Chapter 9 A Primer on Medical MalpracticeMalpractice –

Chapter 9: A Primer on
Medical Malpractice
Malpractice – What is it?
Error - behavioral matter
Misperception
Mistake
Omission
Substitution
Accident - unplanned event
Malpractice - negligence
2
Negligence
An act that a prudent person would not have done or the
omission of a duty that a prudent person would have fulfilled,
resulting in injury or harm to another person.
A civil wrong and part of the law of torts.
Founded on the relationship between the actor and the victim
Requirements of an Act of Negligence
Legally recognized relationship between the health care worker
and patient
Health care worker has a duty of care to the patient

Health care worker breached the duty of care by failing to
conform to the required standards of care
The breach of duty was the direct cause of harm, resulting in the
patient suffering damages as a result of the harm
Malpractice
Negligence that is the proximate cause of injury or harm to a
patient resulting from
A lack of professional knowledge, experience or skill that can
be expected in others in the profession.
OR
From failure to exercise reasonable care or judgment in the
application of professional knowledge, experience or skill.
Medical Malpractice
The commission or omission of an action causing an injury is
shown to arise from the exercise of professional medical
judgment
There must be:
A Physician-Patient Relationship
A Duty to Perform Professionally
6
Sources of Professional Standards
Government statutes and regulations
Professional society standards
Voluntary accrediting agency standards

Administrative policies and rule of the facility
Theories of Liability
Informed consent
Strict liability
Vicarious liability
Res ipsa loquitur
Re ipsa loquitur
The thing speaks for itself
Injury would not ordinarily occur in the absence of negligence
Injury was caused by the actions was within the control of the
defendant
Injury is not due to any action on the part of the plaintiff
Evidence surrounding the circumsta nces is mostly within the
control of the defendant
Hospital Liability for Malpractice
Respondeat superior
Ostensible agency
Staff Privileges
Corporate Negligence
Contributory Negligence
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Other Liability Theories
Intentional tort

Assault and battery
Libel
Slander
Invasion of Privacy
Types of Damages
Compensatory damage
Awards for pain and suffering
Punitive damages
Statute of Limitations
The maximum period of time after the patient’s injury during
which a lawsuit may be commenced.
Most state have a statutory period between one and three years.
Typically the statutory period is deferred (tolled) during infancy
and starts to run only on the patient’s 18th birthday.
Common Malpractice Allegations
Surgery/post-op complications
Failure to diagnose cancer
Surgery/inadvertent act
Improper treatment (birth related)
Failure to diagnose fracture or dislocation
14
Most Expensive Settlements
Improper treatment (birth related)
Failure to diagnose hemorrhage
Failure to diagnose myocardial infarction

Failure to diagnose infection
Failure to diagnose cancer
Other concerns which
may impact liability
Unrealistic patient expectations
Non response to complaints
Illegible medical records
Insufficient information in medical records
No follow-up on abnormal tests
Professional miscommunication
Summary
Risk Managers need to be aware of both professional and
facility liabilities
Malpractice claims can be very complex
Setting policies and procedures and following them are
important in minimizing malpractice liability
Essay Assignment 2: Documented Argument in APA
Your argumentative essay will be on an environmental topic
from the list of options below.
Consider your audience for this paper to be your peers. The
essay should be between 3 ½ and
4 pages (850 to 1,000 words) in length, not including the cover
page, abstract, or reference

page. It should be double spaced in Times New Roman 12 point
font and must include:
• An introduction, a minimum of 3 body paragraphs, and a
conclusion
• a clearly articulated thesis that states the claim, position, or
stance that your essay
will prove in the introduction to your paper
• 4 cited sources
• At least 4 quotes from your sources
• Topic sentences that focus the discussion in the body
paragraphs
• Examples, details, and explanations, and other researched
evidence in the body
paragraphs that clearly support the claim of your thesis
• Counterarguments and refutations that show you understand
the complexity of your
argument and can accurately acknowledge the views of the
opposition and refute
them
• Clear connections between ideas from paragraph to paragraph
and within paragraphs
• Proper APA style format in the cover page, in the abstract, in

the in-text citations,
and in the Reference page (see the template and instructional
video for creating the
APA format)
• Reference page listing a minimum of four sources
• Standard usage, grammar, and mechanics
IMPORTANT INFORMATION:
➢ You will submit your final draft through the Turn-it-in drop
box designated for this
purpose in the course. Please be aware, that although Turn-it-in
does allow for
similarities for quotations up to 24% of your paper, any
similarity above 24% is
considered too high for an original paper and will be flagged as
plagiarism.
➢ You can get help with your paper at any of the campus
writing centers (see the link in
the course with this information), and you can also receive
online help via
SmartThinking, the online tutoring service provided by the
College. This service is
available by clicking on SmartThinking in the left-hand menu
bar of the course under

Tools & Resources.
Choose any of the following 15 topics (Note reference resources
at the end of the topic list):
1. Research alternative energy sources; then make an argument
for the three most
desirable ones to introduce in South Florida. Here is a link with
a list of renewable
energy resources to get you started:
https://www.renewableresourcescoalition.org/alternative-
energy-sources/.
2. Research the status of sea level rise in South Florida today
and the ways in which it is
being addressed through State processes. Make an argument that
the solutions today
are or are not sufficient. Here is a link to a web page that will
help you get started
with your research: https://sealevelrise.org/states/florida/.
https://www.renewableresourcescoalition.org/alternative-
energy-sources/
https://sealevelrise.org/states/florida/
3. Research the effects of the environment on human health.
Does the health of the

environment affect the health of the human beings within it?
Make an argument that
supports your answer. Start your research by reading this
article:
https://orionmagazine.org/article/beyond-the-patient/.
4. Should access to drinking water be privatized? Start your
thinking about this topic by
watching this short video: https://storyofstuff.org/movies/the-
story-of-water/.
5. Where does recycled plastic end up? What solutions to
“plastic pollution” are most
feasible? Start your thinking on this topic by watching the
videos on this page:
https://www.storyofplastic.org/watch.
6. How is biodiversity important to a thriving planet? What are
the dangers of the high
rate of species extinction that the planet is facing? What are the
proposed solutions to
this problem and how effective will they be? Start your research
by reading this
article: https://www.washingtonpost.com/climate-
environment/2019/05/06/one-
million-species-face-extinction-un-panel-says-humans-will-

suffer-
result/?noredirect=on&utm_term=.98fc33bfad58.
7. Are electric vehicles better for the environment? Start your
research by reading this
article from Forbes magazine:
https://www.forbes.com/sites/jamesellsmoor/2019/05/20/are-
electric-vehicles-
really-better-for-the-environment/#5609f23876d2.
8. What are the effects of consumerism on the environment?
What must be done to
address the problem? Start your research by reading this article
from Science Daily:
https://www.sciencedaily.com/releases/2016/02/160224132923.
htm.
9. The government makes the claim that using public
transportation has positive effects
on the environment (See:
https://www.transit.dot.gov/regulations-and-
guidance/environmental-programs/transit-environmental-
sustainability/transit-role);
however, in South Florida, efforts to develop more efficient
public transportation has
been less than successful. What factors have caused this failure?

