Behavioral Health Services Evaluation

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Behavioral Health Services Assessment

Assessment/Evaluation

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Product Code: YG090727_BH

(888) 466-4272

Description

BEHAVIORAL HEALTH SERVICES EVALUATION
Psychiatric claims are on the rise as most others are declining according to the Hospital Professional Liability Benchmarking Report release of 2007. Does your organization�s program mirror this trend? By utilizing a comprehensive and proactive approach to understand each facility�s unique risk reduction opportunities, The RM&PSI has assisted many organizations to:

Improve patient safety practices, thus minimizing the likelihood of medical errors.
Implement evidenced-based practice protocols for high-risk clinical presentations.
Improve process of communication between departments and care providers.
Enhance the quality improvement process using metrics to sustain improvement.
Strengthen the documentation in the medical record that better supports adequate claims defense.
Decrease claims frequency and the associated indemnity and expenses.

According to PIAA closed claims data for the years 2005 through 2007, the average indemnity across all psychiatric claims is $216,200, with several claims that paid greater than $500,000. RM&PSI�s customized risk reduction program plan will assist your organization�s understanding of the significance of behavioral health data trends and patterns. Implementation of The RM&PSI risk reduction strategies will assist in minimizing situations that lead to medical errors and untoward events and clearly could have a sizable financial impact on the organization. Additionally, The RM&PSI focuses on patient-centered approaches and the patient experience. As such, many organizations have reported improvement in patient satisfaction. Finally, The RM&PSI encourages (for many reasons) development of a patient safety culture. This positive environment often leads to improved employee satisfaction, reduced stress and better retention of staff.

Benefits of Clinical Risk Evaluations:
Proactive risk identification and effective management is the most cost effective method of mitigating risk exposure to an organization. All evaluations provide quality improvement and risk reduction opportunities, outlining guidelines, findings, recommendations, and rationale. An action plan provided with the final report details prioritized opportunities for improvement with which the facility may incorporate action steps, accountabilities, timeline and measures for evaluating effectiveness.

Each evaluation includes a formal closing conference with facility leadership and provides a verbal summary of findings and immediate opportunities for improvement.

All evaluations provide the opportunity for expert third parties to assess the high-risk clinical arena of emergency services. This unbiased review of current practices and the report of actual and potential areas of liability may be effectively utilized by the organization to appropriately evaluate and dedicate resources for ongoing improvement in the pursuit of excellence in patient care and safety.

Features

The RM&PSI evaluation of claims has identified frequent contributing factors and effective prevention measures. To assist organizations serving behavioral health services patients, The RM&PSI offers four levels of assessments. All of these evaluations can be tailored to meet the specific needs of a facility.

Four Levels of Assessments

1 Star

This focused clinical risk assessment conducted by a risk management consultant is a one to two-day assessment, based on facility size. This assessment focuses on high-risk area processes and outcomes. The assessment includes an onsite review of facility and department documents, interviews with staff to determine knowledge and compliance with facility policies/procedures and processes, and a limited review of medical record documentation processes. The evaluation and report will include rationale for all recommendations.

2 Star

This focused clinical risk assessment is conducted by a team of two consultants; a risk management expert and a clinical expert. It is a one to two-day assessment, based on facility size and focuses on high-risk area processes and outcomes. The assessment includes an onsite review of facility and department documents, interviews with staff to determine knowledge and compliance with facility policies/procedures and processes, and a more extensive review of medical record documentation processes. The evaluation and report will include rationale for all recommendations.

3 Star

This comprehensive clinical risk assessment is conducted by a team of two consultants; a risk management expert and a clinical expert. It is a one and a half to three-day review based on facility size and focuses on high-risk area processes and outcomes within the structure of the system as a whole. This review has an organizational approach to examine clinical care and inherent latent risks in the system.

This evaluation focuses on processes and outcomes in high-risk areas; it includes staff interviews, medical record documentation practices and procedural review and observations for selected areas as well as an off-site policy and document review and an anonymous culture of patient safety survey and analysis. This assessment offers a more extensive look at the organization�s processes and outcomes in comparison to standards, evidenced-based medicine and best practices. The evaluation and report will include rationale for all recommendations.

4 Star

This comprehensive clinical risk assessment is augmented and conducted by a full complement of experts including a risk management consultant, a physician expert and nurse expert. It is a multi-day assessment, based on facility size and focuses on high-risk area processes and outcomes within the structure of the system as a whole. This evaluation is the most extensive of all reviews.

This evaluation focuses on processes and outcomes in high-risk areas; it includes extensive staff interviews, extensive medical record documentation practices and procedural review and observations for selected areas as well as an off-site policy and document review and an anonymous culture of patient safety survey and analysis. This assessment offers the most extensive look at the organization�s processes and outcomes in comparison to standards, evidenced-based medicine and best practices. The evaluation and report will include rationale for all recommendations.

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