Selected Podcast
Risk Management Consultants: What They Do and How They Keep Your Organization Safe
Health care risk management is a very diverse field and when you meet one risk manager, you meet one risk manager. One size does not fit all. This podcast series will look to discuss risks inherent to a variety of areas in health care. The fifth of the series will explore the unique challenges of health care risk management for those who work under the consulting umbrella.
Featuring:
With a vast healthcare knowledge garnered from more than 30 years in clinical practice, hospital administration, and consulting, Sharon provides comprehensive services to healthcare systems, hospitals, clinics, healthcare providers, and physicians. Her expertise includes consulting with clients about improving patient safety and quality/performance, identifying and evaluating potential liability exposure, developing and implementing risk management programs, and devising solutions to reduce or eliminate loss severity. Sharon served as the assistant vice president of risk management for a professional liability insurance carrier. Sharon also has provided risk management consulting to large integrated health systems and physician groups, and she has developed customized risk service plans/proposals. Sharon earned a bachelor’s degree in nursing from Otterbein University and a master’s degree in hospital administration from Central Michigan University. As a long-term member of the American Society for Healthcare Risk Management (ASHRM) and various state chapters, she has helped to design curriculum, delivered large-scale presentations, and mentored new members. She is a faculty member for ASHRM’s advanced module of the HRM Certificate Program. Her professional designations include certified professional in healthcare risk management (CPHRM), certified professional in patient safety (CPPS), associate in risk management (ARM), and distinguished fellow of ASHRM (DFASHRM). Sharon also is a frequent national speaker on patient safety.
Cyndi has more than 30 years of healthcare, administrative and insurance experience, 25 of those focused on risk management and patient safety. Cyndi’s responsibilities as CEO and Executive Consultant of Siders HealthCare Consulting, LLC include providing customized risk management and patient safety professional consultation and strategic support, coaching, mentoring and education for healthcare organizations and health systems; risk management companies, insurance and claims management companies and insurance agencies.
Cyndi has served as vice president of consulting services for large professional liability insurance companies providing leadership for a team of consultants delivering risk management and patient safety consultative services, education, and strategic support for clients nationally. These services included educational programs and training; comprehensive risk management, patient safety and quality improvement evaluations; coaching and mentoring programs and consultative services for healthcare systems, hospitals, physician office practices, community health centers and senior care facilities. She was also responsible for the development of proactive risk management and patient safety products and services. Prior to her national consulting experience, Cyndi was corporate risk manager for an integrated health system. In this role, she was responsible for the overall risk management and patient safety program, loss control and risk financing, claims administration, contract review, patient relations, and served as a liaison with insurance and regulatory representatives.
Cyndi has Bachelor and Master of Science degrees in nursing from the University of North Dakota. She is a graduate of the Healthcare Risk Management Certificate Program co-sponsored by MMI Companies Inc. and the University of Health Sciences/The Chicago Medical School. Cyndi is a distinguished fellow with the American Society for Healthcare Risk Management, a certified professional in healthcare risk management from the American Hospital Association, a certified professional in patient safety from the certification board for professionals in patient safety, an advanced master trainer in TeamSTEPPS® and a Certified Work Comp Adviosr. Cyndi is current president of the North Dakota Society for Healthcare Risk Management and serves as faculty for the ASHRM Health Care Risk Management Certificate Program. ¬ Cyndi is a frequent state and national speaker on a variety of risk management and patient safety topics and has authored several national publications, including chapters in ASHRM publications. Cyndi is a past recipient of the ASHRM Research Incentive Award.