10. What are the environmental effects of our agricultural
practices? What are some
solutions to these problems? Start your research by looking at
this web page from the
Institute on the Environment at the University of Minnesota:
http://www.environmentreports.com/how-does-agriculture-
change/#section2 and this
article about the threat to food resources:
https://www.msn.com/en-
nz/news/world/climate-change-threatens-the-worlds-food-
supply-united-nations-
warns/ar-AAFwd8r.
11. Overpopulation is among the top environmental problems
facing the world today.
What is the connection between educating women and
supporting family planning and
reducing the risks of overpopulation? Should educating women
be a priority on the
world stage? Start your research by reading this editorial:
https://www.wired.com/story/to-stop-climate-change-educate-
girls-and-give-them-
birth-control/.

12. What are the effects of urban sprawl on the environment?
Should the government
institute strong regulations to curb urban sprawl? Start your
research by reading the
information here: http://www.everythingconnects.org/urban-
sprawl.html.
13. What are the environmental effects of deforestation? What
should be done to solve
the problem of deforestation. Start your research by reading this
article from National
Geographic:
https://www.nationalgeographic.com/environment/global-
warming/deforestation/.
https://orionmagazine.org/article/beyond-the-patient/
https://storyofstuff.org/movies/the-story-of-water/
https://www.storyofplastic.org/watch
https://www.washingtonpost.com/cli mate-
environment/2019/05/06/one-million-species-face-extinction-
un-panel-says-humans-will-suffer-
result/?noredirect=on&utm_term=.98fc33bfad58
https://www.washingtonpost.com/climate-
https://www.washingtonpost.com/climate-

electric-vehicles-really-better-for-the-
environment/#5609f23876d2
electric-vehicles-really-better-for-the-
environment/#5609f23876d2
https://www.sciencedaily.com/releases/2016/02/160224132923.
htm
sustainability/transit-role
sustainability/transit-role
http://www.environmentreports.com/how-does-agriculture-
change/#section2
https://www.msn.com/en-nz/news/world/climate-change-
threatens-the-worlds-food-supply-united-nations-warns/ar-
AAFwd8r
AAFwd8r
AAFwd8r
girls-and-give-them-birth-control/
girls-and-give-them-birth-control/
http://www.everythingconnects.org/urban-sprawl.html
warming/deforestation/
warming/deforestation/
14. How does our overreliance on fossil fuels damage the

environment? What are the
advantages of ending our reliance on fossil fuels? Make a
capitalist argument against
the fossil fuel industry. Start by reading the following opinion
article:
https://www.theguardian.com/commentisfree/2018/aug/16/capita
lism-climate-
change-risks-profits-china.
15. Despite the disasters at the Chernobyl and Fukushima
nuclear power plants, some still
make the argument that nuclear power is a more feasible
alternative to fossil fuels
than other alternative energies? Here are the arguments made by
the World Nuclear
Association: http://www.world-nuclear.org/information-
library/current-and-future-
generation/the-nuclear-debate.aspx.
The following websites might provide some data for your
research:
• The U.S. Environmental Protection Agency Laws and
Regulations:
https://www.epa.gov/laws-regulations.

• The U.S. Environmental Protection Agency Data:
https://www.epa.gov/facts-and-
figures-about-materials-waste-and-recycling.
• World Bank Data:
https://data.worldbank.org/topic/environment.
• United Nations Environment Program:
https://www.unenvironment.org/regions/north-
america.
• 350.org: https://350.org/science/.
• NASA on climate change: https://climate.nasa.gov/.
• The Intergovernmental Panel on Climate Change (IPCC):
https://www.ipcc.ch/about/.
lism-climate-change-risks-profits-china
lism-climate-change-risks-profits-china
http://www.world-nuclear.org/information-library/current-and-
future-generation/the-nuclear-debate.aspx
http://www.world-nuclear.org/information-library/current-and-
future-generation/the-nuclear-debate.aspx
https://www.epa.gov/laws-regulations
https://www.epa.gov/facts-and-figures-about-materials-waste-
and-recycling
https://www.epa.gov/facts-and-figures-about-materials-waste-
and-recycling
https://data.worldbank.org/topic/environment

https://www.unenvironment.org/regions/north-america
https://www.unenvironment.org/regions/north-america
https://350.org/science/
https://climate.nasa.gov/
https://www.ipcc.ch/about/
Chapter 4:
Communications to Reduce Risk
Communication is a risk?
Lack of communication between physicians and their patients
can be a critical factor leading to malpractice lawsuits
Lack of communication can lead to patient dissatisfaction
Dissatisfied patients are more likely to pursue malpractice
litigation
Barriers to Communication
Lack of or poor listening skills
Physical barriers
Personal distractions
Communication depends on…
Personality
Age
Environmental factors
Income
Education
Social situation
Intelligence
Fluid intelligence
Crystallized intelligence

Communication and Risk Management
Understanding patients within their societal environment and
culture is important to managing risk
This will assist with communicating to the patient at their level
of understanding
Misunderstandings due to cultural or societal differences may
be avoided with attention to proper communication
Why do Patients Sue?
Patients tend to sue when the Provider has caused them harm
but also when they feel the Provider has:
Deserted them
Didn’t listen or devalued their view
Didn’t give them necessary information or didn’t explain it
Didn’t understand or acknowledge their perspective
Why is this important?
Patients do not have the skills to accurately identify ‘quality’
healthcare, therefore they tend to view how they are treated
(customer service) as an indicator of quality of care
Poor customer service = Poor quality
What are Patients looking
for with litigation?
Altruism
Rationalization
Recompense
Accountability

Do unto others…
Respect and civility can play a major role in risk management.
Providers need to civil and respectful of their patients’ concerns
by offering:
Empathy
Compassion
Care
Cultural Awareness
Providers need to have an understanding (sensitivity) of their
patients’ backgrounds as cultural differences can lead to
misunderstandings or non-compliance if not properly attended
to.
Cultural destructiveness
Cultural incapacity
Cultural blindness
Patient Empowerment
Studies show that much patient dissatisfaction comes from
deficient communication
Empowering the patient to be an active participant in the
provision of healthcare may lead to improved communication
Programs are available to assist the patient in learning their role
in provision of health
TJC: Speak Up program
AHA: Patient’s Bill of Rights
Facility specific: Complaint/Grievance Process
Health Literacy
Degree to which individuals have the capacity to obtain, process
and understand basic health information.

Approximately 1/3 of adults have basic or below basic skills for
dealing with health material
Health facilities must follow federal regulation to provide
language services for those patients with limited English
proficiency (LEP)
Informed Consent
Informed Consent implies that the patient understands the
service to be rendered, the risks involved and potential
outcomes.
Valid consent is given when the patient:
Has been informed
Is competent
Has not been coerced
Why do risk managers care
about informed consent?
Courts have decided that patients have a right to control their
own body and decide about medical treatment
An informed and educated patient is more likely to have
realistic expectations about his condition/treatment
Patient Education
Poor communication can increase patient non-compliance which
can lead to harm
Adherence to physician instructions can be improved with
communication:
Agree upon diagnosis through discussion
Simplify regimen
Written instructions in understandable language
Motivate the patient to adhere to instructions
Discuss potential risks, side effects and costs

Barriers to Patient Education
Lack of time
Health literacy of the patient
Fear of materials being used against the provider
Skepticism of patient’s ability to follow instructions
Lack of adequate reimbursement
Effects on the provider’s personal life
Difference of Opinion
Due to their level of health literacy, patients and providers may
see potential side effects or adverse reactions quite differently
Provider sees an anticipated outcome
Patient sees an error
Physicians also have a different take on errors and tend to
define them more narrowly
Disclosure
Disclosure can show that the provider is not hiding anything
and may serve to
Lessen the tendency to litigate
Increase the tendency to settle
Patients desire full disclosure of harmful errors
An acknowledgement that the error occurred
What happened
Why it happened
Implication to patient’s health
How it will be avoided in future
An apology
Apologize

If something has gone wrong, the patient has the right to an
apology.
Unfortunately, many providers are cautious to do so due to
concern an apology would be an admission of guilt or wrong
doing
Some states have enacted Apology laws which make physician
apology inadmissible in court
Disclosure, explanation and apology should come within a
reasonable timeframe of the incident.
Key Issue – Patient Satisfaction
Patients who are satisfied are less likely to sue
It has been found that anger, not injury is the trigger for most
malpractice claims.
Studies suggest that empathy and good interpersonal skills may
decrease the likelihood of malpractice claims
Consumer Information
With advent of the Internet and Social Media, healthcare
consumers have access to multitudes of information not only on
healthcare topics, but on their healthcare providers as well
CMS website offers comparison of healthcare facilities based on
reported quality indicators
Accreditation also gives consumers information regarding their
health facility providers
Issues with Web-based Information
Consumer self-rating information is also available on the web
though it is not vetted
Social Media opens issues with confidentiality
Courts have yet to set precedents regarding use of Social Media

Summary
Appropriate and Positive Communicatio n is a valuable Risk
Management Tool as it can have an impact on patient
satisfaction
Dissatisfied patients are more likely to sue even if there is no
injury
Satisfied patients with an adverse event are less likely to sue
Chapter 8: Patient Safety Tools:
Integrating Quality and Managing Risk
Why do we talk about Quality
in the Risk Management setting?
Risk management makes contributions to quality by assuring
that hazards and injuries are less likely to occur for both
patients and employees.
Risk management works to prevent malpractice claims by
identifying, analyzing and treating risks which quality
assessment tries to eliminate
Predicting Hazards and Malpractice
Prediction is not specific in risk management – can say an event
is likely to occur, but not when or to what extent
Confounding factor: increased patient satisfaction tends to
correlate to lower likelihood of legal action by a patient
Incident Reporting: can assist the risk manager in identifying
causes

Healthcare Acquired Conditions
Conditions for which, when acquired during admission in the
health facility, CMS will not reimburse.
Examples include:
Foreign object retained after surgery
Air embolism
Blood incompatibility
Pressure ulcer stage III and IV
Falls and trauma
Catheter-associated infection
Manifestations of poor glycemic control
Importance of Communication
Effective communication is a factor in the likelihood of a
patient deciding not to sue a provider as it has impact on patient
satisfaction
Informed Consent is the result of effective communication
between the provider and patient. The patient needs to know
the possible outcomes of treatment, both good and bad, so as to
have proper understanding and expectations.
What if Unanticipated Outcomes Occur?
Disclosure of unanticipated outcomes is mandatory. The ethical
question is NOT should it be disclosed, but how and by whom.
Risk managers need to plan, prepare and educate staff to avoid
inappropriate disclosure
Enterprise Risk Management (ERM)
An approach to assessing and addressing risks from all sources
that either threaten the organization’s objectives or represent
opportunities to exploit competitive advantage.

Categories of Risk
Operational/Clinical Risks
Financial Risks
Human Capital Risks
Strategic Risks
Legal/regulatory Risks
Technological Risks
Natural Disaster/Hazard Risks
Difference from
Traditional Risk Management
Traditional Risk Management took a more clinically focused
approach and examined risks individually.
With ERM, the Risk Manager has a larger focus and more
strategic position. It begins with risk identification and
determination of the relative importance of the risk
ERM Process
ERM utilizes the steps in the traditional risk management
process
Identify and analyze the exposures to loss
Examine the feasibility of alternative techniques
Select the best technique
Implement the technique
Monitor and improve the risk management program
Quality and Risk Management
Historically Risk Management and Quality initiatives were seen
as separate.
Today, organizations utilize a more integrated approach,
recognizing that many risk management errors are breakdowns

in process (quality) rather than individual error.
Quality Management Techniques
Quality Assurance – a formal, systematic program by which
care given to patients is measured against established criteria.
Quality Management – encompasses monitoring and evaluating
quality issues, followed by changes in the system.
Total Quality Management – W. E. Deming
TQM focuses on the system not the individual
85/15 rule – 85% of problem is related to system failure and
15% is the fault of the people involved
Three premises:
Quality is important and can be measured
People are part of the solution not the problem
Change is fundamental and can be managed
Continuous Quality Improvement (CQI) – process used to
improve their ability to satisfy customer expectations.
Directs attention to the fundamental mechanism that drives a
process or system.
Focuses on techniques to accomplish positive change by
assessing a process that leads to an intervention.
Use of sentinel events

4 Stages for Process Improvement
Dr. Steven Speer recommends the following states to assist with
process improvement:
System design and operation
Problem solving and improvement
Knowledge sharing
Developing high velocity skills in others
Other Quality Tools from Industry
Lean Management focuses on reducing waste and eliminating
error in processes.
Six Sigma focuses on eliminating causes of defects or error and
minimizing variability in process.
Barriers to Quality
Management Initiatives
Separation of administrative functions
CQI implementation can be difficult as physicians tend to focus
on patients not administrative responsibilities
Hierarchical and bureaucratic structure makes empowerment
difficult
Lack of recognition of problem-solving initiative
Lack of vision of the desired outcome
Inflexible attitude of “this is how it’s always been done”
Quality Improvement Teams
Quality Improvement Teams (QIT) are change agents.
Can investigate and recommend improvements, many times in
conjunction with the risk manager who may or may not be a
member of the team.

