Successful Navigation Through an Adverse Risk Environment

By Kevin Klauer, DO, EJD, FACEP
May, 2019

Editor’s Note: “Successful Navigation through an Adverse Risk Environment”, presented by Dr. Kevin Klauer, is one of our two live Risk Education options for SVMIC policyholders and staff. Using an interactive format, Dr. Klauer engages attendees and explores the multiple high-risk features of common clinical presentations that can quickly deteriorate into urgent medical situations.

Clinical risk management is a top concern among healthcare providers, hospital systems, and other health organizations. The risk environment is continually evolving, requiring an ever-shifting focus and anticipation of new issues. One component of successful navigation tends to remain the same – designing and maintaining effective systems that fit within the practice environment’s culture. Everyone who works in a hospital or clinic faces risk and often the trick is to recognize it and be able to respond accordingly to minimize the impact of an unsafe situation or environment. Sounds simple, right? It can be if everyone’s goals are aligned. Regardless of the healthcare team’s size or resources, with a dedicated team of healthcare professionals trained to survey situations for potential risk and an administration that stands ready to investigate and evaluate appropriate measures, a culture of safety will become the norm.

An example is an EHR that may employ poor clinical decision support or unnecessary alerts. Many clinicians wonder how to address these concerns with administration without being labeled as disruptive. One strategy could be to have a standing agenda item or create a task force to propose reasonable solutions. Both involve members of the healthcare team and administration, while keeping the focus on the issue. The desired result of minimizing existing risk and taking steps to avoid anticipated risks can be realized.

Today’s medical practice environment also presents challenges with the increasing number of advanced practice providers. As expected, with the rapid influx of providers, there will be “growing pains” as we define the most effective collaborative workforce models. With the benefit they provide to our healthcare system comes a number of legal and regulatory demands. Many physicians and advanced practice providers are unclear about the roles and responsibilities with respect to supervision or collaboration. Understanding scope of practice, regulatory requirements, and developing a quality improvement plan are crucial to determining best practices when collaborating with or supervising advanced practice providers.

Other risks facing healthcare providers are not generated by or completely within the provider’s control. An example is a patient expecting to video or audio record the entire medical encounter. While there is much debate about such recording of the medical interaction, it is certainly a reality worth addressing. Rather than allowing for unfettered access, or strictly prohibiting recording, practices may consider a policy outlining a mutually agreed upon time to record, such as the discharge discussion.

While clinical risk management is a huge concern, there are strategies and tools for recognizing and handling these situations. I will address these issues and more at Risk Education seminars beginning in June and running through September. Non-clinical risk management principles affecting the practice of medicine and the associated liability exposures involved in each will also be covered. Closed claims analyses, with actual cases; the current evidence supporting best practices; and solid recommendations for risk mitigation will be provided. This seminar takes its cues from the audience, engaging in practical, thought-provoking dialogue on a variety of topics. See a full seminar schedule and register to attend here.


Kevin Klauer, DO, EJD, FACEP

About the Author

Kevin Klauer, DO, EJD, FACEP was elected to the American College of Emergency Physicians, Board of Directors in October 2016. He serves as chief medical officer, Hospital Based services, chief risk officer, executive director of the Patient Safety Organization, and the medical director for the Medical Call Center for TeamHealth. He is a clinical assistant professor at The University of Tennessee and Michigan State University College of Osteopathic Medicine. 


The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time.