Caroline Bell, RN, FASJD, CPHRM, DFASHRM | Sharon Groves, BSN, MSA, CPHRM, CPPS, DHRM, ARM | Cyndi Siders, RN, MSN, DFASHRM, CPHRM, CPPS, CWCA
Caroline Bell is a veteran of creating and implementing effective risk management approaches in healthcare organizations. She has over 25 years of experience in the healthcare industry. Caroline’s collaborative and results-oriented approach facilitates the adoption of impactful risk management strategies in healthcare entities. Caroline’s extensive experience includes leadership and execution in risk management and patient safety programs for healthcare risk consulting firms, medical malpractice insurance companies, large and mid-size health systems, and academic university medical centers. Her clinical experience is vast and enables her to provide guidance across multiple specialties and disciplines. Caroline provides consultative services to improve and enhance risk management and patient safety programs. She assists healthcare organizations with clinical risk management program design and development; enterprise risk management evaluation, development and implementation; strategic risk management initiatives including implementation and evaluation. She also specializes in coaching/mentoring risk management professionals at all levels of healthcare organizations. Caroline has a Bachelor of Science in Nursing and a Juris Doctor degree. She is a Certified Professional in Healthcare Risk Management (CPHRM). Caroline is actively engaged in local and national risk management societies and has served as a member of a variety of professional committees. She is a Distinguished Fellow of the American Society for Health Care Risk Management (DFASHRM) and was the 2019 President of Colorado Healthcare-Associated Risk Managers (CHARM), faculty member for ASHRM’s ERM Certificate Program and she’s an ASHRM board member. She has authored numerous articles and speaks on a local, national and international level on healthcare risk management topics.With a vast healthcare knowledge garnered from more than 30 years in clinical practice, hospital administration, and consulting, Sharon provides comprehensive services to healthcare systems, hospitals, clinics, healthcare providers, and physicians. Her expertise includes consulting with clients about improving patient safety and quality/performance, identifying and evaluating potential liability exposure, developing and implementing risk management programs, and devising solutions to reduce or eliminate loss severity. Sharon served as the assistant vice president of risk management for a professional liability insurance carrier. Sharon also has provided risk management consulting to large integrated health systems and physician groups, and she has developed customized risk service plans/proposals. Sharon earned a bachelor’s degree in nursing from Otterbein University and a master’s degree in hospital administration from Central Michigan University. As a long-term member of the American Society for Healthcare Risk Management (ASHRM) and various state chapters, she has helped to design curriculum, delivered large-scale presentations, and mentored new members. She is a faculty member for ASHRM’s advanced module of the HRM Certificate Program. Her professional designations include certified professional in healthcare risk management (CPHRM), certified professional in patient safety (CPPS), associate in risk management (ARM), and distinguished fellow of ASHRM (DFASHRM). Sharon also is a frequent national speaker on patient safety.
Cyndi has more than 30 years of healthcare, administrative and insurance experience, 25 of those focused on risk management and patient safety. Cyndi’s responsibilities as CEO and Executive Consultant of Siders HealthCare Consulting, LLC include providing customized risk management and patient safety professional consultation and strategic support, coaching, mentoring and education for healthcare organizations and health systems; risk management companies, insurance and claims management companies and insurance agencies.
Cyndi has served as vice president of consulting services for large professional liability insurance companies providing leadership for a team of consultants delivering risk management and patient safety consultative services, education, and strategic support for clients nationally. These services included educational programs and training; comprehensive risk management, patient safety and quality improvement evaluations; coaching and mentoring programs and consultative services for healthcare systems, hospitals, physician office practices, community health centers and senior care facilities. She was also responsible for the development of proactive risk management and patient safety products and services. Prior to her national consulting experience, Cyndi was corporate risk manager for an integrated health system. In this role, she was responsible for the overall risk management and patient safety program, loss control and risk financing, claims administration, contract review, patient relations, and served as a liaison with insurance and regulatory representatives.
Cyndi has Bachelor and Master of Science degrees in nursing from the University of North Dakota. She is a graduate of the Healthcare Risk Management Certificate Program co-sponsored by MMI Companies Inc. and the University of Health Sciences/The Chicago Medical School. Cyndi is a distinguished fellow with the American Society for Healthcare Risk Management, a certified professional in healthcare risk management from the American Hospital Association, a certified professional in patient safety from the certification board for professionals in patient safety, an advanced master trainer in TeamSTEPPS® and a Certified Work Comp Adviosr. Cyndi is current president of the North Dakota Society for Healthcare Risk Management and serves as faculty for the ASHRM Health Care Risk Management Certificate Program. ¬ Cyndi is a frequent state and national speaker on a variety of risk management and patient safety topics and has authored several national publications, including chapters in ASHRM publications. Cyndi is a past recipient of the ASHRM Research Incentive Award.
