Reports To: Associate General Counsel (“AGC”) and General Counsel Sr. V.P. of Legal Services (“SVP”)
The Clinical Risk Manager is responsible for the development, coordination and maintenance of the Nationwide Children’s Hospital, Inc. (“NCH”) Risk Management Program. The Clinical Risk Manager, in collaboration with the SVP, AGC, and all other Legal Services attorneys (“NCH Attorneys”), identifies, evaluates, and works to mitigate risks and/or potential risks and liability to NCH patients, employees and visitors. The Clinical Risk Manager performs surveillance and evaluates patient safety risks in a uniform and consistent manner to promote and facilitate a proactive approach to patient and employee safety consistent with best practices of a high reliability organization. The Clinical Risk Manager, in coordination with the NCH Attorneys, is also responsible for developing loss prevention programs in the area of professional liability and general liability through the analysis of generic and clinical data, and through the communication of remediation plans and reports to NCH professional, managerial and executive staff. The Clinical Risk Manager encourages and consistently reinforces compliance with NCH policies, as well as with safety regulations, infection control procedures, ethics and compliance, risk management activities, and universal protocols. The Clinical Risk Manager interfaces internally with NCH employees to ensure communication and cooperation with risk management efforts, and maintains an exchange of information externally with professional organizations, peers, and other resources to improve and update the Risk Management Program.
Registered nurse or Allied Health Professional with a Bachelor of Science and a minimum of five years of clinical pediatric experience.
Extensive experience with electronic medical record and event reporting systems.
Ability to effectively and efficiently review and analyze data for trends and to draft and present reports of findings.
Highly effective verbal and written communication skills.
Strong critical thinking, leadership and independent decision-making skills in the realm of risk management.
Superior judgment and discretion in the handling of very sensitive and confidential information.
Nursing Licensure in the State of Ohio preferred.
Duties and Responsibilities
Conducts high quality, in-depth, multi-disciplinary investigations of all patient events that are likely to present significant risks to NCH patients and employees.
Works closely and collaboratively with NCH clinical teams and leadership in fact-gathering, interviewing key stakeholders, and sharing critical information about patient safety events in a confidential manner.
Assists and resolves daily, time-sensitive calls to Legal Services from employees regarding patient/family concerns.
Represents Legal Services in Quality Improvement (“QI”) initiatives, including but not limited to Root Cause/Microsystem Analyses and/or QI-Directed Morbidity and Mortality meetings.
Assists leadership in determination of serious safety events utilizing Healthcare Performance Improvement methodology.
Collaborates on interviews of relevant employees when the risk of litigation has been identified and assists in the development of action plans.
Participates in patient safety and employee safety huddles, including but not limited to assisting with the investigation and development of any remediation plans.
Reviews and evaluates potential and current claims with relevant NCH departments and NCH Attorneys. Recommends to AGC and/or SVP approval or denial of requests for reimbursement or adjustment of claims payments to insurers or patients/patient families.
Proactively reviews, assesses and make recommendations for changes to NCH systems to mitigate risks.
Opens and maintains legal files and updates in the claim/event reporting system.
Prepares applicable reports on all assigned cases as requested and in collaboration with AGC.
Participates with the AGC, SVP and litigation paralegals in the review of compensable events, including determining level of liability and setting reserves.
Manages the event reporting systems for Legal Services, including but not limited to reviewing and critically analyzing all patient and employee events for risks and trends.
Develops remediation plans when risks are identified.
Facilitates the roll-out of such remediation plans to relevant NCH departments and staff.
Represents Legal Services in monthly stakeholder meetings with the event reporting system vendor.
Participates in resolving real-time issues with the event reporting system.
Plans for event system upgrades and testing.
Makes recommendations for changes and monitors how upgrades will impact the Legal Module of the event/claim reporting system.
Provides necessary information relevant to issues before the professional liability committee and participates in discussions as appropriate. Facilitates dissemination of information to the appropriate departments at the direction of NCH Attorneys.
Ensures compliance with the provisions of the Safe Medical Device Act.
Collaborates with various departments to determine if a medical device or supply issue meets the voluntary or mandatory criteria for reporting to the FDA via MedSun.
Maintains an established process to review medical device and supply recalls/safety notices for NCH, including but not limited to facilitating regular meetings with BioMedical Engineering, Peri-Op/Research/NCH Supply Chain, and Lab representatives to determine that all notices have been reviewed and appropriate actions have been taken. Serves as NCH contact for onsite visits and calls from FDA related to FDA notifications to NCH of recall/safety notices.
Ensures that NCH has taken appropriate action in response to such recall/safety notices.
Risk Management Educational Programming
Identifies educational needs of NCH, and develops educational offerings independently and/or in collaboration with NCH medical/legal/nursing leadership.
Presents and educates employees across NCH on various risk issues, including but not limited to best practices in documentation and event reporting.
Engages in rounding and regular meetings with medical/nursing leadership on risk management issues and trends.
Maintains awareness of current healthcare risk management and legislative activity affecting Risk Management by participating in local and national professional societies, such as the American Society of Healthcare Risk Managers and the Ohio Society of Healthcare Risk Managers.
Authors risk management articles in NCH publications, including publishing articles in “Everything Matters in Patient Care.”
Interdepartmental Exchange of Information
Coordinates Risk Management functions with multiple disciplines and other risk management and quality improvement peers.
Represents Legal Services on established and adhoc multi-disciplinary hospital committees/task forces.
Provides information and reports as required or requested.
Reviews and evaluates information from those committees for potential risk and liability exposure.
Assists with the development or revisions of any committee action plans/policies/processes.
Interfaces with the Patient Relations staff and NCH Attorneys to develop a coordinated approach to patient and family complaints, including but not limited assisting in written and oral communications with patients and families.
Reviews and analyzes subpoenas/requests for information and relevant medical records in collaboration with Legal Services paralegal and NCH Attorneys. Reviews and analyzes subpoenas and other legal requests for potential litigation/risk to NCH and responds accordingly to the legal team.
Supports accreditation processes such as Magnet, Commission on Accreditation of Rehabilitation Facilities, and The Joint Commission by submitting NCH Risk Management plan/documents and participating in an on-site activities as requested.
Litigation Coordination/Support in Collaboration With SVP and/or AGC
In coordination with NCH Attorneys, paralegals and defense counsel, analyzes and assists in collection of documents, information and reports in preparation for discovery.
Prepares correspondence regarding claims and investigations.
Serves as liaison between employees and outside counsel and/or insurance investigators in coordination of litigation-related discussions
Reviews and assists in responses to complaints and written discovery requests
Attends preparatory meetings for depositions, depositions, mediations and trials as requested by the SVP and/or AGC
Acts as a resource/consultant for NCH employees and leadership for questions and concerns regarding liability and risk management issues.
Proficient in word processing and spreadsheet applications.
Performs in accordance with system-wide competencies/behaviors.
Performs other duties as assigned.
Internal Number: CRM112019
About Nationwide Children's Hospital
At Nationwide Children’s, Everyone Matters. We have a purpose for every passion. Join our team and discover your passion for what’s possible in providing best outcomes for children. The moment you walk through our doors, you can feel it. When you meet one of our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it, too. Welcome to Nationwide Children’s Hospital, where Passion Meets Purpose. We’re 12,000 strong. And it takes every single one of us to improve the lives of the kids we care for, and the kids from around the world we’ll never even meet. Kids who are living healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere. Ask anyone with a Nationwide Children’s badge what they do for a living. They’ll tell you it’s More Than a Job. It’s a calling. It’s a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere.