Insights from ISMIE’s risk management team

Risk Manager Q&A: Michael H. O’Neill, CPHRM

In this interview, Michael H. O’Neill, CPHRM, shares insights on the risk management trends that have emerged during the COVID-19 pandemic and offers thoughts on what practices and facilities may see in the future.

So many new challenges have emerged since the start of the pandemic, it’s hard to know where to begin. Some of the key issues I would highlight are:

• Needing to continually adapt as our understanding of the virus evolves
• Concerns about healthcare professionals’ physical and emotional wellbeing, including burnout, stress and grief
• Re-envisioned ways of delivering care, such as:
  • Pop-up treatment facilities, field hospitals, and mass vaccination sites
  • Healthcare professionals being asked to expand their normal scope of practice due to the “all hands on deck” nature of the pandemic response
  • Retired physicians and clinicians returning to practice to help battle the pandemic
• Questions and dilemmas related to medical ethics
• Rapid adoption of telemedicine
• Business challenges due to staffing issues or a temporary pause of “normal” practice operations
• Addressing the risks related to patients having delayed their routine or preventive care
• Navigating the vaccine rollout

While this is not a comprehensive list by any means, I think it underlines many of the biggest challenges that have emerged this year. It’s also worth reiterating that frontline healthcare professionals have shown extraordinary dedication, resilience and skill in navigating these unprecedented times.

Telemedicine has seen a huge boom, and while some of the specific parameters may change in the future, it appears that telemedicine is here to stay. So far, this has resulted in a lot of positive outcomes. Being able to care for patients virtually has increased access to care while helping patients avoid the risk of COVID-19 exposure during an in-person visit. In addition, healthcare practices and facilities have gotten a lot better at identifying patients for whom a telemedicine visit would be appropriate and creating tracking processes for care provided virtually. Many have also upgraded their internet bandwidth to allow for better streaming quality during virtual visits.

However, it’s still important to keep key risk management fundamentals in mind when treating patients virtually. For example, telemedicine visits should be documented thoroughly, with an acknowledgement of the limitations of a virtual visit and an explanation of the clinician’s reasoning for not seeing that patient in person.

One positive outcome has been that good handwashing practices and hand sanitizer use are at an all-time high. In addition, the widespread adoption of practices like mask use and social distancing appears to have reduced the spread of other illnesses, such as the flu.

Another highlight has been the sensitivity and compassion extended to physicians, healthcare workers, and other frontline workers. I’ve heard of wonderful things happening, like people sending free lunches to healthcare professionals who work in hospitals. Society has recognized healthcare professionals’ dedication, professionalism and courage, as well as the intense stress and burnout risk facing those who are on the front lines. This gratitude for healthcare professionals is extremely deserved and long overdue, so that’s a positive development.

What I’ve heard is that physicians and practices are making it a priority to hold regular check-ins with clinicians and staff. More and more practices and facilities are using team huddles as a way for everyone to touch base and look out for each other.

It goes without saying that the physical and emotional strain of providing healthcare during the COVID-19 pandemic has been enormous. Healthcare professionals have lost colleagues and watched COVID-19 patients pass away alone, without family members able to be there in person. It’s so important for healthcare leaders to reach out to their colleagues and staff and let them know it’s OK to seek help, for example, through an employee assistance program (EAP) or a hotline through the organization’s managed care organization, if either is available. Encouraging colleagues to nurture and protect their own wellbeing is essential, especially given the extreme challenges healthcare professionals continue to face due to the pandemic.

Healthcare professionals have had to overcome innumerable challenges in the past year, and the fact that they’ve done so is truly remarkable. I can only imagine everything that will continue to be written about the lessons learned from the COVID-19 pandemic. Healthcare will never be the same. Here at ISMIE, our risk management team will use all that we’ve come to know over the past year to continue supporting our policyholders as they work to reduce risk and improve patient safety – not only related to the pandemic but throughout their practice of medicine. We’ll continue to take an active role in monitoring emerging risk management issues and providing guidance on how to navigate them.

I’d also like to remind policyholders that ISMIE has developed many risk management resources to help navigate the ever-changing healthcare landscape. Our Resource Library includes articles and webinars on topics such as telemedicine and COVID-19 vaccine risk considerations, in addition to a wealth of information on a variety of risk management topics.

In his role as ISMIE’s Assistant Vice President of Risk Management Operations, Michael H. O’Neill, CPHRM, oversees the coordination of ISMIE’s risk management activities, as well as the company’s risk assessment program. Mr. O’Neill is a Certified Professional in Healthcare Risk Management through the American Hospital Association and completed his Healthcare Risk Management certification through the American Society of Health Care Risk Management (ASHRM). He is a member of ASHRM, the Chicago Healthcare Risk Management Society and the Illinois Society of Healthcare Risk Management, and has been with ISMIE since 2002.

The recommendations contained in this article are not intended to define conduct that is appropriate in every case, should not be considered as establishing any standard of care, and do not constitute legal advice. Physicians, clinicians and healthcare providers should take care to ensure that all care rendered reflects the best clinical judgment and complies with the laws and regulations of the state or location at which the care was provided.