Transcription:
Bill Klaproth: Welcome to the ASHRM podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ashrm.org. That's A-S-H-R-M.org/membership to learn more and to become an ASHRM member. I'm Bill Klaproth.
So are you thinking about hiring a consultant? Do you have a special need for a consultant? Do you have questions on how they work, maybe how they got their start and exactly what they can do for your organization and how they can help keep your organization safe?
Well, we've got the podcast for you as we're going to talk with Cyndi Siders, CEO and executive consultant at Siders HealthCare Consulting; Sharon Groves, patient safety and risk consultant at the Groves Risk Group; and Caroline Bell. Caroline is the principal and founder of IERM.
Cyndi, Caroline and Sharon, thank you so much for your time. It is great to talk with you. So let's learn more about each of you and how you got into consulting. So, Caroline, let me start with you. How did you launch your career as a risk management consultant?
Caroline Bell: Well, Bill, I was a nurse for about 10 years and decided to go to law school. And I wanted to enhance my career by combining both my nursing and legal background. So I was hired as a risk manager at a healthcare system in about 2002. And I worked as a risk manager in the healthcare delivery setting for several years. And then, approximately five years of that experience in that type of setting, I was prepared to transition into a consulting role with a malpractice carrier. And later, I transitioned into independent consulting.
Bill Klaproth: Okay, good story. I wonder if many kind of follow that same path, although probably not, probably everybody reaches a point where they become a consultant in different ways. So, Cyndi, let me ask you the same question. How did you launch your career as a risk management consultant?
Cyndi Siders: Thanks, Bill. I also am a nurse by background and I had an opportunity to move to the quality department. I was there for a short period of time and the risk management position opened up and it sounded interesting to me. So I moved in as the director of risk management for this health system. I hadn't had an opportunity to have formal training in risk management. And MMI Companies and the University of Health Sciences, Chicago Medical School offered a one year risk management training program. I enrolled in the program, met the folks at MMI Companies and, at the end of the program, they offered me a position as a national consultant with them. So I've worked nationally with different insurance companies and risk management companies. And about seven years ago, I started my own consulting company.
Bill Klaproth: Okay, Cyndi. Well, thank you very much. That's interesting. I love hearing these stories. And Sharon, let me ask you, how did you launch your career as a risk management consult?
Sharon Groves: Thank you, Bill. So I have a similar background to Caroline in that I'm a nurse, and I took a leap from being an intensive care unit nurse into risk management. And after many years, I left there and went to a large insurance company in actually for almost 20 years. Then, I decided, "Well, you know, I'm going to just take a break and do nothing for a while." I didn't really put a shingle out and say, "Hey, I'm a consultant," but it was like word of mouth. Somebody needed someone to do a webinar and they said, "Well, Sharon, you know, is not working anywhere. Why don't you ask her?" And then that led to, "Oh, we need some help with some policies and procedures." And then I wrote a couple of articles. And so for me, my launch into being a consultant was really word of mouth after I decided to quit working at an insurance company and that's how my path took off.
Bill Klaproth: Yeah, that's interesting. You didn't find it. It kind of found you.
Sharon Groves: Right. And that happens a lot of times.
Bill Klaproth: Yeah, I bet. I bet. All right. So let me ask you this then, so what does a consultant do then? We probably have an idea in our minds of what a consultant does. But in reality, that might be different. So Caroline, let me start with you. What does a consultant do?
