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Clinical Risk Management

 

Overview

 

The Victorian Clinical Risk Management (CRM) strategy has been in place since 2001 to address adverse events and medical error in health care. As part of this strategy the Department of Human Services (DHS) introduced the Limited Adverse Occurrence Screening (LAOS) program for Victoria�s small rural hospitals. This program was developed at the Wimmera Base Hospital in Horsham in collaboration with West Vic Division of General Practice and the Centre for Rural Health at Monash University, adapted for use by small rural hospitals in the Wimmera region. Evaluation in 1999 showed  it was an effective model particularly in engaging GPs who provide acute care in small rural hospitals. DHS funded West Vic Division to roll the program out to 5 other lead divisions in 2001 and so cover all small rural hospitals in Victoria.

 

 

Medical records meeting one of six criteria (screening criteria) are identified by the hospital Health Information Manager at the time of discharge coding and forwarded to GP reviewers who review for the presence of adverse events or education opportunities. The treating GP is asked for their review of events affecting an individual patient. De-identified case records are analysed by a local panel of GP reviewers and recommendations outlining system and/or patient care improvements to prevent the re-occurrence of the error are shared with all hospitals and GPs across the local area.

 

 

The LAOS program has broken down many of the barriers small rural hospitals have faced in participating in formal medical peer review. The GPs reviewing medical records are working in a similar environment to the doctors being reviewed and are located in a different geographical area to provide an "arms length" review process. The program aims to ensure that experience and knowledge is shared throughout the rural medical profession in a non-threatening manner.

 

The six lead divisions managing the program are:

 

 

Objectives

 

The GPV state-wide co-ordination role was recommended in the DHS review of the LAOS program undertaken in 2005 and has been funded since 2006. The objectives of this role are:

 

    1. to achieve standardisation and consistency in the LAOS program processes and improve the efficiency and effectiveness of the program 
    2. to develop a governance structure for the LAOS program with agreed performance measures, in partnership with DHS
    3. to facilitate the development of a standard format for LAOS recommendations and submit them to the department�s Clinical Risk Management Reference Group for review and subsequent statewide dissemination
    4. to assist GP reviewers to receive education which includes:
      • a standardised education and training package
      • detail regarding privacy and statutory immunity legislation.

 

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For further information contact:

Lesley Hawes, Clinical Risk Management Program Consulant Ph: 03 9341 5241 | Fax: 03 9341 5299 | Email: l.hawes@gpv.org.au

Last updated: Wednesday, 16 July 2008