Customer is Key
The quality improvement process views the customer as central
to its purpose.
It is imperative to know who the customer is and their
importance to providing care.
Note: the customer is not always the patient.
CQI and Labor Relations
Risk managers should make sure that any QIT or other CQI
program teams are reviewed and deemed allowable by the
NLRA.
Some teams may be viewed as labor organizations dominated by
the employer if not structured properly
Determining the Effectiveness
of Risk Management
There is currently no research to definitively demonstrate the
effectiveness of risk management programs.
However, risk management programs are important as adverse
events do happen, and there is a need to investigate and
implement strategies/improvements to minimize the risk of
adverse events recurring.
Program Evaluation
What are the areas of responsibility or functions defined for risk
management?
Which information or data are collected and available within
each of these areas of responsibility or function?
Can this information or data be categorized and analyzed
systematically to derive measures of effectiveness?

Use of Standards
A standard must be reasonable, achievable and measurable
Results standards: what is accomplished
Activity standards: means by which something is accomplished
Evaluation Tools
Root Cause Analysis
Failure Mode, Effect and Criticality Analysis
External Evaluation
The Joint Commission may evaluate a healthcare organization’s
risk management program during the accreditation process.
Third party payers may also evaluate risk management programs
to determine insurability of the organization.
Benchmarking with other organizations.
Practice Guidelines
Practice guidelines can set a standard of care to help minimize
risk
May be difficult to monitor
Risk increases as departure from stated guidelines can be a
source of liability
High Exposure Issues
Clinical Activities
Monitoring
Medical Records
Electronic Health Records

HIPAA
Credentialing
Withholding of Treatment
Disclosure
Summary
Quality and Risk Management overlap
Risk Managers can utilize quality techniques and reports to
assess risk and recommend improvements
Chapter 7: Assuring Safety and Security in Healthcare
Institutions
Safety and Security – Risk?
Health facilities that experience adverse events due to safety or
security issues can incur penalties ranging from large fines to
loss of accreditation.
An aggressive and well-organized safety and security
management program can help minimize risk of and adverse
event.
Regulation and Accreditation
Medicare and Medicaid require a participating healthcare
organization to satisfy the Conditions of Participation (CoP)
relevant to the management of safety and security.
Accreditation by the Joint Commission, DNV Healthcare Inc. or
HFAP ensures that the facility meets the CoP requirements
State Departments of Health also regulate safety and security in
healthcare organizations

Safety vs. Security
Safety can be a broad category with standard policies and
procedures throughout a facility or system.
Hand-washing policy
Use of Personal protective gear
Hazardous waste disposal
Security must be more site specific.
Safety and security policies sometimes conflict.
High Risk Events
A facility may incur major penalties if a “never” adverse event
occurs (an event that should not occur if appropriate
safety/security measures were in place)
CMS may not reimburse costs of a never event and many third
party payers have a non-reimbursement program as well.
Techniques for Managing
Safety and Security
Risk Assessment Estimate
Failure Modes and Effects Analysis (FMEA)
Root-cause Analysis (RCA)
Technological Redundancy
Crew Resource Management
Red Rules
Potential Environmental Hazards
OSHA has a list of the types of hospital-wide hazards and
provides information on how to prevent and respond to them
Three categories of hazardous materials
Biological

Chemical
Radioactive
Security: Unwanted Intruders
Use of high-tech solutions to manage visitor and employee
access
Automated turnstiles with card swipe readers for employee
entrances
Visitor areas/desk where all visitors enter and sign-in.
Employee ID badges
Secured areas
Potential Security Hazards
Theft of Patient Valuables/Employee theft
Infant abduction
Workplace Violence
Gangs
Patient Valuables
Provide a safe in the building to house valuables
Provide receipts for any valuable stored by facility
Encourage patients to leave valuables at home or give to family
to take home
Violence in the Workplace
Patients have a right to treatment but staff have a legal right to
a safe workplace
Watch for signs that may lead to violence (in patients, visitors
and staff)
Anger
Stress

Under the influence of drugs/alcohol
Gangs
Many health facilities treat victims of gang violence and
occasionally the dispute continues upon arrival at the facility.
Use of metal detectors is increasing to prevent entrance of
weapons into the health facility
Information Security
With increasing use of information management systems,
healthcare facilities must insure that the system itself is secure
from unauthorized access or violate HIPAA regulation
Entry to system is password or thumbprint protected
Use of firewalls to block unauthorized internet access
Use of Virtual Private Networks
Fire Safety
Health facilities must comply with NFPA standards for fire
suppression systems, fire barriers, smoke compartments,
detectors and alarms, and emergency exits and lighting
Defend in Place
Fire Safety Plans and Training
Facility Design and Operation
The design of the physical plant can help ensure safety and
security of the facility
Proper ventilation design can ensure indoor air quality and
safety
Use of improved technologies to keep water clean and prevent
growth of bacteria
Use of technologies to prevent scalding from high water

temperatures
Emergency Preparedness
Dedicated resources for emergency preparedness
Designation of a command structure
Culture of continuous training
Frequent and critiqued disaster drills
Constant updating of plan to reflect changing risk and
conditions
Types of Threats
Security
Utility Failures
Geologic
Structural
Other
Plan for Information System Continuity
As healthcare organizations rely more heavily on information
technologies, it is imperative that there be a specialized disaster
plan for information technology.
Backup data systems
Independent emergency power supplies
Alternative network communication
Summary
Safety and security incidents can be serious threats to the
financial well-being of the healthcare organization.
The Risk Manager must be aware of potential safety and

security situations and ensure policies and procedures are in
place to minimize the risk of an incident.
Chapter 1:
Risk Management Dynamics
Healthcare can hurt…
In the 1970’s, the fact that receiving healthcare services can
actually cause harm was brought to the forefront with the
Institute of Medicine report “To Err is Human: Building a Safer
Health Care System”:
In 2 studies, adverse events occurred in 2.9% and 3.7% of
hospitalizations
More than half of these adverse events were the result of
preventable medical errors
Extrapolation: > 1 million medical errors may occur each year
resulting in 140,000 deaths
More data about medical errors
Studies indicate the following:
Hospital employees recognize and report only 1 in 7 medical
errors that harm Medicare patients
Even after medical errors are reported and investigated, many
hospitals do not change their practices to prevent repetition of
the event
>50% of patients treated for side effects and other medication
related injuries were 65+ years old
Continued reporting of wrong-site surgeries

