Helping an evolving profession

This year’s ASHRM president, Ann Gaffey is looking forward to helping the profession move forward, providing advice and resources to assist risk managers in their evolving roles. HRMR reports.

Healthcare risk managers face a host of opportunities in 2016 as they work to advance their programs by facilitating the implementation of enterprise risk management (ERM). Changing payment models, the future of the Affordable Care Act and delivery of healthcare across the continuum, not just in hospitals, will offer new challenges that risk managers can help their organizations address successfully.

That is the view of Ann Gaffey who, as this year’s president of the American Society for Healthcare Risk Management (ASHRM), is committed to helping the society’s members promote and improve ERM in their organizations and adapt to the changing risk management landscape.

“My mission is to advance the ASHRM mission and vision, and ensure we remain influential leaders in healthcare risk management,” she says. “Moving our strategy forward to advance patient safety using risk management principles is on my agenda every day. I can’t think of more important work to support those providing care to patients in our healthcare organizations.”

For Gaffey, the opportunity to become ASHRM president was the culmination of many years’ involvement with the society.

“I can’t envision my career path without ASHRM,” she says. “I got involved as a volunteer in committee and taskforce work years ago because I wanted to be part of something bigger in my professional life. That work offered me the opportunity to make professional contacts that really broadened my view, and gave me people I could pick up the phone and ask questions of.

“The connections you make through ASHRM are invaluable. More importantly, the friendships I have made help to bring sanity—and some fun—to some of the challenging days we have in our field. As much as these connections are important, so are the ASHRM resources. If you have a question, ASHRM has the answer.”

Gaffey served on the ASHRM board from 2008 to 2010, which gave her the opportunity to work on the big issues affecting its members and the industry, setting future strategy and seeing vision become reality.

“ASHRM has always been there for me, and I am honored to be able to give back to our profession and our members,” she says.

First steps

Gaffey’s own career in risk management began after she moved from clinical nursing to quality improvement, working with physicians coordinating peer review activities. As issues and errors were identified that went beyond an individual’s clinical practice, she found her work with the risk manager to be diverse in its approach to solving the problems they were identifying. This piqued her interest, and she started to seek a role in risk management.

“This strategic work ensures ASHRM is the primary source of education for the healthcare risk management field, and that our core body of knowledge will consistently meet their needs."

“When I found a risk management–specific role, I was given the opportunity to work in all the principal areas of risk management. The diversity of my role, the challenges presented that I developed solutions for, and the experts it allowed me to work with got me hooked, and 25 years later, I’m still here,” she says.

Her first risk management role was as risk manager for Columbia Hospital for Women, an acute care, high-risk obstetric and neonatal facility in Washington, DC.

“I credit a lot of my success in risk management to that very first position,” she says. “I was responsible for all domains of risk management—from identification and loss control, to insurance program management working with brokers and excess markets, to managing my own claims program. I got to do it all, which I didn’t realize at the time was the best start you could get in risk management.

“This exposure to analytics, insurance, claims, legal and regulatory matters, and the ability to grow my leadership skills positioned me to grow with a strong foundation underneath. I have relied on that broad knowledge base every day, and have been purposeful about the positions I have pursued to ensure I am never stagnant in our field.”

Her subsequent career has seen her progress to associate director of clinical risk management at George Washington University, Washington DC, and later to vice president, risk and client relations for ELM Exchange, where her primary emphasis was on working with professionals responsible for risk management and patient safety education initiatives utilizing the company’s online, case-based medical-legal education courses.

In 2010 she took on her ongoing position of president of Arlington, VA-based Healthcare Risk and Safety Strategies, where her role was to provide innovative risk management and patient safety education and consultative services to professional liability insurance carriers and healthcare clients. The emphasis is on risk identification, assessment, analysis and prevention, and insurance management, providing strategies to improve and enhance existing risk management programs.

Since January 2013 she has also served as senior vice president, healthcare risk management and patient safety for Sedgwick, based in Memphis, TN. Here she is responsible for leading and providing consultative services to improve and enhance risk management programs with emphasis on risk identification, assessment, analysis and prevention as well as innovative risk management and patient safety education to Sedgwick and other healthcare clients.

