Risks and strategies can be classified into three
1. Clinical knowledge and
Strategies to reduce risk
related to clinical knowledge and skill include:
- Keeping up
to date with clinical knowledge, skills and best practice and using
appropriate and up-to-date resources to support clinical
- Attending peer meetings and discussing management of
- Taking a thorough history and examination when attending
- Documenting all aspects of the consultation in the clinical
record – remember, this is considered a legal document and is your best
defence in the event of legal investigations. Review the standards expected
of clinical records relating to consultations and apply them
systematically. Ensure any other doctors working in your practice are also
committed to thorough and complete documentation.
- Clinical staff
being aware of their own scope of practice and referring patients on
- Investigating further if treatment is not
- Making use of protocols, checklists and clinical decision
- Looking after your own health
- Reporting or
addressing concerns if you feel you or practice staff are being exposed to
unsafe work practices.
Effective communication is fundamental to the
doctor-patient relationship, as communication failures underlie many patient
complaints or findings against doctors in legal-related claims. Strategies to
reduce risk due to communication issues include:
- Building a
patient relationship based on open communication and shared
- Showing empathy to patients
- Managing adverse
events or complaints in a timely and efficient manner to ensure the patient
(or a staff member) feels their concerns have been acknowledged and
- Minimizing interruptions during consultations
- Managing unrealistic patient expectations.
regularly with your practice staff through staff meetings, sharing feedback
and receiving their input
- Providing a practice environment where
patients feel welcome and staff are skilled in all aspects of managing
- Educating staff in techniques to provide the best patient
communication at all levels.
- Fostering strong relationships with
professional colleagues and the healthcare team, within your practice as
well as in your local healthcare community.
- Keeping open and
transparent channels of communication with health facilities you interact
with (e.g. hospitals, radiology and pathology services)
consent process allows the patient to understand the implications of a
proposed treatment, medication or procedure – in other words, ensuring you
obtain informed consent
Ensuring informed financial consent process
explains to all patients where there will be any additional charges for any
service – consultations or procedures.
Practice managers know all too well that effective risk
management in practice is to a large extent all about employing or
developing appropriate systems. These systems allow consistent level of
operation and serve to prevent errors and mistakes. System, policies and
procedures which decrease risk in practice include:
- Complaints-handling procedures
- A practice “policies and
- Test tracking and follow-up processes
- Recording of appointments, recalls, cancellations and any failure to
- Documentation of all patient communications with the practice
in the patient record
- Infection control and waste management
- Recruitment, orientation, training and management of
- Managing confidentiality and privacy
- Computer security and data back-up.
As well as being a requirement of good medical practice,
according to the Medical Board of Australia, the National Safety and Quality
Health Service Standards requires the establishment of an organisation-wide
risk management system in healthcare providing organisations and businesses.
This standard incorporates identification, assessment, rating, controls and
monitoring for patient safety and quality, and includes the use and
monitoring of an organisation-wide risk register, and that actions are
taken to minimise the risks to patient safety and quality of care.
Risk management framework
As a practice
manager, you need to ensure your practice has a risk management framework in
place. This framework encompasses a set of components that are used to
establish, support and sustain risk management throughout your practice.
This is also about developing the risk criteria and risk champions. The key
elements of a risk management framework include:
- Risk management
policy – This is a general statement of direction or intent and commitment
to risk management within the practice.
- Risk attitude – This
defines the practice’s general approach to the management of risk and will
dictate and influence how risks will be managed.
- Risk management
process – This sets out how the practice applies policies, procedures and
practices to a set of activities designed to establish the context,
communicate and consult with stakeholders, identify, analyze, evaluate,
treat, monitor and review risk.