04/12

Clarity Group Partners with the National Rural Health Association

Healthcare News and Trends

Patient Safety Awareness Week - Be Aware for Safe Care

Clarity White Paper Focuses on Recent OIG Report

To learn more about the OIG report and new ways to think about incident reporting tools, read the rest of the White Paper: OIG Reports "Hospital Incident Reporting Systems Do Not Capture Most Patient Harm" - A Call to Action for Healthcare Providers and a Positive Push for PSOs

Hospitals Employ Increasing Numbers of Physicians - Understand the Risks and a Possible Solution

Historically, it has been common for employed physicians to be insured under the hospital's self insured retention, and while this has been a simple and expedient solution, it might not be the best way to manage the medical malpractice exposure. Here are some additional areas to consider: 

• By folding the physicians into the hospital's policy, the Self Insured Retention (SIR) and limits of liability, which are often greater than what is statutorily required for physicians by the state, are exposed to allegations of negligence that result from office-based practice in which the hospital could potentially have no involvement, thereby exposing much higher limits in a potential medical malpractice action.
• So far, excess carriers and reinsurers have not increased premium to cover the additional exposure with increasing numbers of physicians being added to the hospital's policy, but this situation might not last much longer.
• Hospitals are unable to properly quantify the premium associated with physician risk, which impacts the expense allocation made to the physicians and their practices.
• Hospitals are unable to offer insurance for prior acts when bringing new physicians on board, which increases the purchase costs as tail coverage must be purchased from the previous physician insurer and potentially impedes the acquisition process.
• When physicians leave the employment of the hospital or the physician retires, the hospital is unable to provide insurance for tail coverage other than indemnification through the SIR. 
• Hospitals are not able to bring contracted physician groups into their SIR, which may impact the overall market strategy of the hospital. 

A New Solution that Supports the Acquisition Strategy and Provides Flexibility and Accountability

Clarity Group, Inc. is working with Health Care Casualty RRG, Inc., a Risk Retention Group domiciled in Washington, D.C., which for the first time is making itself available to provide professional liability coverage for the employed physicians of qualified healthcare systems. Clarity has been the insurance operations manager of this RRG since its inception in 2005; the company is well established and has an excellent performance history. The HCCR vehicle gives healthcare organizations a powerful tool that:

• Meets their insurance needs for the employed physicians of the organization;
• Allows for actuarially determined premium allocation for each physician;
• Enables claim settlements and expenses to be properly allocated to the individual physician and practice;
• Allows for the ability to use a US based carrier and the possibility to cross state lines to increase the organization's market presence;
• Allows for the potential to use their hospital captive insurance company as a reinsurer of the RRG for the portion of the exposure related to the hospital's physicians;
• Provides the ability to attract new physician groups and provide tail coverage as needed;
• Segregates the physician risk from the hospital based risk exposure and helps protect the SIR and excess limits of the hospital;
• Enables the hospital to participate in a strong Risk-Quality-Safety program to support mitigating risk exposure in the ambulatory settings;
• Enables the hospital to offer the insurance product to contracted physician groups as the hospital strategy evolves.

If you would like more information on the Health Care Casualty RRG, Inc. Employed Physician option, please contact Drew Becker at dbecker@claritygrp.com or view our brochure.

Understanding Hospital Professional Liability Claim Costs

Clinical Risk Management Issues

It has been estimated that 80% of serious preventable adverse events involve miscommunication between caregivers during a patient handoff. Since handoff communication has become such a serious issue, the Joint Commission added a requirement to the 2006 National Patient Safety Goals that said hospitals need to implement a standardized approach during the handoff process. Even though there has been an increase in emphasis on the importance of effective handoff communication, these situations still occur resulting in patient harm.

Sample Areas of Potential Risk in Handoff Communication 

• Poor handoff environment - distractions, interruptions, noise
• Test results pending at the time of handoff
• Reports that are amended after the handoff
• Incomplete information

Short Self-Assessment to Evaluate Your Handoff Communication

• Have you developed a standardized process for handoff communications tailored to the specific handoff communication?
• Do you follow up your verbal handoff communication with written communication?
• Do you summarize and repeat back information that has been communicated to ensure accuracy?
• Do you devote adequate time to the handoff communication?
• Have you implemented the use of forms and checklists to ensure that important information is provided?

Patient Safety Organizations

4th Annual Meeting of PSOs - April 10-11, 2012

AHRQ Common Format Utilization:  Moving From Analysis to Action

Tom Piotrowski, RN, MSN, NE-BC, CSSGB, Executive Director of Clarity PSO, a division of Clarity Group, Inc. spoke at the 4th Annual Meeting of PSOs about the use of the AHRQ (Agency for Healthcare Research and Quality) Common Formats aggregate report templates to advance event reporting and improve patient safety in the healthcare setting. Clarity was asked to present Common Format project data as a result of the success we have seen through these common reporting templates.

Clarity PSO has been able to work with its contracted providers to adopt the Common Formats for a number of event-specific templates. The term "Common Formats" refers to the common definitions and reporting format that allow healthcare providers to collect and report patient safety events that occur in acute care hospitals and skilled nursing facilities in a standardized method. The result has been highly valued aggregate reports where hospital providers can compare several aspects of clinical performance related to patient safety. In addition, Clarity PSO has been able to harness the power of these aggregate reports to begin driving real improvements in the delivery of care.

