Empowering health care individuals and teams to proactive risk success

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Mitigating risk in a healthcare practice is about more than compliance, coding and billing, quality and safety, or legal issues. Today’s healthcare teams are impacted by myriad challenges, from cyber security to labor issues. In addition, a dynamic U.S. financial sector is producing more market uncertainty, with higher inflation and interest rates creating an environment where a growing number of companies are faced with credit rating downgrades, defaults, and bankruptcies. In these complex times, individuals still play a pivotal role in uncovering risk before it can cost an organization valuable resources.

Risk comes from anywhere and everywhere, so not only do organizations need system wide solutions, individuals and teams must also be part of the solution. Developing proactive individual risk champions creates a culture of collaboration that results in improved communication, better decision-making, enhanced quality, a safer environment, reductions in workforce stress, and better performance outcomes. Proactivity that leads to individual and cross-functional risk avoidance can deliver cost reductions, including by categorizing, prioritizing, addressing, mitigating, and managing risk daily.

The importance of risk mitigation in health care

The presence of risk in healthcare operations is not new. In fact, it’s a topic that healthcare professionals learn about from the very beginning of their studies. It’s something they invest in mitigation for throughout their careers, including financially in response to expanding insurance premiums and in time and resources by participating in professional development and training programs. However, the type of catastrophic events that can occur in the medical profession now impact much more than patient health. Additional impacts, including catastrophic financial effects to the entire organization, can also occur.

But proactive risk mitigation planning is about more than preparing for catastrophic events. Improved daily productivity and risk management also enhances outcomes and helps organizations cut costs before issues arise. A culture of individual and team preparedness mitigates risk before it has a chance to impact patients or the organization. It has also been shown to boost staff morale – a benefit that has increased in importance as the healthcare workforce continues to be impacted by diverse challenges.Another benefit of proactive risk planning was highlighted in healthcare organizations’ response to the global COVID-19 pandemic. A strong culture of collaboration and continuous risk mitigation helps strengthen our response during a crisis and ensure continuity of operations during short and long-term unplanned events.

Where risk lurks – traditional versus contemporary

Most professionals are well versed in where risk traditionally lies in healthcare practice. The clinical, operational, financial, and strategic risks of running a healthcare facility are well documented. In addition, new risk categories are now impacting the profession. For example, new marketing opportunities bring new risk, highlighted by an Ohio surgeon whose state medical license was permanently revoked after she live streamed a patient procedure1. Workforce development and human resources requirements have also changed dramatically in recent years. The healthcare workforce is beset by numerous challenges, including 27 labor strikes in 20232 and post-pandemic, an exodus of professionals from the workforce (with estimates as high as 20% and the main reason given as not feeling valued by employers).

Information technology (IT) and cybersecurity costs continue to rise. Over the past three years, the average cost of a data breach in healthcare has grown 53.3%, increasing more than $3 million compared to the average cost in 20203.”Over the past four years, there has been a 239% increase in the number of large data breaches4. Adverse events in healthcare continue to pop up year after year, placing patients and workers at risk. From a growing number of natural disasters affecting U.S. infrastructure, to increasing economic pressures, the impact of contemporary risks continues to grow.

Developing proactive risk champions in healthcare

Creating a culture of proactive risk mitigation requires everyone’s buy in, with individuals playing a pivotal role. Risk management in healthcare relies on the active participation of all staff members. Each person's vigilance and judgment are key to a proactive defense against risk. To build this culture, we must embrace an ethos of transparency and open dialogue. Staff members at all levels must be empowered to voice concerns and take the initiative to reduce risk. Ongoing professional development in this area, as well as cross-functional collaboration, is key to enhancing an organization's ability to manage risk effectively.

To kick-start a culture of proactive risk mitigation, identify and develop risk champions at all levels and empower them with the tools and resources to be successful. Expand from the traditional roles of Chief Risk Officer, Risk Manager, and Compliance Officer, to include others throughout the organization. A robust Risk Team is vital to bring together clinicians, administrators, financial experts, and legal advisors in a coordinated effort to manage and mitigate risk. Task this team with identifying, evaluating, planning, preparing, and responding to potential threats. Effectively communicating their expanding knowledge is key to strengthening the organization's defenses.

An organization’s success (or failure) is anchored in leadership's dedication to creating a vigilant and proactive environment. Leaders must foster trust and collaboration, while recognizing the essential contribution of all individuals and teams. An organization’s C-suite should lead by example to embed risk-conscious thinking into its organizational culture, with clear communication of expectations and the provision of needed resources. A culture of risk prioritization and accountability permeates every level, empowering every team member.

Leading by example: What individuals and teams can do

Whether identified as a “Risk Champion” or not, every individual has an important role to play in mitigating risk before it can impact the business. Building a culture where everyone works together and is supported to ‘See something, say something,’ is everyone’s responsibility. Active listening and good questioning skills are essential – and something that can be practiced through professional development opportunities and during team meetings. Practice scenario planning and response often. Train all team members to ask the ‘What if’ questions and speak up when the answer identifies risk potential. Once a culture of proactive risk mitigation is created, it must be supported. Continuous education, training, improvement, and proactive practice is key to staying in front of the next threat. Ongoing planning and preparation is key to long-term risk mitigation.

Citations

1. Frehse, Rob. “Ohio plastic surgeon who livestreamed patient operations on TikTok has state medical license revoked permanently,” CNN. https://www.cnn.com/2023/07/13/us/ohio-doctor-tiktok-license-revoked/index.html
2. Gooch, Kelly. “US healthcare workers walk off the job: 27 strikes in 2023,” Becker’s Hospital Review. https://www.beckershospitalreview.com/hr/us-healthcare-workers-walk-off-the-job-7-strikes-in-2023.html
3. Cost of a Data Breach Report 2023. IBM Security.
4. HHS’ Office for Civil Rights Settles Ransomware Cyber-Attack Investigation, U.S. Department of Health and Human Services. October 2023. https://www.hhs.gov/about/news/2023/10/31/hhs-office-civil-rights-settles-ransomware-cyber-attack-investigation.html

Scott Nelson is a health care industry leader with over 20 years of experience across adult and pediatric ambulatory and hospital-based primary, specialty, and ancillary medical care services.