Developing an Aging Services Risk Management Program

August 22, 2014 | Aging Services Risk, Quality, & Safety Guidance

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A comprehensive risk management program applies risk management techniques to all areas of operation of an aging services provider, from safety issues (e.g., trip hazards) and promotion and creation of a culture of safety to employee health (e.g., prevention of back injuries) and resident care (e.g., prevention of medication and dietary errors).

Demand for a comprehensive risk management program within aging services organizations has increased as the organizations respond to various concerns, including the following:

The aging services sector provides services to a population with unique needs. This population is extremely vulnerable to adverse events and errors, such as falls and medication mistakes, and these clients are often affected by poorly managed transitions from one care setting to another, such as from the hospital inpatient setting to a short-stay unit within a nursing home.

Staffing issues also present concerns, given the importance of consistent and effective staffing and of employee health and wellness on care continuity. The turnover rate among caregivers in aging services facilities is high, and ensuring staff competency and attending to worker safety are ongoing challenges. In 2012, the rate of nonfatal occupational injuries for staff in nursing and residential care facilities was 13.1 per 100 full-time workers, almost five times the rate observed in private industry overall (U.S. BLS). Employee welfare and safety risks also vary depending on the service line involved, adding another layer of complexity.

Risk management programs can help to identify and address the system flaws that contribute to resident and worker harm. Yet surveys conducted to assess the safety climate among some aging services providers have found mixed results regarding organizations' safety cultures, which serve as the foundations for effective risk management programs. A hallmark of a culture of safety is an atmosphere in which healthcare workers can report actual or potential errors, events, and hazards without fear of reprisal.

The most recently available comparative database for the Agency for Healthcare Research and Quality's (AHRQ) Nursing Home Survey on Patient Safety Culture indicates that while 86% of respondents agreed that residents are well cared for and safe, only 51% of respondents said staff are treated fairly when they make mistakes and feel safe reporting their mistakes (Sorra et al.). Staff reluctance to report errors and near misses can hinder an organizations' ability to identify and prevent system flaws that contribute to errors. The 2011 report is based on data from...

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