The silent organizational pathology of insidious intimidation

While organizations are valiantly striving to address acts of disruption among physicians and nurses, a silent and yet equally disruptive pathology is spreading through the veins of the organization. This behavior is found among all ranks and responsibilities, from the C‐suite to the housekeeping staff. It occurs daily and is rarely reported. It continues because its nature is such that it is difficult to measure, the victims often feel helpless, and the perpetrators are often those in positions that are not normally perceived to be as essential to the flow of patient care. Nonetheless, this insidious intimidation chills communication, reduces morale, and ultimately harms patients. Organizations that desire a culture of safety and comfort must address this behavior through individual coaching, education of all staff, a willingness to tackle system frustrations that amplify and perpetuate the behavior, and establish processes for dealing fairly and firmly with the behavior.     

Fall prevention in our healthiest patients: Assessing risk and preventing injury for moms and babies

Attention is needed in preventing patient falls in newborns and in obstetric units of hospitals. The majority of prenatal, postpartum, and newborn falls are preventable. Little effort has been made to address fall risk during the prenatal period, during labor, and after delivery in the postpartum period for moms and babies. Risk factors for falls in these populations have been identified, and targeted risk assessments and fall prevention interventions have been developed to eliminate these falls. Evidence demonstrates success in reducing falls with a variety of low‐cost but high‐return initiatives, comprising prenatal education, patient and family engagement, implementation of unique fall risk assessment tools, postpartum mobility assessments, and changes in patient rounding frequency.     

The timing of early resolution: Working at the patient's pace

In recent years, risk managers have been charged with educating providers who need to know how to communicate to a patient that an unanticipated or adverse event has occurred. Much has been written about the elements that should be part of a disclosure conversation: who should be involved, what should be said and when it should be said. Patients have acknowledged their desire to have early, and complete, information where possible. However, what is lacking is an understanding of what happens after the initial disclosure conversation, when the time comes to discuss accommodation or compensation with the patient or family. This article will look at the post‐disclosure status of the patient or family, the steps of the grieving process, and the mechanisms for both the risk manager and the provider to successfully bring closure to the event.     

A customizable plan for effective claims management

Claims administration is central to healthcare risk management. This article examines several key aspects of claims management and provides useful information for both new and experienced claims professionals. It offers tools and examples for inexperienced risk managers to master effective claims management practices and outlines suggestions that seasoned risk managers can use to update or validate their own processes. These claims management practices serve to protect the organization's assets and can be customized to meet each organization's needs.