What comes to mind when you hear the term “risk management”?
As nurses, our typical first response is “patient safety,” or we think about nurse roles such as patient safety officers. Most don’t realize though, that the original focus of risk management was preventing loss; mainly the loss of resources. These resources were primarily related to finances, property and human resources (our staff), and Risk Managers were charged with identifying ways to enhance processes in organizations in order to increase efficiencies, leading to higher productivity and lower rates of avoidable loss.
Although nurses may be more familiar with what is considered “clinical risk management” — processes we have in place to help identify potential risk to patient safety and/or quality — clinical risk management did not become a predominant responsibility for risk managers until the late 1990’s. They took on this role after the Institute of Medicine report “To Err is Human: Building a Safer Health System” highlighted the need to focus on patient safety. This report stated that as many as 98,000 deaths occurred each year in hospitals due to medical errors. The IOM’s recommendations to address safety concerns moved from the traditional “who” to blame to “what” to blame; they recommended that organizations review their processes to determine what systems issues were creating unsafe environments where clinicians were vulnerable to errors.
In recent years, the role and responsibilities of the Risk Manager have evolved further to assume oversight for both enterprise and clinical risk management. These roles are important because organizations must be proactive in recognizing vulnerabilities within their clinical and non-clinical operations. They have obligations to forecast, plan and implement processes to enhance organizational efficiency and effectiveness, decrease financial risk, ensure quality care, provide a healthy work environment, and positively impact patient safety.
Is it a big job? Absolutely! How does a Risk Manager do all of this?
Successful Risk Managers do this through the work of the entire team. As nurses, we consider ourselves team members whether we are formal members of a “team” or not, and this makes nurses well-suited to the role of Risk Managers.
Nurses are well prepared and in the best role to see ways to improve processes and increase efficiency; we use, or manage the use of, most supplies in our organizations and can spot ways to decrease costs, improve the way supplies are used and identify how our organizations can save money on supplies and services. We are also most often the first to recognize actual and potential safety issues for our patients, staff and others in our organization, and we naturally become clinical risk managers. We not only recognize these issues but most often know how best to address them and resolve them.
I have been a nurse for approximately 34 years, serving in roles from the bedside as an ICU staff nurse to the boardroom as Chief Nursing Officer at large academic medical centers and many roles in between. These roles have allowed me to personally experience, witness and lead as risk management has evolved. Cultures of blame and punishment have changed to environments of improvement and learning in most organizations. Nurses have been, and should continue to be, leaders in this transformation. We are in the best position and have the knowledge and skills required to carry on the mission of transforming healthcare into the next century.
June 17 – 21 is National Risk Management Week. Let’s challenge ourselves and improve the care we provide our patients, enhance the work lives of our staff, and improve the efficiency of our organizations by adding the title of “Risk Manager” behind our names and seeing our work through a different lens to make a difference.
Greg Eagerton, DNP, RN, NEA-BC, joined UAB School of Nursing in November 2017. He brings more than 30 years of experience in the Veterans Affairs Health System, including more than 17 years as a Chief Nursing Officer, to the position of Nursing Health Systems Leadership Specialty Track Coordinator. During his time at the Durham, North Carolina VAMC and Birmingham VAMC, Eagerton led the way in implementing the role of Clinical Nurse Leaders in a practice setting. His research and published works also involve leadership and partnerships to improve quality care for veterans.