What can be done?
The Joint Commission recommended safety standards in 2001
that relate to:
Providing leadership
Improving organizational performance
Information management
Patient’s rights
It is imperative to monitor adverse events from 2 standpoints:
Quality of care
Legal responsibility to do no harm
How do we monitor adverse events and ensure patient safety?
Recognize and minimize instances where a medical error can
occur
This is the function of Risk Management
What is Risk?
Uncertainty about future events that may threaten the safety of
patients and the assets and reputations of providers.
What do we mean by assets?
People – patients, clinicians, volunteers, and employees
Property – buildings, facilities, equipment, and materials
Financial – revenue, reserves, grants, and reimbursement
Goodwill – health and well-being, reputation, and stature in the
community

What is Risk Management?
Discipline for dealing with the possibility that some future
event will cause harm.
An organized effort to identify, assess and reduce risks to
patients, visitors and staff
Objective of Risk Management
To reduce the risk of preventable accidents and injuries and
minimize the financial loss if one occurs
It provides strategies, techniques and an approach to
recognizing and confronting any threat faced by an
organization.
In other words…
What can go wrong?
What will we do to prevent harm and in the aftermath of an
incident?
If something happens, how will we pay for it?
What are the risks we
are trying to protect against?
Antitrust violations
Breach of contract
Casualty exposure
Defamation
Embezzlement
Environmental damage
Fraud and abuse
General liability

Hazardous substance exposure
Professional malpractice
Securities violations
Transportation liability
Worker’s compensation
So, what will be done?
In the Risk Management Process we will:
Identify Risk
Perform Risk Analysis
Implement Risk Control/Treatment
Finance Risk
Risk Identification
Continuous collection of information to search for the various
liability risks such as
Property risks
Casualty/liability risks
Employee benefit risks
Risk Analysis
Evaluating past experience and current exposure to limit the
impact of risk, keeping in mind that there are different levels of
Risk
Severity to the individual and/or organization
Number of people harmed or potentially harmed
Likelihood or frequency of occurrence
Risk Control/Treatment
Most common function of risk management programs

Risk Management programs should categorize potential liability
into 4 categories:
Bodily injury
Liability loss
Property loss
Consequential loss
Risk Control/Treatment
Risk Acceptance
Exposure Avoidance
Loss Prevention
Loss Reduction
Exposure Segregation
Contractual Transfer
There are many methods and techniques an organization can use
to minimize risk:
Risk Financing
An organization should have financing available to fund losses
and implement risk management activities
Self-insurance
Commercial insurance
Budgetary funds set for activities and/or losses
American Society of Healthcare Risk Management (ASHRM)
Components in a risk management program:
Designate risk manager
Access to all data

Organizational commitment
System for identification, review and analysis of adverse
outcomes
Ability to integrate and share data
Evaluate risk management program activities
Provide educational programs
Provide information on staff competency
Three Major Functions of Risk Management – Business
Orientation
Reducing the organizations’ risk of malpractice suite by
maintaining or improving the quality of care
Reducing the probability of a claim being filed
Preserving the organization’s assets once a claim has been filed
‘Red Flag’ Areas to Watch
Treatment Conditions
Patient Relations
Practice Management
Conduct of Staff
Risk Management Tools
for Identifying Risk
Incident Reporting
Occurrence Reporting
Occurrence Screening
Incident Reporting

System to identify events that are not consistent with the
routine operation of a hospital or routine care of patients
Occurrence Reporting
A policy listing specific adverse events that MUST be reports
Required by some states and insurers
Can increase identification of adverse events to 40-60%
Occurrence Screening
System that identifies deviations from normal procedures or
expected outcomes
Uses criteria to identify adverse events but does not rely on
staff reporting
Increases identification of adverse events to 80-85%
Risk and Quality of Care
There is sometimes overlap between these functions in the
healthcare setting.
Integrating risk management and quality assurance functions
can result in:
Maximization of the use of limited resources
Elimination of duplication
Developing new solutions to problems
Facilitation of training programs
Improvement of budget process
Specific Risk Management Functions
Incident Identification, Reporting and Tracking
State Mandated Incident Reporting
Incident Review and Evaluation
Take action to prevent recurrence of incidents

Internal Documentation
Credentialing and Privileging
Patient Complaint Programs
Risk Management Education
Summary
Risk Management is about reducing preventable adverse events
and minimize financial loss should such events occur.
There are many tools available to assist the Risk Manager.
Chapter 2:
Regulatory Environment
Most Regulated Industry
Health Care is one of the most regulated industries in the US.
It is vital to be aware of and understand what regulations may
affect the facility.
Standards
Statements concerning proper procedures taken in a given
situation:
Explicit or implicit
National or local
Validated or Consensual
Used or ignored
Periodically updated or static

3
Legal Standards
Judicial system (court decisions) provides initiative for
implementing standards public health rules
Disease reporting requirements
Immunizations
Worker’s comp
Licensing of professionals
Federal Mandatory Regulations
CMS
OSHA
HIPAA
EMTALA
Mammography Quality Standards Act
Safe Medical Devices Act
MedWatch
MWTA
EPA
Medical Waste Tracking Act
5
State Mandatory Regulations
Professional Licensure of Providers
Smoke-free Workplaces
Smoke-free Environment
Violence Prevention

Medical Waste Tracking Act
6
State Mandated Risk
Management Legislation
Risk Management Responsibility
Governing Body Involvement
Risk Identification
Risk Analysis
Risk Management Education
State Mandated Risk
Management Legislation
Sharing Information
Patient Grievance Procedures
Immunity and Confidentiality for Providers
Risk Management Follow-up Procedures
Reimbursement Standards
Payers set their own standards for reimbursement
Fee for service
Negotiated fees
Capitation
Prospective payment
RBRVS
Medicare - is a federal program so the standards are the same
across the US
Medicaid - is a state run program so each state sets its standards
for reimbursement

9
Medicare Incentives to Improve Quality
Evidence based medicine in now generally accepted as essential
to effective and safe medical practice.
This link was presented in 2 seminal works from IOM:
Crossing the Quality Chasm
To Err Is Human
Deficit Reduction Act 2003 and Beyond
Pay for Posting
Pay for Performance
Value Based Purchasing
Scores and Withhold Determination
False Claims Act
Anti-fraud activities
Lawsuits
Revocation of Medicare participation
Practice Guidelines
Accreditation Programs develop standards and facilities can
voluntarily apply for review
Joint Commission on the Accreditation of Healthcare
Organizations (Joint Commission)
National Committee for Quality Assurance (NCQA)
Many equate facility accreditation with quality
Medicare accepts a JCAHO accreditation as evidence that a
hospital meets Medicare conditions of participation