Caroline Bell: Well, Bill, I'd like to answer the question from a broad perspective and then a little bit from the operational perspective so that the folks can really understand what it is that a consultant can do for them. So, very broadly, a consultant is an expert at the application of the risk management process. He or she is a systems and process expert, and they're a master at the art of leveraging expertise to facilitate the achievement of an organization's objectives.
So generally, the risk consultant facilitates improvement through risk assessments, education, coaching and other mechanisms. For general purposes though, the consultant does assist the organization to achieve their strategic, operational and other goals. This can be enterprise risk management. It can be focused clinical assessment. It can be risk management department evaluation and restructure. It can be a number of things. But when we talk about the operational perspective, once an organization engages the consultant, that consultant then collaborates with the relevant experts and the key stakeholders within an organization world, where they will provide the services to frame those objectives and maybe the focus for the consulting services.
Bill Klaproth: Okay. So you're there to mainly help them achieve their goals, collaborate with them to achieve their goals and bring the expertise that you have and helping them do that. Is that basically right what I heard from you?
Caroline Bell: Correct.
Bill Klaproth: Got it. And I know everybody's got a little bit of different perspective on this. So Cyndi, how about you in your role as a consultant? Tell us what it is that you do?
Cyndi Siders: Consultants can work in different roles. So as we've mentioned, you can work for an insurance company and be a consultant and help the underwriters to determine if the client is a favorable risk in the practices that they have in place, so supporting the client put those best practices into place, and that might be education materials, onsite consultation. You can work as an independent consultant, as Caroline talked about several ways you can do that. Or you can work for an insurance agency. In that way, you're supporting a client with a variety of needs that they might have. So rather than doing an assessment, for example, for an insurance company, you might come in and they have a new risk manager or they have a new director of nursing, and it's so much to do their role and to understand risk management and the interface with quality. And so you're helping them to create a roadmap in their organization on what are the risks, what are the next steps, how can I manage those risks? So that's a little bit different perspective on consulting.
Bill Klaproth: Yeah, that makes sense. So basically, you're bringing your particular skills and expertise in a certain area into the organization where someone on that staff might not possess, right?
Cyndi Siders: Exactly.
Bill Klaproth: Yeah. Okay. Yeah, that's cool. Okay. Sharon, how about you? Any thoughts you want to add to that on what consultants do?
Sharon Groves: When you take it down into the next level, okay, so those were really good overviews, and I just want to bring out that when you are there with the customer, having listening skills so that they know that you're listening and giving them feedback, but understanding what it is that they really need. So listening to them and having your risk management hat on to listen for key areas that they might need help with and giving them that feedback. So listening skills throughout all of this is very important.
Bill Klaproth: So you could also be someone to help them identify needs within the organization, that they might not have time to uncover or develop themselves.
Sharon Groves: Right.
Bill Klaproth: Yeah. So it's varied the roles that a consultant can do depending on the application for the individual organization then is that right, Sharon?
Sharon Groves: Correct.
Bill Klaproth: Okay. Got it. So, when I'm hearing you talk, I'm thinking of someone outside the organization coming into the organization, but then how might someone become a consultant within their own organization? How does that work, Sharon?
Sharon Groves: Well, I think people, if they sit down and really think about their job that they do on a daily basis, they're already being a consultant within their facility. Let's say the OB department has had an issue. They call the risk manager and say, "I need some help," and that risk manager comes and listens to the problem and what issues they're having and gives them some ideas. Now, they might not be an expert in OB and you don't have to be. You don't even have to be a nurse to be a risk manager, but you can be a consultant and help other departments work through what issues they're having and plus there are other resources for you as a risk manager to help you be a consultant for them.
Bill Klaproth: So as you're all talking, I'm thinking to myself here how risk management has changed throughout the years. So I'm curious, Cyndi, let me ask you this, what are some of the recent trends then in consulting services when we think about risk management?
Cyndi Siders: Great question. Well, over the past two years, every healthcare organization from outpatient services to inpatient services have been managing the pandemic in their organization, and so infection prevention, protocols and practices, having accessibility to personal protective equipment, practice protocols, care protocols for patients, for residents, if you're in long-term care. So certainly, there has been a change in focus there.
