Kaiser Risk Management

Kaiser Permanente is committed to providing high-quality, affordable health care services and improving the health of our members and the communities we serve. We recognize that one of the best ways to achieve these goals is to prevent and manage risk.

Our Risk Management Department works with all areas of the organization to identify, evaluate and mitigate risks that could adversely affect our ability to meet our mission and goals. We strive to create a culture of safety and responsibility throughout Kaiser Permanente, where employees are encouraged to report concerns and incidents so that we can learn from them and take steps to prevent them from happening again.

The Executive Summary provides an overview of our approach to risk management, highlights some of our recent accomplishments, and describes our plans for the future.

Kaiser Permanente is constantly evolving to meet the ever-changing needs of our members and communities. Our Risk Management Department is committed to keeping pace with these changes and to continuing to provide high-quality, effective risk management services.

The nation’s largest integrated health care delivery system is Kaiser Permanente (KP), which serves nine states and over nine million people. KP provides services in nine states and has more than 9 million members with an annual operating income of $53.1 billion in 2013. KP participates in NCQA, TJC accreditation, and the implementation of a state-of-the-art electronic health records system that focuses on integration and quality of care standardization to improve quality.

KP has a long history of being an innovator in the health care industry. In 1945, industrialist Henry J. Kaiser and physician Sidney Garfield founded KP with the goal of providing affordable, quality health care to workers in the then-new Kaiser shipyards. Their innovative prepaid group practice model was duplicated across the country as other companies looked to provide similar benefit packages to their employees.

KP’s size, scope, and experience have positioned it well to lead the way in developing new approaches to risk management that can be adopted by other health care organizations. KP’s Risk Management Department is responsible for protecting the organization’s people, property, reputation, and finances from avoidable losses. The department accomplishes this by identifying, evaluating, and minimizing exposure to risk through a variety of methods including insurance, loss prevention, and safety programs.

The KP Risk Management Department has been proactive in developing innovative approaches to risk management. In 2004, the department implemented an electronic Incident Reporting System (IRS) which captures data on all incidents reported to the department, regardless of whether or not they result in a claim. The data collected in the IRS is used to identify trends and hot spots so that proactive steps can be taken to prevent future losses.

In addition to the IRS, KP’s Risk Management Department has developed other innovative programs such as:

– A “Return to Work” program which assists injured employees in returning to modified duty assignments as soon as possible after an injury

– A “Patient Safety” program which uses data from the IRS to identify potential safety risks and implement corrective action

– A “Workers’ Compensation” program which focuses on early return to work and prevention of secondary injuries

KP’s Risk Management Department has been successful in reducing the number and cost of claims through its innovative programs. Between 2004 and 2013, the department reduced the total number of reported incidents by 28%. The total cost of claims paid during this period decreased by 41%, from $74 million to $43 million.

KP’s experience shows that a proactive, data-driven approach to risk management can be successful in reducing the number and cost of claims. Other health care organizations can learn from KP’s example and adopt similar strategies to improve patient safety and control costs.

The following summary focuses on KP hospitals located in northern California. It will cover topics such as the purpose of risk and quality management, how to identify and manage risks, current risks, quality outcomes, organizational goals, and the connection between risk and quality management.

Kaiser Permanente’s Risk Management Department is responsible for identifying, evaluating, and managing risks that could potentially impact KP’s ability to achieve its strategic objectives. The department works closely with KP leadership and staff at all levels to develop and implement strategies to mitigate identified risks.

Kaiser Permanente’s risk management program is designed to protect the organization’s patients, members, employees, and assets from potential harm. The program includes a comprehensive approach to identifying, assessing, and managing risks associated with Kaiser Permanente’s operations.

Risk management is an important part of Kaiser Permanente’s overall commitment to patient safety and quality care. By proactively identifying and managing risks, Kaiser Permanente can help ensure that its patients receive the safest and highest quality of care possible.

Current risks that Kaiser Permanente is managing include:

-Clinical risks associated with the use of new medical technologies

-Increased competition from other healthcare providers

-Changes in government regulations

-Cybersecurity threats

Kaiser Permanente’s Risk Management Department is continuously working to identify, evaluate, and manage these and other potential risks to ensure that Kaiser Permanente can continue to provide safe, high-quality care to its patients.

The department has also developed a number of quality initiatives aimed at improving the safety and quality of care delivered to KP patients. These initiatives include:

– The Patient Safety Organization

– The Quality Improvement Organization

– The Performance Improvement Department

Kaiser Permanente’s Risk Management Department is committed to continuously improving the safety and quality of care delivered to KP patients. By working collaboratively with KP leadership and staff, the department can help ensure that Kaiser Permanente remains at the forefront of delivering safe, high-quality patient care.

A health care company’s risk management plan should include attention on continuous quality improvement (CQI). The goal of CQI in healthcare, as defined by Sollecito and Johnson (2013), is to provide a “structured organizational process for involving personnel in planning and executing a continuous flow of improvements to provide high-quality health care that satisfies or exceeds expectations.” (p. 4) By connecting the activities of risk management and quality improvement, you’re more likely to see them succeed.

One of the most important aspects of quality improvement is data collection and analysis. In order to make informed decisions about how to improve processes and reduce risks, organizations must first understand where they currently stand. This requires ongoing monitoring and measurement, as well as regular review and assessment.

Kaiser Permanente has long been a leader in both quality improvement and risk management within the health care industry. The organization has developed a number of innovative approaches to tackling these essential functions, which have helped to improve patient care and safety while also reducing costs.

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