Summary
IGNORANCE of the Law is no excuse
Know the regulations
Identify which ones are pertinent to the facility
Ensure that appropriate policies are in place
Document compliance
Chapter 3:
Risk Management in Employment
Employment Relationship carries Risk
Risk to an organization is not limited to provider-patient
relationships
As in any business, the healthcare organization has
responsibilities to its employees. Many of which, if not
properly implemented/enforced, can lead to negative and
litigious results
Employment-at-Will
An employer may dismiss an employee hired for an indefinite
period of time for any reason or no reason at all without
incurring liability to the employee
Caveat: cannot discharge for an unlawful reason, such as racial
discrimination

Implicit Employment Contracts
Though most states follow the employment-at-will doctrine,
many organizations may unknowingly negate their ability to
apply this principle through
Employer policies (i.e. progressive disciplinary policy)
Oral assurances (i.e. looks like you have a bright future ahead
of you here)
Industry customs (i.e. after so many years in one position,
employees are promoted to the next level)
Employer conduct (i.e. allowing some employees more chances
to correct errors than others)
Burden of Proof
In civil litigation of discrimination, the burden of proof is
usually on the plaintiff -they must show:
Membership in a protected group
Satisfactory job performance or appropriate qualifications for
the job being sought
Receipt of discipline, termination or rejection despite having
the qualifications
Employees of another protected class were disciplined less
severely or the employer continued to accept application of
people who were no better qualified
Sexual Harassment
Unwelcome sexual advances, request for sexual favors or other
verbal or physical conduct of a sexual nature when it is one of
the following:
is a condition of employment
is the basis of employment decisions
interferes with work performance
creates a hostile work environment

The employer must be made aware there is an issue and then
take action. The employee cannot sue unless he/she has told
someone and nothing was done.
6
Minimizing Risk of Sexual Harassment
Organization must exercise reasonable care to prevent and
correct any sexually harassing behavior
Written policies/procedures
Documented staff training on policies/procedures
Consistently adhere to and enforce policies
Immediately investigate allegations of sexual harassment
Responsibility of the Employee
Employee must report occurrences of sexual harassment to
employer
Employer must be given the opportunity to investigate and take
corrective action
Though it is important that an employer investigate all reports
of sexual harassment, proactively addressing situations or
behavior that may be perceived as sexual harassment is
imperative.
If management is aware of a potential situation and does
nothing, the risk of litigation and penalty is increased
People with HIV or AIDS
are protected by the ADA
Persons with HIV disease, both symptomatic and asymptomatic,
have physical impairments that substantially limit one or more
major life activities and are, therefore, protected by the law.

Americans with Disabilities Act 1990
Definition of Disability:
A physical or mental impairment that substantially limits one or
more major life activities or a record of such impairment or
being regarded as having such an impairment.
The facility must determine the essential job functions of a
position and make reasonable accommodations for a disabled
employee.
Essential job functions and Reasonable accommodations – page
76
During an interview
1) Can’t specifically ask about disability during job interview
process.
2) Can ask if applicant can perform the essential functions of
the job with or without reasonable accommodations.
10
Due Process
When confronting alleged misconduct, there must be Due
Process:
A clear rule against the misconduct
The rule must be reasonable
A thorough and objective investigation
Notice of the charges and penalty
Opportunity to respond or appeal in some way
Worker’s compensation
Mutually beneficial social insurance system where the employer

takes care of an injured employee’s medical costs and part of
the salary in exchange for the waiver of the employee’s right to
sue.
Retaliation
Retaliation may be said to occur when an employee is subjected
to adverse employment action (i.e. termination) because of an
action he took that was within his rights (i.e. reported sexual
harassment)
Retaliation is more easily proved by the claimant than other
allegations. A claim includes:
The employee engaged in protected activity
The employer took adverse action against the employee
A causal connection exists between the protected activity and
the adverse employment action
Whistleblowing
Whistleblowing is the action in which an employee reports
employer misconduct to legal authorities. It is supported by
The Elder Justice Act
False Claims Act
Whistleblowers do NOT have to report the misconduct
internally to management first
Social Media
As employees become more adept in using social media,
employers must take care in policing so as not to impinge upon
freedom of speech
Employers need to implement policies that clearly define what
is and is not permitted during work hours in terms of us of
company computer

Define confidential information that is not to be shared
Prohibit defamation, harassment and use of questionable
websites
Background Checks
Background checks are required in many states and help
minimize the risk of Negligent hiring.
Healthcare organizations must perform due diligence w hen
hiring:
Background check for criminal record or other disqualifying
actions
Validating credentials
Incivility and Violence
Poor and/or disruptive behavior (some of which is violent) by
physicians and nurses is well documented.
Ignoring this problem can increase the risk of patient and
employee safety as well as of litigation and penalty
Defamation
As part of their due diligence, prospective employers will
contact previous employers to requesting a reference. This may
cause a dilemma for the previous employer:
Should they provide true information about the applicant and
perhaps open the organization up to defamation charges?
If they do not disclose information regarding the potential for
future harm to patients, is the previous employer liable shoul d
harm take place?
Recommended Risk Management Strategies for Employers

Address issues of microinequity which, alone may appear of
little concern, but over time have large implications to
employee morale, retention and patient safety
Nurture employee engagement
Management should be proactive in monitoring provider and
employee behavior
Be consistent in application of policy
Summary
It is crucial to understand employment laws and how they relate
to the facility
Ignorance may lead to increased risk of employment related
lawsuits
Patient safety may also be at risk if employment laws are not
followed
Management staff and employees must know and follow
employment policies
Chapter 6: Ethical Issues
for Risk Managers
Why is Ethics Important
to Risk Management?
For many issues, there are laws to guide how facilities need to
deal with ethical situations
Abortion -- EMTALA
HIPAA -- Civil Rights Act
For other issues, no legal guidelines are available.
The Risk Manager needs to assist the facility to develop
appropriate procedures for dealing with ethical issues

Ethical Issues
Ethical Issues have become increasingly important to risk
management.
Some issues are bound by law while others are not, leaving the
risk manager to confront and solve them to the best of their
ability.
Many healthcare organizations establish ethics committees to
assist with managing ethical situations
History of the Ethics Committee
The forerunners of Ethics Committees:
Dialysis committees of the 1960s
Abortion and Sterilization committees
Impetus for establishing today’s Ethics Committees sprang from
high profile cases
Karen Ann Quinlan
Baby Doe
Growth in the field of Bioethics has also provided support for
Ethics Committees
Growth of Ethics Committee
The healthcare industry has witnessed a growth in use of ethics
committees due, in part, to the focus of accrediting bodies on
patients’ rights and ethical issues during the survey process.
Organizations with ethics processes and oversight in place may
see better outcomes for patients
Role of the Ethics Committee
Education
Policy Development

