Medical Malpractice Assessment

Assessment Introduction

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pmattes@sterlingagency.com 586-323-5700
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Welcome to the Medical Malpractice IQRM!

Medical malpractice refers to an act of negligence by a doctor, nurse, or other medical practitioner, resulting in the injury or death of a patient. It is an issue that not only impacts the safety of patients, but also the financial security and reputation of the delivery system that provides care for them.

In recent years, the number of medical malpractice claims filed is trending downward, however, the severity of claims is trending upward – as are the number of large verdicts.  The days of ‘one-size-fits-all’ coverage are drawing to a close, and as a result new financing models, risk services, and tech-enabled tools for risk prevention and management are appearing on the market. In short, policies are becoming more customized and are becoming increasingly tied to a healthcare organization’s ability to manage its risk in effort to not only reduce premiums, but to also provide more dynamic risk financing options for organizations with clean claims histories.

Please click below to begin a 16 statement survey to gain your organization’s IQRM Effectiveness Risk Audit Score for Medical Malpractice. 

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Assessment Introduction
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Question 1

How effective is your organization with regards to identifying and evaluating risk control activities, using both formal methods (standardized event reporting system, risk assessment tools) and informal (open communication with clinical staff)?

Question 2

How effective is Senior Management, Risk Management, and Quality at collaborating when adverse patient outcomes occur?

Question 3

How effective is your organization’s credentialing process when reviewing and verifying (including education, training, work history, and experience) applicants who are applying for their privileges or seeking to renew them?

Question 4

To what extent does senior leadership support a ‘just culture’ of safety for reporting adverse events and near misses?

Question 5

How well does your organization utilize evidence-based, and best, practices to promote patient safety and prevent patient harm?

Question 6

Utilizing a standardized, risk adjusted tool, how effective are the organization's risk assessment procedures with regards to annually identifying risks and planning effectively to address potential exposures?

Question 7

To what degree does your risk management plan address the structure and processes for risk management activities within the organization?

Question 8

To what degree do your policies suggest you implement proactive risk assessments, such as FMEA (Failure Mode Effects Analysis), prior to implementing new processes so you may identify potential risk areas where medical errors or patient harm could occur?

Question 9

How effective is your claims management process in connecting the organization’s appetite for managing risks with its financial ability to satisfy claims when and if they occur?

Question 10

To what extent does your organization’s corporate compliance process include billing, coding, accounting compliance, and HIPAA compliance?

Question 11

How robust is your organization’s processes for selection, hiring, and retention of staff and while addressing employee turnover in a proactive manner?

Question 12

How effective are your organization's training and on-going educational opportunities at assuring support staff competency, promote quality-of-care and patient safety, and promote work-related employee safety?

Question 13

How comprehensive and continual (on-going) is your organization’s process to monitor and manage legal and regulatory requirements, including compliance, licensure, and accreditation?

Question 14

How effective is your organization’s internal QAPI (Quality Assessment and Process Improvement) process at measuring, tracking and providing trend quality indicators to ensure patient and staff safety, regulatory compliance, and process improvement?

Question 15

To what degree are the processes in place to manage the selection, maintenance and security of technology within the healthcare setting, include organizational strategy [HIPAA, EHR (Electronic Health Records), cyber and social media] and clinical processes [EHR, clinical equipment, and communication processes]?

Question 16

How effective is your organization’s emergency preparedness program in addressing risk related to natural disasters, exposures and business interruptions?

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