Navigating the Complexities of Healthcare Risk Management

Heather Morris is the Director of Clinical Risk Management at West Tennessee Healthcare, with over a decade of experience in nursing and risk management. She holds a bachelor's degree in business management from the University of Tennessee at Martin and began her career as a registered nurse in 2012.

Through this article, Heather offers a comprehensive overview of the critical role of risk management in healthcare and provides practical strategies for addressing the challenges faced by healthcare professionals.

Journey to Current Role

I began as a registered nurse working in pediatrics, newborn nursery, and peri-procedural. I always knew that I wanted to be able to make a difference for patients and healthcare workers but in a more behind-the-scenes role. I chose to go back to school and obtain my bachelor’s in business management. Before graduation, I noticed an opening in risk management and was selected as an assistant risk manager, as my healthcare and business degrees positioned me well to learn and excel in this type of role. Through personnel changes and unexpected opportunities, I was given the opportunity to prove myself as a leader at the start of COVID and was promoted to System Director of Risk Management and now System Director of Clinical Risk Management, which allows me to achieve that original goal of helping patients and front-line healthcare providers.

Challenges in Risk Management Operations

Covid presented many challenges in the healthcare world, such as loss of workers, burnout, sicker patients, deviation from standard practices, and the list goes on and on. Now that we are post-covid, many of these same challenges still remain. We have to stay proactive in our efforts to encourage a safety-focused culture to make sure the safest and most up-to-date best practices are being educated to our employees. We have recently joined a PSO, which provides regular educational opportunities for me to take part in with my staff to see how other facilities are combating different issues. We work as a team to learn from each other and how we can best serve our patients and fellow healthcare workers. We round in all of our hospitals to learn and get comfortable with the other healthcare leaders so we stay up to date on current issues and challenges that may need to be addressed and research the best ways to fix those issues. My team walks alongside of me, not behind me, and we are steadily learning and improving together to ensure we all stay knowledgeable and motivated to do our jobs well.

Strategies for Identifying and Mitigating Risks

We have a risk reporting system that all of our employees are encouraged to use to alert us of potential safety/risk issues. These issues are given a score based on severity and probability of occurring again and our approach is based on what score an event gets. If we see a trend of a common event type, we will perform a failure mode effects analysis to identify all potential process failures and address them to the best of our ability. We also identify safety opportunities through our facility rounds and speaking with frontline staff to identify trends or concerns straight from the source.

Staying updated with evolving regulations

We have a Director of System Accreditation that I work very closely with. Their focus is knowing these standards for our system and I work with them as needed to ensure these are being followed and implemented with any improvement work that is being completed throughout the system.

Initiatives for Improving Patient Safety

The first thing we did when I became Director of Risk was obtain an improved reporting system and then campaign across the health system to encourage safety reporting. You can’t become safer as a health system until your staff have a means to and feel comfortable sharing safety concerns as they occur. From the initiation of the system to now, we have increased our reporting by more than 50% in 3 years. With each of those reports, we have had the opportunity to identify potential improvements that can be made for safety. These might take the form of a root cause analysis, FMEA, or just a local investigation and improvement on the floor. We have established programs that award our employees for safety reporting and being a part of improvement opportunities.

Approach to Investigating Significant Events

We try to involve all individuals that had any part of the event to make sure we hear all sides of the story. We make sure each individual knows that the work that is being done to investigate a situation is being done in the spirit of improvement and safety. Blaming and fingerpointing are never allowed and only calm, fair discussion is encouraged with an effort to improve. We also try to ensure no investigation of a serious safety event is ever left without a corrective action plan that includes as many strong actions as possible. We then attempt to measure the effectiveness of those plans over time to ensure they are adequate plans and then roll them out across the system as necessary to help improve safety all over.

Advice for Aspiring Clinical Risk Management Professionals

Go into every situation with an open mind and a willingness to learn from the health professionals around you. I have learned so much more regarding patient care being away from the bedside just by listening to the intelligent individuals around me who do it every day. Be a teammate, a helper, and a friend. People are more likely to work with you and listen to you if you treat them with respect and they know you are truly there to help them and not make their lives harder. Listen to them and be empathetic to their needs and issues. The issues going on behind the scenes are often the reason an event occurs and if you aren’t looking for them, you just might miss a big root cause of your issues. Finally, always stay process-focused.