Also, we've been hearing about staffing needs. There are staffing shortages across the country, so recruitment and retention of staff. Also, leadership turnover in organizations. So having that continuity of risk, quality clinical care and services in the organization's certainly an evolving ever-present trend.
And then we know during the pandemic people needed different options to have healthcare. So there was very much an expansion of telehealth and telemonitoring and how we could access care. And then we heard about how there were some access issues, availability, affordability, health equity concerns that people are addressing. And of course, you've probably noted in the media that there's stress, there's fatigue, there's burnout in the healthcare field. So while that's a small list of things that people are dealing with including financial risks with all of the items I've mentioned, I think that that's been top of mind for most healthcare organizations.
Bill Klaproth: It sounds like the pandemic has brought a full suite of additional consulting services. Would that be fair to say?
Cyndi Siders: Certainly, there's been a need to how to manage these different areas that are coming up and resources. So, yes, I agree.
Caroline Bell: This is Caroline, and I'd like to add to what Cyndi has already stated and she's spot on with those particular issues. But when I think about recent trends within a risk management department specifically, that the trend is to convert to a more proactive than a reactive risk management program. So I'm getting a lot of requests for assistance and converting those programs and guiding risk management programs to become more proactive and also to make them more standardized.
Bill Klaproth: Yeah, that's an excellent point to add in. And Caroline, let me ask you this then, since you were talking about clients reaching out to you to ask for assistance, and I know they do that with real time issues, can you share some examples of issues you've recently assisted your clients with?
Caroline Bell: Sure. And first of all, it's important to state that the consultant really should serve as a coach to assist their clients to reach the proper conclusion on their own, unless it is that the client specifically requests research on a particular topic. So the consultant can serve as a coach by asking some probing questions like, "Why do you think that is? When have you done something like this before? Do you feel that is right? What policies already exist to address the problem?" Those are just some examples. So the consultant can coach the client to determine what policies procedures or maybe committees that might already be in place at their organization to manage the issue.
For example, early in the COVID pandemic, I received several questions on how to manage patients or families that request ivermectin, which was something that wasn't available. So the consultant should ask, "What policies are in place to address ivermectin administration? Have you managed this question before? And if so, how was it addressed? Whom in the organization is best suited to educate the patient and/or the family on the organization's policy or existing protocols if they exist?" Many times, somebody is reaching out just to confirm their existing thoughts, what they think that they should do or how they should handle a particular issue. And so, the consultant can be that second opinion, so to speak, for those real time issues.
Sharon Groves: This is Sharon. And so I just would like to add a couple of examples. One, I was working with a company that is a non-emergency care transport company. And in interviewing the different staff, it came to be that they really didn't have a safety program. And so I worked with them, listened to them and helped them write a safety program. And it gave them the framework of what they needed to do to get better results, to decrease falls, people falling from the transportation vehicle. That would be one example.
Another example in a hospital, I had five hospitals in the system that they were having punctures during abdominal surgery, and they were trying to figure out why is this happening. So I observed in several ORs, I watched them, I talked to the different staff and came to find out what was the problem and I worked with them to help them decrease this issue and then they had a good outcome and the numbers got better. So listening and helping them, like she said, be a coach to help identify what the issue is because they know, in a lot of cases, trying to get this fixed is really important.
Bill Klaproth: What an important role you played in working on that safety program and the punctures issue as well. So I'm thinking what are some of the other ways you've achieved value for your clients? Caroline, let me ask you that.
Caroline Bell: Generally, the consultant contributes value by facilitating the creation of early warning systems. And this can be through the establishment of risk indicators, so that the organization can implement necessary measures to timely control or even eliminate risk. So when they establish those key risk indicators and they're prepared to take timely action, it directly results in value in terms of revenue savings or sometimes even revenue generation, claims control and so on. So even further, the risk consultant can drive value by facilitating risk prioritization. Also, the implementation of cost effective and efficient measures to control or eliminate risk, and also by coaching the key stakeholders to achieve their stated goals within their organization.
