RISK MANAGEMENT & GOVERNANCE

Michael Gorton – Russell Kennedy

ACHSE – 3 March 2004

The context

Rise in claimsSeptember 11Collapse of HIH/UMPUnder funding of MDO’sFearFinancial incentives for risk management

The Government Response

UMP support (and levy)Tort law reformRisk management (safety & quality)

Tort Law ReformProportionate liabilityCaps and thresholdsOpen disclosureLimitation period for claimsDefinition of negligence (IPP)Abolish exemplary damagesGood Samaritan Structured settlements

Governance & Management

LiabilityEntityIndividualsVicarious liability

AccountabilityDelegationReporting

Risk ManagementLegal riskFinancial riskBusiness risk

Compliance

Towards a governance culture

Organisational culture (open)Staff knowledge, beliefs and valuesSystem designResourcesManagement model

Key Governance Issues

Identification of and compliance with standards Recognise opportunity cost

Getting it rightDoing it wrong

Key Governance IssuesLevels of delegationSystems of Accountability and Reporting Regimes Policies

Quality of care and serviceSafety (including emergency)Legal risks

Education and training Notice requirements/Compliance Checklist/Sign-offIncident Monitoring/Complaint Handling

Medical Governance

MACCredentialling

Clinical Risk CommitteeQAComplaints analysisIncident data

Vicarious Liability

EmployeesAgentsPrivatised services/facilities

Informed Consent

Not a formDoctor certification Information sheets Checklist Records/notes

Communication and Prevention

Studies of patients complaints and why they complain, indicate that some of the following factors are relevant

They have not received an explanation which they can understand and acceptThey believe their treatment has been negligent or below standard (whether, in fact, it has or not)They have not been treated with consideration or sympathy or courtesy

Communication and Prevention

They have sought information, but have not received an explanation, or their reasonable requests have not been metThey have been discharged before they fully recovered (or they thought they had fully recovered), or discharged without proper explanation or follow upThey are chronic complainers

Avoiding Liability

Good care and serviceProtocols and proceduresCOMMUNICATION!!Complaint handling procedures – timely, sensitive, communicativeNOTES AND RECORDSInsurance

Risk Management and Governance

Michael GortonRussell Kennedy Solicitors

PO Box 5146AA, MelbourneTel: 03 9609 1625Fax: 03 9609 1825

Email: mgorton@rk.com.au