Consultation
Composition of the Ethics Committee
Generally interdisciplinary (the committee’s most important
aspect)
May also include a member of the clergy, the healthcare
organization’s attorney, a risk manager, and/or administrative
personnel.
Ethical Guidelines for Risk Managers
Autonomy (Self-determination)
Patients have the right to make their own healthcare decisions.
Beneficence
Obligation to do good for the patients
Justice
Obligation to treat all in an equitable fashion
Ethical Standards for Decision Making
Decisional Capacity
An individual’s ability to weight the relative benefits, risks or
burdens of treatments plans and make an informed decision
Substituted Judgment
Applies when an individual who previously had decisional
capacity has either temporarily or permanently lost that
capacity.
Seeks to find what that person would have decided in the
circumstance
Ethical Standards for Decision Making
Best Interest

Applies when an individual never had decisional capacity or
when there is no way of knowing the individual’s wishes
Makes use of the ‘reasonable person’ standard
Informed Consent
In keeping with the concept of autonomy, clinicians are
obligated to provide patients with information regarding their
condition and possible treatments in order for them to make an
informed decision as to their choice of healthcare services.
Code of Ethics
Almost every profession of healthcare providers provides its
members with a set of standards detailing the values, duties and
ethical responsibilities of the profession.
A practitioner’s Code of Ethics is a set of guiding principles
Everyday Ethical Issues
Many ethical dilemmas arise in providing healthcare services
for the following vulnerable populations:
Perinatal
Pediatric
Geriatric
Terminal
Summary
Risk managers work to protect their organization from litigation
and should therefore participate in cases of ethical issues.
Institutional ethics policies and consultation with an Ethics
Committee can assist the organization through ethical situations
and may reduce legal liability.

Chapter 5:
Financing Risk
Financing Risk
Risk exists for a healthcare organization is there is an event or
action that can have impact on its financial or operational
performance.
Healthcare organizations work to balance this by covering the
financial risk or transferring it.
Financing risk means to ensure that adequate funds are available
to cover costs related to unexpected events
Transferring risk is accomplished by purchasing insurance.
To Finance or Transfer Risk
Management of risk is paramount to the healthcare organization
and should be tailored to the specific needs and structure.
The healthcare organization must determine what risk can and
should be internally financed versus what risk should be
transferred
The goal of risk management is to add value to the organization
by appropriately and wisely managing risk
Costs of Adverse Risk
Defense Costs
Settlement or Judgment
Loss Reduction

Employee Morale
Opportunity Costs
Identifying Risk
Risk managers work to identify areas of risk exposures in order
to minimize the likelihood of adverse events as well as how to
cover costs if they should occur by monitoring:
Adverse incident reports
Patient safety data
Quality indicators
Insurance company claims
Employee satisfaction/complaints
Patient satisfaction/complaints
Accreditation survey results
Financial reports
Professional literature
Financing the Risk
The fiscal well-being of the organization is the determinant of
how best to managing the financing of risk.
Internal financing is not prudent if the organization does not
have available funding to cover risk.
External financing of risk is less costly yet still is a financial
expense to the organization and must be weighed as to how
much coverage is needed.
Analyzing How to Finance Risk
Healthcare organizations evaluate cost-effectiveness of
available risk financing alternatives through:
Quantitative analysis measures an event’s risk variables
Qualitative analysis measures the event’s impact on the
organization

Insurance Options
Traditional Insurance Companies
Fairly common
Standard coverage
Cost is relative predictable
Events not covered by insurance remain the responsibility of the
healthcare organization
Self-Insurance or Self-Funding
Requires a significant amount of capital and financial reserves
Choosing an Insurance Plan
Make sure the plan meets your needs in terms of:
Portability
Flexibility
Services provided
Choose a company based on:
Experience -- Staffing
Technology -- Procedures
Costs -- Protection
Total Cost of Risk
In order to balance the need for risk financing with the cost,
healthcare organizations need to estimate the total cost of risk
by analyzing:
Cost of risk transfer
Cost of risk retention
Administrative costs associated with managing both the
exposure to risk and claims if adverse events occur
Areas of Exposure
Automobile Liability
Aircraft Liability

Business Interruption and Income
Crime
Cyber Liability
Directors/Officers Liability
Emergency Evacuation
Employment (injury/illness, benefits, practices)
Areas of Exposure
Fiduciary Liability
General Liability
Licensing Board Discipline
Media
Medical Equipment Breakdown
Patient Confidentiality
Professional Liability
Property
Insuring Agreements
Insurance company will pay sums that the insured becomes
legally obligated to pay.
Occurrence Policies cover all injuries that occurred during the
policy period, regardless of when they were reported.
Claims Made policies cover injuries reported during the policy
period that occurred after the policy retroactive date.
Summary
Financing of Risk is a major component of Management.
Determining the method of financing risk as well as selecting
the appropriate liability insurance company and plan is essential

HAS-6505 Health Care Risk Management: Assignment Week 4
Case Study: Chapters 8 & 9
Objective: To judgmentally reveal your knowledge of the most
common Patient Safety Tools integrating quality and Managing
risk, the role of the communication on Medical malpractice and
your ability to apply them to your Healthcare Organizations. .
The analytical exercises will improve students’ understanding
and ability to think critically about the public relations process,
and their problem-solving skills. As a result of this assignment,
students will be better able to understand, analyze and diagnose
Risk Management issues and strategies to prevent them.
ASSIGNMENT GUIDELINES (10%):
The students will complete A Case study assignmen ts that give
the opportunity to synthesize and apply the concepts learned in
this and previous coursework to analyze a real-world scenario.
This scenario will illustrate through example the practical
importance and implications of various roles and functio ns of a
Health Care Administrator and Risk Management. The
assignment will be 3-4 pages long reflecting your understanding
and ability to apply the readings to your Healthcare
Organization. Each paper must be typewritten with 12-point
font and double-spaced with standard margins. Follow APA
style 7th edition format when referring to the selected articles
and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1. Introduction (25%) Provide a brief synopsis of the meaning
(not a description) of each Chapter you read, in your own
words.
2. Your Critique (50%)
Case Study:
Surgical mistakes can result in serious medical complications

