Best Practices in Risk Management

The RMF Case

The Risk Management Foundation (RMF) of the Harvard Medical Institutions employs a comprehensive and proactive approach to risk management. One of the key strategies involves the collection and analysis of comprehensive data from each claim. This data, coded into a highly detailed taxonomy, is analyzed to identify latent sources of medical error. The insights derived from this analysis are then used to establish patient safety best practices. For instance, when data revealed that physicians at a particular hospital were not asking patients to sign consent forms, RMF partnered with the hospital to establish effective consent protocols.

In addition to data analysis, RMF collaborates with the Harvard Medical Institutions to develop educational tools, programs, incentives, and research initiatives (Bohmer et al., 2009). These initiatives are designed to improve patient safety in high-risk areas. Rather than focusing on individual doctors' behaviors and habits, these risk management programs emphasize team-building, communication, and standardized processes that address organizational and systems issues.

To encourage adherence to safety protocols and participation in risk management initiatives, RMF offers incentives such as lower premiums for physicians who participate in certain patient safety programs. Furthermore, RMF has partnered with Harvard Business School to develop educational programs tailored to the specific issues facing individual hospitals. These programs, attended by hospital leadership, focus on important strategic issues relating to the quality and safety of patient care (Bohmer et al., 2009).

RMF has also established a for-profit division called Strategies. This division packages and sells risk management products and services used by the Harvard Medical Institutions to other hospitals, healthcare systems, and medical malpractice captives. This initiative not only serves as a revenue source for RMF but also helps in growing RMF’s claims database with data from non-HMI providers, thereby identifying best practices from outside the Harvard system.

RMF is proactive in addressing emerging malpractice risks. For instance, with the rise in outpatient-based claims, RMF has developed an Office Practice Evaluation (OPE) program to identify opportunities to reduce risk in office-based practices (Bohmer et al., 2009). Additionally, RMF provides support for hospital risk managers, shifting their historically reactive role to one that is more proactive. After an adverse medical event, a hospital’s risk manager is called upon to manage the fallout of the event, often communicating with patients’ families or helping prepare for a potential claim or lawsuit.