Monday, December 1, 2008

Newsletter Archive- Managing Risk

Dental Office Waiting Area
Dental Office Waiting Area in Juneau, Ak
Platinum Strategies for Protecting Your Million-Dollar Practice

By Linda Harvey, RDH, MS, LHRM
Horizon Consulting Group, Inc.
Dentistry has experienced significant changes that have dramatically impacted the delivery of care. Innovative communication tools and technology offer exciting advancements, yet they also present new risks. Whether you seek to maintain or attain a million-dollar practice, risk management is an important tool that can help protect all of your assets.
Designing and building a risk-proof practice doesn’t happen overnight. It begins with a clear vision of what you plan to accomplish. Next design risk management as a core operational function to tie all the vital clinical, business, and financial functions of your practice together. Remember to view risk management as part of the ongoing maintenance process.
Traditional versus the new risk paradigm.
Risk management has historically transferred risk and minimized loss through different types of insurance coverage. However, current events, new regulations and rapidly changing technology contributed to the need to redefine risk. These changes paved the way for Enterprise Risk Management (ERM), a progressive approach to risk management that incorporates traditional loss exposures, yet is significantly more comprehensive.
Platinum strategies for implementing ERM
This new model recognizes that risk management begins in the planning stage and remains part of the core structure of all of your systems and processes. Successful dental offices strategically and proactively integrate risk management throughout hiring, team building, financial planning, communication, and documentation procedures. The four platinum strategies below can help you develop a comprehensive program for your practice.
Platinum Strategy #1: Discover the six domains in your practice management program where there are underlying risk management considerations.
ERM expands risk beyond the traditional categories into six areas known as risk domains. These domains relate to six key areas in your office. They are:

  • Operational
  • Financial
  • Human capital
  • Strategic
  • Legal and regulatory
  • Technology

  • Risks rarely occur as a single isolated event. In fact, they are quite interwoven. The ERM domains are fluid and frequently overlap, thus any given risk may exist in more than one domain. For example, you can expect an employment issue (human capital) to impact operations and finance.
    Platinum Strategy #2: Identify recordkeeping habits that could make or break your defense.
    With the growth of electronic records, recordkeeping has become more important than ever. Electronic record systems require a substantial investment of time, effort and money. The transition from paper to computer must be planned and executed properly otherwise, unforeseen gaps in documentation may occur. As a result, quality of care is compromised as well as your legal defense should a suit be filed.
    Whether paper or electronic, simple details such as the words you choose when writing progress notes may or may not convey your intended meaning. Subtle differences in the meaning of words or the manner of expression may affect quality of care, patient safety or the outcome of litigation. How well your notes are written can mean the difference between having patient-centered defensible records or self-serving defensive records. Good recordkeeping habits must prevail.
    Platinum Strategy #3: Recognize subtle communication patterns that can turn potential legal complaints into platinum customer service experiences.
    Increased emphasis is also being placed on team communication and dynamics. Given the fact staff interact with patients far more than you do, training in risk communication has never been more crucial. Risk communication is consists of good customer service skills, expertise in handling difficult patients and understanding the subtle difference between a complaint about quality of care versus a threat to sue. How you (or your staff) say what you say makes a difference.
    Verbal communication with patients must also be captured in writing. Recall those times when you discussed concerns, obtained informed consent or had an after-hours telephone call with a patient. When key patient-related information is discussed, the conversation must be documented. Over time your memory will fade and a judge or licensing board is far more likely to believe the patient.
    Platinum Strategy #4: Leverage teamwork and develop a “no-losers” policy to ensure a culture of safety.
    Providing quality care in a safe environment is directly related to the strength of your risk management program as well as the culture of your practice. The culture of a practice consists of the attitudes, beliefs and norms of a team. The culture of your practice is also directly related to your leadership abilities.
    A culture of safety refers to the beliefs, attitudes and support processes that exhibit how patient safety is valued in your practice. Developing a culture of safety involves nurturing a positive environment where everyone can freely discuss safety concerns and offer solutions. This culture is based upon trust and respect, rather than blame and finger pointing. Having a “no-losers” policy signifies everyone is a winner when it comes to supporting a culture of safety.
    Your million-dollar plan As you identify, evaluate and select new products and equipment for your practice, you must continually identify and evaluate risk to protect your practice. Now is the time to ask yourself whether your risk management strategies are reactive in nature or are they well-built into the infrastructure of your practice. Prevent sleepless nights spent worrying about your practice by building a solid foundation.
    Linda Harvey, RDH, MS, LHRM
    Linda Harvey teaches dentists how to protect their million-dollar practices through effective risk management and patient safety. She holds current licensure in both healthcare risk management and dental hygiene. Linda’s programs complement management consultants whose clients need a specialist in risk management.
    Linda is co-author of the Dental Risk Prevention series and is a featured writer in trade journals, publications, and newsletters. Her courses are approved by the Florida Board of Dentistry to fulfill disciplinary sanctions. She works with private practices as well as facilities that are AAAHC and Joint Commission accredited.
    Clients internationally utilize Linda’s training systems, so they can focus on what they do best -- providing exceptional patient care. Linda can be reached at or

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