By providing the highest level of innovative and integrated consulting expertise, Clinical Risk Solutions will partner with your physician practice to develop and implement strategic initiatives that focus on care standardization, clinical operational efficiency, team culture, communication, documentation, regulatory compliance, and the development of a patient safety-centered model of excellence.

Focus areas of review and organizational program development include the following opportunities:

Physician Practice and Regulatory Assessment

  • Enhance physician practice organizational structures to integrate quality, safety, regulatory compliance, and risk management
  • Practice Assessment: comprehensive clinical risk assessment of the practice structures and regulatory compliance.
  • Regulatory Compliance:
    • Centers for Medicare & Medicaid Services (CMS)
    • Recovery Audit Contractor (RAC) review
    • Health care fraud and abuse
    • "Anti-Kickback" law
    • Stark I, II"/Self-Referral Law
  • Corporate Compliance:
  • Audit tools and training
  • Professional liability insurance brokerage services:
    • Broker RFP process and selection criteria
    • Broker performance measures
  • Bioethics/medical monflict
  • Medical mediation and conflict resolution process

Medical Staff Structure Review

  • Credentialing: re-credentialing, clinical privileging
  • Bylaws: rules and regulations
  • Peer review process:
    • Ongoing and focused professional performance evaluation (OPPE and FPPE)
  • Competencies (ACGME) and the Joint Commission:
    • Medical knowledge
    • Patient care
    • Interpersonal and communication skills
    • Professionalism
    • Systems based practice
    • Practice-based learning and improvement
  • The Joint Commission and CMS
    • Standard survey readiness/tracer methodology
    • Standard interpretation and resource tools
    • Physician leadership training
    • Hospital leadership and medical staff relationships
    • Conflict of interest
    • Professional behavior
    • Adverse event disclosure

Education and Physician Development

  • Culture and Staff Performance: Developing a patient safety-centered culture of excellence within the operational systems through staff education and engagement
  • Communication: Developing effective skills and techniques to enhance patient satisfaction and decrease medical malpractice liability
  • Documentation: strategies to strengthen documentation skills and regulatory compliance, and reduce liability
  • Policy development: Informed consent, end-of-life care, patient termination from practice, critical lab and diagnostic test result management, resident and AHP supervision
  • Contract negotiation
  • Medical error management:
    • Documentation, investigation, disclosure, mediation/resolution
  • Reduction of health care-associated infections
  • Medication sample handling/regulatory compliance
  • Medication reconciliation process