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10 practical ways to reduce liability risk.

Risk management in a nutshell

Ensuring the highest quality care for residents and protecting your facility from liability are constant concerns for nursing home administrators. In addition to putting together and following a comprehensive risk management program, here are some practical ways to reduce liability in your facility:

1. Investigate and analyze ALL incidents: know the causal factors, ask why and how did this happen, and what can we do to keep it from happening again?

2. Maintain a physician credential file for each physician granted admission privileges. The file should contain the license to practice, DEA number, certificate of insurance, and admission privileges to local hospitals. (All prospective contracts between the facility and outside parties should be reviewed by legal counsel).

3. Place a photograph of the resident on the Medication Administration Record to ensure that proper identification is made prior to administering medication. This can be helpful in coping with elopement.

4. Consider creating a "safe haven" outside the facility for residents who may wander. A safe haven -- which can be an enclosed courtyard of fenced-in area -- is a less restrictive means of keeping residents from eloping from the facility.

5. Color code the ID bracelets of residents assessed to be highly susceptible to falls so that the staff is alerted to closely monitor them.

6. Incorporate regular staff development training in customer relations and service. The facility coordinator or a consultant can provide techniques on improving interpersonal relations with customers, i.e., residents and families. Through improved communications, staff members can more easily address their customer's needs. Seminars can also be provided on such subjects as hospitality training and fun ways to prepare and serve meals.

7. Make customer service a priority. Make your customers feel important, wanted and appreciated.

8. In addition to the above, know what your customers want and value; listen well, be compassionate and responsive. Regular informal meetings between administrators, staff, residents and families can provide an opportunity for friendly, and many times educational, conversation.

9. Make your work "fun" for your staff and provide incentives for them to do better. Many long-term care facilities have an employee-of-the-month award, a "cleanest wing" award or a suggestion box program in which everyone (staff and residents) is encouraged to participate. Possible prizes can be a cash award or a free lunch at a nice restaurant.

10. Make two programs a "must" in your facility: Quality Assurance (or continuous quality improvement) and risk management. For details and suggestions on how to put together a risk management program tailor-made for your facility, contact your insurance carrier. However, observing the simple tips above will help control your exposure to loss. and that, in a nutshell, is what risk management is all about.

Joy Howe, RN, NAHA, MS, is Director, Long-Term Care Services, CIGNA Care Providers insurance, Philadelphia, PA.
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Title Annotation:nursing homes
Author:Howe, Joy
Publication:Nursing Homes
Date:Mar 1, 1993
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