“I really enjoy working with healthcare providers at the point of care, teaching them about risk management principles and patient safety, and working with them to make care safer for their patients,” she says.
“Bringing best practices to the bedside is rewarding—helping these folks understand their roles in delivering safe care, and how their individual contributions to improving safety can make a big difference beyond what they might imagine.”

New challenges

During her time in healthcare risk management, Gaffey has seen the industry grow in sophistication as the clinical care and the systems that support care become more complex. “Added to that is the growing burden of legal and regulatory compliance,” she says. “These increasing complexities require us to broaden our approach to the work we do, and to be more strategic in working with stakeholders in our organizations.
“It is imperative that we transition from our traditional risk management framework to an enterprise approach. This evolution from working in silos to facilitating the development and implementation of ERM programs reflects the continuing maturity of the healthcare risk management field.”

The field is also quite literally maturing, with the aging risk management population a key issue that Gaffey aims to address as ASHRM president.

“Historically, a common path to healthcare risk management was someone coming from a clinical background into the role,” she says. “Often this path was a second career of sorts, and not typically the first job someone would move into out of school. With this history, many of our members are now approaching a time where retirement is close.

“What we also know is that we are seeing an increase in membership of individuals who are coming to healthcare risk management earlier in their career, and with a variety of backgrounds.”

Recognizing this changing dynamic, ASHRM has been working hard on the development and delivery of educational programs, toolkits and other resources that respond to the need for competency-based learning.

“This strategic work ensures ASHRM is the primary source of education for the healthcare risk management field, and that our core body of knowledge will consistently meet their needs, regardless of their longevity in the field,” says Gaffey.

Providing support

Another key challenge facing the profession is cyber security and the increased use of smartphones and wi-fi technology in the healthcare setting.
“Cyber security should be at the top of everyone’s risk register,” says Gaffey. “We read daily about new breaches in security, the numbers of people affected, and the cost to organizations that were breached. The amount of diligence needed to continuously train employees in the importance of maintaining privacy and security, test our systems, and maintain ongoing compliance cannot be overestimated.”
However, she is optimistic about the opportunities presented by such advances in technology.

“Our opportunity is to embrace what technology is bringing to the delivery of healthcare in all settings. While the challenges of ensuring privacy and security remain extremely great, technology significantly expands the reach of delivering healthcare to rural areas, those with limited ability and resources to travel, and those with limited access to specialists.

“This world of connected health is where we need to be to care for our patients. It can increase access, increase efficiency in our delivery system, and improve the health status of the patients we serve.”

Part of the way in which ASHRM serves its members is by sharing tools and resources to help them address the most important issues they face in their work. A key type of risk exposure that will affect many in 2016 is mergers and acquisitions, which can raise certain challenges for risk management.

“Mergers and acquisitions have an expansive effect on healthcare risk management, from the due diligence work required by the acquiring organization, to the resulting program changes when the merger or acquisition is complete,” says Gaffey.

“Insurance programs can become quite complex—if, for example, there are two separate captive insurance companies—and there is also the challenge of managing the risks that come with new care settings.

“Mergers and acquisitions generally lead to the expansion of services, which may now add a long-term care exposure, home healthcare, durable medical equipment, multiple physician practices and more. Our members can find the tools and resources within our ASHRM content to support their work in these new risk exposures, which may not be familiar to them.”

It’s clear that Gaffey, and ASHRM as a whole, are strongly focused on keeping pace with changes in the industry and providing material and other services that will help healthcare risk managers navigate the changing landscape successfully. With that in mind, it is full steam ahead for 2016.

“I am very excited to be leading an organization that works diligently every day to provide our members with exceptional resources,” says Gaffey. “I value the opportunity to work with our volunteers who are committed to supporting safe and trusted healthcare.

“I am also privileged to work with our committed ASHRM board of directors, who each bring impressive experience to the table, and who thoughtfully work to advance our strategy and plan for the future. I look forward to contributing to the growth of ERM across our industry, and to advancing our strategic plan to support that work.”