for patients. Errors by surgeons can run the gamut from
performing unnecessary surgery on a patient, to negligent
technique in carrying out the procedure -- even leaving medical
instruments inside a patient. Many (though not all) common
surgical mistakes rise to the level of medical negligence and can
form the basis of a medical malpractice lawsuit against the
surgeon and any other responsible party. To give you an idea of
what these cases might look like, this article provides a
snapshot of three real-life surgical mistake medical malpractice
cases.
Sophia Savage Case
In 2018, Sophia Savage underwent a hysterectomy at the Three
Rivers Medical Center in Louisa, Kentucky. During the surgery,
a surgical sponge was left inside her abdomen, but the presence
of the sponge wasn't revealed until 2020, when Savage had an
x-ray after she reported pain in her stomach. She had to undergo
additional surgery to remove the sponge. During this procedure
it was discovered that the sponge was lodged in her lower
intestine. The doctors had to remove a 49 centimeter section of
her small intestine in order to remove the sponge. Due to this
she suffered from lingering abdominal pain, diarrhea, and
constipation as well as bouts of anxiety and depression. She and
her husband Darrell file a surgical mistake lawsuit against the
Three Rivers Medical Center. The court awarded them $2.5
million in damages. Her husband Darrell was awarded
additional $500,000 for loss of consortium.
1. Discussion, designate and remark the Risk Management
strategies and recommendations to prevent this Medical
Malpractice Situation happen again.
3. Conclusion (15%)
Briefly summarize your thoughts & conclusion to your critique
for the case study. How did these articles and Chapters impact
your thoughts on Inform Consent and Patient Education?

Evaluation will be based on how clearly you respond to the
above, in particular:
a) The clarity with which you critique the chapters;
b) The depth, scope, and organization of your paper; and,
c) Your conclusions, including a description of the impact of
these Chapters on any Healthcare Organization.
ASSIGNMENT RUBRICS
Assignments Guidelines
10 Points
10%
Introduction
25 Points
25%
Your Critique
50 Points
50%
Conclusion
15 Points
15%
Total
100 points
100%
HSA-6505 Health Care Risk Management: Assignment Week 3
Student PowerPoint Presentation: Chapter 6 & 7
Objectives:The presentation assignment has several goals. It
requires students to apply concepts from Ethical Issues for Risk
Managers and Assuring safety and Security in Healthcare

Institutions. The process of Safety and security will allow
students to practice close the Risk assessment and Failure
modes of techniques for managing, a skill they will be using as
Healthcare Administrator. In addition, presenters learn as they
teach others and contribute multiple critical perspectives to
class discussion.
Format and Guidelines:The student will create a Power Point
Presentation from Chapter 6, Chapter 7 of the Textbook related
to Week 3 (Choose your desire topic form these chapters).The
Presentation should have a minimum of 12 slides, including
Title Page, Introduction, Conclusion, and References.
The student must use other textbooks, research papers, and
articles as references (minimum 3).
Due date: Sunday, March 21, 2021 at 11:30PM.
1. Title Page: Topic Name, Student Name
2. Introduction: Provide a brief synopsis of the meaning (not a
description) of the topic you choose, in your own words
3. Content Body: Progress your theme, provide Material,
illustrations and Diagram to explain, describe and clarify the
Topic you choose.
4. Conclusion: Briefly summarize your thoughts & conclusion
to your critique of the articles and Chapter you read.
5. References: The student must use other textbooks, research
papers, and articles as references (minimum 3).
Florida National University
Student PowerPoint Presentation: Chapter 7 & 8

Grading Sheet
Student Name __________________________________
Date_____________________
Category
Possible Points
Actual Points
Presentation style and content.
3
Distributed bibliography w/ 3 additional readings
2
Inclusion of diversity content Pictures, Graphic, etc.
2
Length: Minimum 12 slides
1
Required Format
2
TOTAL
10
Page | 3
Critical Reflection Paper: Chapters 4 & 5
Objective: To critically reflect your understanding of the most

common policies and procedures of risk management, the role
of the communications to reduce the risk and improve patient
safety and your ability to apply them to your Healthcare
Organizations.
Students will critically analyze the readings from Chapter 4 & 5
your textbook. This assignment is designed to help you review,
critique, and apply the readings to your Healthcare Organization
as well as become the foundation for all of your remaining
assignments.
You need to read the chapters assigned for week 2 and develop
a 2-3-page paper reflecting your understanding and ability to
apply the readings to your Healthcare Organization. Each paper
must be typewritten with 12-point font and double-spaced with
standard margins. Follow APA style 7th edition format when
referring to the selected articles and include a reference page.
(not a description) of each Chapters you read, in your own
words.
What is your feedback to the content of the chapters?
What did you acquire about Communication and its impact on
malpractice litigation?
What did you absorb about Insurance Models and Risk
Retention?
Did these Chapters change your thoughts about Social Media
Challenges and Clinician-Patient Online Interaction? If so,
how? If not, what remained the same?
3. Conclusion (15%)
of the Chapter you read. How did these articles and Chapters
impact your thoughts on Inform Consent and Patient Education?

a) The clarity with which you critique the articles;
these articles and Chapters on any Healthcare Organization.
ASSIGNMENT RUBRICS
10 Points
10%
Introduction
25 Points
25%
Your Critique
50 Points
50%
Conclusion
15 Points
15%
Total
100 points
100%
Page | 2
HAS-6505 Health Care Risk Management: Assignment
Week 1
Critical Reflection Paper: Chapters 1, 2, 3
Objective: To critically reflect your understanding of the
readings and your ability to apply them to your Health care

Setting.
Students will critically analyze the readings from Chapter 1, 2
and 3 in your textbook. This assignment is designed to help you
review, critique, and apply the readings to your Health Care
setting as well as become the foundation for all of your
remaining assignments.
You need to read the chapters assigned for week 1 and develop
a 2-3-page paper reflecting your understanding and ability to
apply the readings to your Health Care Setting. Each paper must
be typewritten with 12-point font and double-spaced with
standard margins. Follow APA style 7th edition format when
referring to the selected articles and include a reference page.
(not a description) of each Chapter and articles you read, in
your own words.
What is your reaction to the content of the chapters?
What did you learn about Risk Management Activities and
Tools?
What did you learn about Legal Standards and Risk
Management related with OSHA and HIPAA?
Did these Chapter change your thoughts about Risk
Management in Employment? If so, how? If not, what remained
the same?
3. Conclusion (15%)
of the Chapter you read. How did these articles and Chapters
impact your thoughts on Regulatory Environment, and
Institutional Imperative?
a) The clarity with which you critique the chapters.

these articles and Chapters on any Health Care Setting
ASSIGNMENT RUBRICS
10 Points
10%
Introduction
25 Points
25%
Your Critique
50 Points
50%
Conclusion
15 Points
15%
Total
100 points
100%

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