Enterprise Risk Management – A Framework for Success.

Asked to describe the approach in a nutshell, Mitchell defines ERM as a broad, comprehensive framework of activities that risk management professionals use to identify and manage risks across the entire healthcare organization.

“This applies to a stand-alone clinic or an entire healthcare system. It allows value protection—preventing loss and harm—but also includes value creation, such as attaining new products and services,” she says.

In Mitchell’s view the switch to ERM is a logical response to the diverse challenges that US healthcare is facing at present, including an increase in technology, clinical integration, supply chain complexity and healthcare reform.

The new approach is markedly different from traditional risk management, which takes a clinical approach and examines risks individually.

“Traditionally, the risk manager is trained and educated at looking at risks in the clinical environment. Now they are taking their skills and using them in strategic and financial planning, operations, technology development and human capital,” says Mitchell.

Instead of handling risk in functional silos where measurements of success are variable, ERM strives to use common metrics across risk domains to determine the effectiveness of risk management approaches.

“With an integrated, enterprise-wide view of risk, the risk manager has a much more strategic position, focusing on opportunities as well as risks,” she says.

It’s a win-win

The opportunities are not only financial. Mitchell says that everyone benefits from the ERM approach, including patients, caregivers, the community and the healthcare system.

“The challenges are great—but not insurmountable,” she says. “Risk managers will have to break down the silos and lead the ERM process. We know we cannot do it alone. They will be working in partnership with other members of the organization.”

ASHRM has embraced ERM as the future of healthcare risk management, says Mitchell.

“We need to transfer our rigor in clinical risk and apply it to all areas of the healthcare organization. A successful organization manages its risks.”

ASHRM has incorporated the development of ERM into its four strategic goals for the next two years, and has devoted many resources to develop education around ERM, reaching out to other industries and communicating the value of ERM to its members, who the association is determined to help on their ERM journeys.

“In the future risk management professionals will be considered the experts in all risks,” says Mitchell. “They will be sought after for their skills and expertise in making risk management decisions which maximize value protection and creation by managing risk and uncertainty and their connection to total value.

“The business of healthcare will be ‘healthier’ because of the work of risk managers, and ERM will help provide even better care for patients—the ultimate goal of all healthcare providers.”

She says that the move towards an ERM approach is happening against the backdrop of rapid change, much of it driven by the Affordable Care Act.

“The challenge, as for everyone in healthcare, is to keep up with a fast-changing environment and doing more with less,” she says. “As for ASHRM, in 2015 we will be continuing to move forward with our patient safety and ERM strategies.”

ERM, ASHRM 2014, Jacque Mitchell, HRMR