New website for Patient Relations & Clinical Risk (PRCR): Remember to update your bookmarks

December 21, 2020  //  FOUND IN: Updates & Resources

Patient Relations and Clinical Risk is uniquely positioned within Michigan Medicine, and uses a novel approach nationally, focused on evaluating early signals that may suggest opportunities to prevent and mitigate clinical risk.

The perceptions of patients, families, faculty and staff afford early detection of actual or potential patient harm. When unexpected patient harm does occur, PRCR serves as the first responders — assessing the situation, facilitating debriefs and disclosure, gathering the facts and assuring that patients, families and those involved in the event have the necessary resources to produce the best possible outcome.

On top of that, the team works to find a resolution achieved through timely initiation of the Michigan Model of early claims resolution (also referred to as Communication and Resolution Programs or CRPs).

Learn more about the role PRCR plays at Michigan Medicine and how this work benefits you by exploring the department’s new website.

Below is a snapshot of what you’ll find when visiting the new site.

Patient Relations

Michigan Medicine aims to resolve patient complaints and grievances at the local level and in real-time. When that isn’t possible or when a patient/family provides concerns in writing (a formal grievance), patient relations specialists are available and ready to assist. Customer service issues with which PRCR often assist include long wait times, rude interactions with staff, dissatisfaction with food options, etc. On average, nearly 500 grievances and complaints are addressed per month by a team of approximately six specialists.

The following was recently shared by a patient’s son after successful resolution:   

Sometimes, despite everyone’s best efforts, resolution is not able to be achieved. Often, this is due to misperceptions that are unable to be corrected through communication and explanation.

When these situations occur and Michigan Medicine firmly supports the care delivered, patients and families are referred by PRCR to relevant external agencies (i.e., LARA, Michigan Department of Licensing and Regulatory Affairs and Livanta, Medicare Quality of Care Complaints) for additional review/investigation, allowing for an official, objective third party to weigh in on the matter.

Timely resolution of grievances is required!

CMS and The Joint Commission (TJC) require that grievances be resolved within 7 days. In addition, each time a survey or unannounced on-site visit from one of these organizations occurs, an audit of grievance handling coincides — assessing for gaps and substantiated allegations.

PRCR works diligently to resolve complaints. In FY20, Michigan Medicine resolved 70% of grievances within 7 days and 93% within 30 days. In the last 4 years, only two (out of 13,000 grievances managed) were substantiated. This success is entirely dependent on timely responses, communication and strong partnerships with leadership of the involved areas. Patients and families want to feel heard and every effort should be made to resolve concerns at the point of care before they feel the need to escalate. It’s the right thing to do! 

PRCR also partners with the Office of Patient Experience, offering feedback gleaned from patients and families regarding opportunities for improvement. 

Clinical Risk

Clinical risk consultants support faculty and staff in managing:

  • unexpected outcomes and quality of care concerns resulting in actual or perceived patient harm;
  • grievances and complaints from patients/families which involve quality of care concerns;
  • acute serious safety events;
  • allegations of medical malpractice/professional liability and/or
  • allegations of abuse or neglect.

If ever you’ve been the recipient of a Notice of Intent to file a lawsuit, you know how unnerving that experience can be. Fortunately, Michigan Medicine is nationally and internationally recognized for effective and efficient handling of these situations for all involved through:

1) open and honest dialogue with patients and families, including timely communication of unanticipated outcomes;

2) early and comprehensive investigation with review by dedicated peers and external reviewers to assess allegations for merit;

3) quick and fair compensation where warranted and rigorous defense when the care provided is deemed reasonable.

At Michigan Medicine, providers are frequently spared from having to undergo stressful depositions and/or court appearances and can continue focusing on providing excellent patient care and/or engaging in ground-breaking research. By applying a principled approach to concerns regarding the care provided, patients and families determined to have been harmed by unreasonable care are provided with the ongoing care and resources necessary to return to a state of health and/or optimal functioning and all involved are able to experience closure sooner than the court system typically allows. The provider-patient relationship is preserved, we learn from the experience, focus on preventing a recurrence, and share lessons learned throughout the institution. 

Claim histories for credentialed providers & data sharing

In addition to the above, PRCR provides medical malpractice claim histories for the purpose of provider credentialing/re-credentialing and shares grievance, patient harm and claims data across the organization for use in risk prevention/mitigation, quality improvement and dissemination of lessons learned through our claims process/litigation.

PRCR provides data using Tableau dashboards to committees/groups such as the Grievance Committee, clinical departments, Office of Clinical Affairs/Service Chiefs, Office of Patient Experience, etc.

In addition, ad hoc analyses of PRCR data are performed upon request.