Managing risk: Dedicated team addresses concerns regarding care

June 17, 2019  //  FOUND IN: Our Employees,

Members of the Patient Relations and Clinical Risk team.

With specialized care delivered at Michigan Medicine daily, patients and staff members are sometimes put in challenging situations. To help navigate and address these events, there is a dedicated team in place — Patient Relations and Clinical Risk (PRCR).

“We look into incidences when there are concerns about the reasonableness or appropriateness of patient care,” said Jenny Hartl, a clinical risk consultant with the team. “We work with patients, staff and providers to find out what happened and to identify the events that led to the original concern.”

In honor of Health Care Risk Management Week, here’s what you may not know about PRCR.

Addressing concerns

In addition to written correspondences via email and letters, PRCR handles approximately 300 phone calls per month. When patients, families or employees reach out, their concerns are triaged to a patient relations specialist or to a clinical risk consultant.

The patient relations side of the office is customer-service based, responding to patient and family concerns regarding their experience at Michigan Medicine.

“This could be long wait times, rude interactions with staff, unhappiness with food options and other situations of this nature,” said Ashley Harmer, administrative manager of the patient relations team. “Those are all important issues, but not directly related to clinical care.”

The team that handles these types of concerns is comprised of six patient relations specialists, two managers and two administrative assistants. Their goal is to respond to patients and families within seven business days from when PRCR is first contacted.

“We look into all complaints and concerns to address them in a timely manner and, hopefully, to help resolve the issues,” Harmer said.

Protecting quality of care

The clinical risk side of the team, meanwhile, looks into issues that affect the quality of care delivered at Michigan Medicine. PRCR is nationally- and internationally-recognized for disclosing, reviewing and compensating quickly and fairly when unreasonable medical care causes injury, and defending care when it is deemed reasonable.

“We believe that court should be the last resort, not the first,” said Hartl. “This is our approach to medical malpractice and is known as the ‘Michigan Model.’”

Patients and families can reach out if they believe they were injured during their care or if the care they received didn’t go as they expected.

But they aren’t the only ones who can initiate contact with PRCR. Anyone on the care team should reach out if they feel patients are at risk, when there is patient injury, or there are allegations of abuse.

“No matter who reaches out, we’ll look into issues when care is in question,” Hartl said.

Transparent investigations

So what happens once PRCR is contacted?

“Our system is fairly simple,” Hartl said. “First, one of 11 risk consultants and three administrative managers will reach out to the people involved and get their perspective on what happened. Then our office will identify a group who can review the facts and weigh in on the appropriateness of the care that was provided.”

Inquiries can take anywhere from a few days to a full month. Throughout the process, transparency is the No. 1 goal.

“We keep patients, families and employees in the loop at all times,” Hartl said. “We openly share our review process and the results of the care review.”

Once findings are made, PRCR shares these with the patient, individual units and other appropriate partners across the organization.

As Hartl said: “We have a great relationship with our colleagues throughout Michigan Medicine, including the Office of Patient Experience and the Office of General Counsel.”

A partner in progress

Hartl said the main misperception about her team is that they are not partnered with the providers and staff, or that they are patient advocates.

In fact, the opposite is true, as the office collaborates with and supports the various services across Michigan Medicine.

“We are dedicated to the Michigan Model; doing the right thing for our patients while also supporting our providers and staff,” Hartl said. “By learning from our patients’ experiences, we are able to reduce patient injuries and medical malpractice claims. But we couldn’t do our work without the collaboration from our patients and families, or from our staff and colleagues throughout our health care system.”

To learn more about the Michigan Model, visit the Patient Relations and Clinical Risk homepage.