Healthcare Risk Management Week 2021: What Healthcare Managers Should Know

Healthcare risk managers are a critical aspect of any modern healthcare organization. They identify risks that could lead to serious safety events and also play an active role in helping a healthcare organization navigate clinical, risk financing, regulatory, and business issues.

Healthcare risk managers are often the go-to professional in a crisis, acting as a liaison between providers, patients, families, organizational leaders, and the community. Effective healthcare risk management saves lives, prevents errors, lowers costs, optimizes outcomes, and boosts public health. On the heels of the Covid-19 pandemic, it’s never been more important.

This year’s Healthcare Risk Management Week (HRM Week) takes place from June 21-25, 2021. Hosted by the American Society for Healthcare Risk Management (ASHRM), it’s a time to recognize the important work of healthcare risk management professionals in the workplace and in the community. This year’s theme is Prepared for the Present, Planning for the Future.

To learn more about the importance of healthcare risk management for healthcare managers, and what it takes to effectively manage risk in a healthcare environment, read on.

Eric S. Swirsky, JD MA, is a clinical associate professor in the Department of Biomedical and Health Information Sciences at the University of Illinois Chicago (UIC), where he also serves as director of graduate studies and PhD program director. Using his unique blend of experience and knowledge, Swirsky teaches courses in communication skills, professionalism, and ethics and legal issues in health sciences. His scholarly interests revolve around the ethical conundra attendant to human interaction with computers and data.

As an ethicist-attorney, Swirsky serves on UI Health’s Ethics Committee, the Research Ethics Consultation Service, the editorial board of the American Journal of Bioethics, and the Board of Directors for the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).

“Risk management is a systematic approach to identifying, analyzing, and responding to risks, and trying to ensure that outcomes have maximal benefit,” says Eric S. Swirsky, JD, a clinical associate professor in the Department of Biomedical and Health Information Sciences at the University of Illinois Chicago (UIC). “We’re going to make mistakes, and not every risk is going to be averted. But that’s not the point. The focus needs to be on maximizing benefit rather than trying to cut loss. It can lead to the same outcome, but the attitude is different.”

Healthcare managers are presented with a unique set of variables: a responsibility to institutions and providers, a responsibility to legal and regulatory guidelines, a responsibility to the patient community, and a responsibility to operate a profitable business. Those responsibilities each come with associated risks that can and often do conflict. Based on those risks, it’s up to the healthcare manager to identify, research, negotiate, and execute decisions that provide the most benefit to the most people.

“It’s related to negotiation skills,” Swirsky says. “And an essential part of negotiation skills is the ability to meet people’s needs and interests where they are. You have to be able to speak their language and give things that people want. This applies to all stakeholders: patients, providers, and the C-suite. So how do you, as the grape between these large elephants, keep from getting squashed? You have to be able to navigate all of these very difficult areas.”

“Communication skills are essential in risk management,” Swirsky says. “We need to make sure we are listening to people and speaking with people in ways that are meaningful.”

Communication in healthcare risk management contains multitudes: managers need to be able to give and receive feedback; they need to be adept at delivering both good and bad news; and they need to pivot discussions from points of disagreement to points of mutual desire. While some people mistake communication skills as simply the ability to get across one’s own message, the best managers know that effectively understanding someone else’s message is equally important.

“Because of the tenuous position they play with very powerful players and the great amount of risk that they’re trying to manage, healthcare risk managers need to understand conflict management,” Swirsky says. “That means knowing how to deal with conflict between other people, and then between you as the risk manager and other people. But it also means moving away from a zero-sum game and towards a collaborative relationship where we’re all working with a focus on maximizing community health and benefit for all.”

“An understanding of technology is a professional necessity in healthcare risk management,” Swirsky says. “The amount of data that’s out there is a rich source of information that can be leveraged to the benefit of risk managers. The risk manager’s best friend is information.”

The healthcare industry is one of the biggest producers of recorded data and also one of the biggest consumers. As a healthcare manager, being data-driven is crucial, as is fluency in the tech solutions adopted by the healthcare industry.

But healthcare managers also have to understand the limitations of the tech and the data that they’re using. In some cases, the limitations are obvious, with privacy concerns perhaps the most glaring issue. But other challenges are more innocuous, having arisen from subtle differences in the priorities and incentives of different healthcare stakeholders.

“Electronic medical records (EMRs) have become quite adept at capturing fees and charges,” Swirsky says. “On the other hand, the literature reflects quite well that the modern EMR is not as useful for coordinating care, or for letting providers know what’s going on with the patient with data that’s immediately actionable. EMRs have become a data behemoth whose primary utility is billing documentation and capturing fees.”

Healthcare managers need to align themselves with professionals who also understand how to use tech and data to improve public health. Health informaticians and health information managers are important allies. But it’s also important to remember that the data doesn’t tell the whole story, especially when it comes to health disparities.

“Particularly with the Covid-19 pandemic, we’re seeing the disparities that exist between different communities,” Swirsky says. “But you don’t see the disparities in the data, necessarily. Sometimes it’s what’s missing from the data, what’s not there.”

“It’s very important for risk managers to be able to engage with and have skills related to decision-making,” Swirsky says. “Decision-making is a science, and it’s absolutely essential.”

The Covid-19 pandemic shone a light on health disparities as well as the dilemmas healthcare managers face in times of crisis. Healthcare facilities had to maintain patient and healthcare worker safety while reducing the spread of infection and managing the risks, needs, and challenges of all stakeholders.

Healthcare is a business in the US, and healthcare managers need to meet a financial bottom line. But more so than any other business manager, healthcare managers engage with a human element, which acts as a different bottom line. Negotiating the boundaries and risks where these two bottom lines meet is the hallmark of an effective healthcare manager.

“Healthcare risk managers play a role in democratizing data, making it useful for more people, and addressing data gaps and disparities,” Swirsky says. “But healthcare risk managers also use their role to care for families in need. How can we use risk management as a caring response to patients and families in need? That should be the focus of all members of a healthcare team, and healthcare risk managers are essential members of that team. What I’d hope to see is that the future would be a focus on maximizing benefit for community health rather than mitigating loss for an institution.”

As the field of healthcare continues to evolve, so do the best practices of effective healthcare risk management. To learn more about the current state of healthcare risk management, and where it’s going, check out some of the resources below.

• American Society of Healthcare Risk Management (ASHRM): Founded in 1980, ASHRM is a professional membership group of the American Hospital Association (AHA) that boasts nearly 6,000 members. Check out their healthcare risk management professional overview here.
• What Is Healthcare Risk Management? (NEJM): Published in 2018 in the New England Journal of Medicine, this article covers the key concepts of healthcare risk management, including enterprise risk management (ERM) as it applies to healthcare facilities and healthcare professionals.
• Journal of Healthcare Risk Management (JHRM): Published on behalf of ASHRM, this journal publishes work related to evidence-based health care risk management and enterprise risk management.