"Clarity PSO has been on the forefront of progressing AHRQ's PSO model and values since its inception. We are very excited to have the opportunity to speak about our work with healthcare providers and how they have successfully utilized the AHRQ Common Formats. In light of the recent OIG Report, which states that only 14% of patient harm events are captured annually, this is an important time to discuss better utilization of these templates for the overall goal of improving patient safety," states Mr. Piotrowski.

To learn more about the AHRQ Common Formats and how they have driven change, view the presentation slides.

Software Developers Meeting - AHRQ Common Formats - April 12, 2012

Project Management Success: Adoption of the AHRQ Common Formats in Safety Event Reporting

Jessica Riley, Project Manager of Clarity PSO, a division of Clarity Group, Inc. and Craig Russell, VP, Information Services & Products of Clarity Group, Inc. spoke at the Software Developers Meeting - AHRQ Common Formats on April 12, 2012. During their presentation, Jessica and Craig discussed the process Clarity uses to help providers make the transition to the AHRQ Common Format templates. They covered the challenges of the process as well as how Clarity has been able to successfully convert the Clarity PSO Member providers to the AHRQ Common Formats through Clarity's Healthcare SafetyZone® Portal, a cloud-based patient safety event management tool.

To learn more about Clarity's process of adopting the AHRQ Common Formats in safety event reporting, view the presentation slides. 

Contributor: Tom Piotrowski, RN, MSN, NE-BC, CSSGB, Executive Director of Clarity PSO

Author: Jessica Riley, Project Manager of Clarity PSO

In this second White Paper,we explore how providers can begin to remove barriers that may have previously derailed and limited the ability to influence quality and safety efforts through working with a PSO and adopting common nomenclature for the reporting of medical errors. This White Paper gives unique insights into how one large healthcare system successfully adopted the AHRQ Common Formats in their work with Clarity PSO. We present here an interview with Damon Newton, Director of Risk Management at Holmes Regional Medical Center of Health First, Inc. in Rockledge, FL. In this interview, Mr. Newton discusses his organization's process in adopting the AHRQ Common Formats, how these templates addressed human factor issues in the face of a new reporting nomenclature, and how receiving data and reports back from the PSO has been beneficial in improving patient safety in their organization.  

Here are a few of the questions asked to help us understand the process, outcome, and value of adopting the AHRQ Common Formats and reporting to a PSO: 

• What were the primary motives for your organization to adopt the AHRQ Common Formats? 
• What have you found interesting about Clarity PSO reports analyzing and benchmarking Common Format safety events across member providers?
• What do you think other hospitals would find valuable about adopting Common Formats and participating in a PSO?
• How has the PSO provided value for you as it relates to safety event management and reporting?
• What is something you found interesting, sparked a need for change, and/or caught your attention from Clarity PSO's reports analyzing your safety event data related to falls events?
• Do you believe that safety event reporting efforts nationally help support creating a just culture?

To find out the answers to these questions and more, read the White Paper: The Patient Safety Act - What's in it for Healthcare Providers Part 2

Want to learn the basics of a Patient Safety Organization? Watch our video, 'PSOs Made Easy!'  

Clarity Group Spotlight

Clarity Group, Inc. presented a session at the National Rural Health Association's 35th Annual Rural Health Conference in Denver, CO on April 18th in partnership with the Critical Access Hospital (CAH) Quality Network through the North Dakota Center for Rural Health. The session entitled, "Improving Care Quality and Patient Safety in Critical Access Hospitals," introduced a process for rural hospital tracking and analysis of events for the purpose of benchmarking across facilities/states to discover best practices.

Clarity has been working with the CAH Quality Network since 2008 and was honored that they invited us to present on this important topic with them at NRHA. Nick Hajek, Accounts and Marketing Manager of Clarity Group. Inc. presented with Shawnda Shchroeder, MA, CAH Quality Network Coordinator at the Center for Rural Health, University of North Dakota.

On March 22, 2012, Clarity Group held a webinar on the Benchmark for Excellence in Patient Safety™ Program, a national safety and quality benchmarking program designed specifically for hospitals and other healthcare organizations that have fewer than 100 beds. The webinar presented success stories from those currently participating in the program and discussed how others can implement peer benchmarking at their organizations and save time and money while improving patient safety outcomes.

- Benchmark for Excellence in Patient Safety™ Program Brochure

- Benchmark for Excellence in Patient Safety™ Program Webinar Recording 

- The Healthcare SafetyZone® Portal Brochure

For more information about the Benchmark for Excellence in Patient Safety™ Program visit our website or contact us at 773-864-8280   

Visit Clarity at: 

The Dakota Conference on Rural and Public Health
May 30 - June 1, 2012

Grand Forks, ND 

Visit our Website!  

Contact Us:

Phone: 773-864-8280

Email: info@claritygrp.com

Is there something you would like to learn more about? Or do you have comments about a topic discussed? Let us know! We appreciate your feedback. Contact us at jsaffa@claritygrp.com to let us know what you think.