1. RISK MANAGEMENT & GOVERNANCE Michael Gorton – Russell Kennedy ACHSE – 3 March 2004

2. The context Rise in claims September 11 Collapse of HIH/UMP Under funding of MDO’s Fear Financial incentives for risk management

3. The Government Response UMP support (and levy) Tort law reform Risk management (safety & quality)

4. Tort Law Reform Proportionate liability Caps and thresholds Open disclosure Limitation period for claims Definition of negligence (IPP) Abolish exemplary damages Good Samaritan Structured settlements

5. Governance & Management Liability Entity Individuals Vicarious liability Accountability Delegation Reporting Risk Management Legal risk Financial risk Business risk Compliance

6. Towards a governance culture Organisational culture (open) Staff knowledge, beliefs and values System design Resources Management model

7. Key Governance Issues Identification of and compliance with standards Recognise opportunity cost Getting it right Doing it wrong

8. Key Governance Issues Levels of delegation Systems of Accountability and Reporting Regimes Policies Quality of care and service Safety (including emergency) Legal risks Education and training Notice requirements/Compliance Checklist/Sign-off Incident Monitoring/Complaint Handling

9. Medical Governance MAC Credentialling Clinical Risk Committee QA Complaints analysis Incident data

10. Vicarious Liability Employees Agents Privatised services/facilities

11. Informed Consent Not a form Doctor certification Information sheets Checklist Records/notes

12. Communication and Prevention Studies of patients complaints and why they complain, indicate that some of the following factors are relevant They have not received an explanation which they can understand and accept They believe their treatment has been negligent or below standard (whether, in fact, it has or not) They have not been treated with consideration or sympathy or courtesy

13. Communication and Prevention They have sought information, but have not received an explanation, or their reasonable requests have not been met They have been discharged before they fully recovered (or they thought they had fully recovered), or discharged without proper explanation or follow up They are chronic complainers

14. Avoiding Liability Good care and service Protocols and procedures COMMUNICATION!! Complaint handling procedures – timely, sensitive, communicative NOTES AND RECORDS Insurance

15. Risk Management and Governance Michael Gorton Russell Kennedy Solicitors PO Box 5146AA, Melbourne Tel: 03 9609 1625 Fax: 03 9609 1825 Email: mgorton@rk.com.au