Bill Klaproth: Well, thank you for sharing that, Caroline. And again, it really makes sense when you put it that way to understand the real value that a consultant can bring. And I know there's different styles and different ways of working with people. So, Cyndi, what are some examples of consulting styles and what styles have you used?
Cyndi Siders: Great question. As you've indicated, there are certainly different styles and people develop their own consulting style. My style is I work with different groups, whether it's an insurance company or I'm contracted individually, is to understand the client's needs and to best represent them in the reports. So what are the risk issues that we're seeing? How are they managing those risks? And as we make recommendations, suggestions, how would they can actually put it into play, how it makes a difference in their organization and how it can impact risk. And I find that that adds additional value. Sometimes people don't understand all of the requirements, accreditation, licensure, regulatory agencies, why are those in place? And so being able to coach and mentor why they're there, why they're a risk and how these practices that we're suggesting can add value to the organization and reduce risk, reduce time, move your model more proactively, as Caroline mentioned, is a style that I use and I found that to be very effective. People like that. They're the expert and we're providing them with additional assistance on how they can support their work.
Bill Klaproth: Yeah, you used the words coach and mentor. Cyndi, is that kind of the best way consultants or generally the way most consultants work with their clients is as a coach and mentor?
Cyndi Siders: I would guess so. I know that sometimes depending on who you're working for and the job you're assigned, some consultants may use more of a surveyor-type style where we're looking for non-compliance. I prefer the collaborative let's look for best practices where you have best practices and where are there opportunities.
Bill Klaproth: Yeah, collaborations are so important. So let's talk about reaching other stakeholders, people that you also have to engage, such as leadership, physicians, the governing board. How do you deal with those stakeholders?
Caroline Bell: Yeah. Well, first, it is important that participating leaders understand the purpose of the consultant services. We learn the hard way that assumptions can be made. So it's important for the consultant to control that narrative either through verbal or written invitations that explain the role of the consultant and the goal of the visit, that the services are meant to include all relevant leaders, stakeholders, and it helps the organization achieve its goals. So they have a stake in the game.
We know too that it can be challenging for C-suite leaders to participate in the process, so a consultant can demonstrate to leaders their stake in the process. So, for example, with one organization, I helped them to design their communication and resolution program. And so it was important to present to the board what is this and what is it that the organization needs from the board, what are some of those indicators or those success measures for the program, and what questions should the board be asking of leaders of the organization so that they know that the program is working the way as intended through their oversight.
And we know that the leaders within an organization are best positioned to drive change within that organization. So without active participation by key leaders, stakeholders, physicians, they won't achieve the maximum value for the process. So to clearly communicate that and control the narrative of that is really important for a consultant to do for the organization.
Cyndi Siders: This is Cyndi and I totally agree with what Caroline has said. Bringing information that supports the current strategic, financial, operational, those domains of enterprise risk management to the organization, so they can understand current state of risk where there's potential risk, how they can prioritize that risk, being a support to the organization. And I, like Caroline, have worked with boards of directors and what is their role with risk management? Many of them have not had formal risk management training. So to be able to understand what is risk management, what is enterprise risk management, what are the right questions that I should be asking to understand our level of risk in the organization and how we can support that in our decision-making, I think it's critical.
Bill Klaproth: Absolutely. Well, this has been a great discussion on how you became consultants and how you work with your clients. So I'm just curious what ASHRM resources have you found valuable to support your role as a consultant. Caroline, let me start with you.
Caroline Bell: Sure. So it does depend on what it is that you would use the resources for. They're all stellar. They've all been developed by seasoned risk managers, risk management professionals. But if I were to choose some of my favorites, I would say that the ERM resources such as the ERM Playbook, they do provide excellent information and tools that can be used to implement ERM, and even conduct an enterprise risk assessment.
If somebody's looking for specific clinical areas, there are various playbooks, such as OB, Physician Office, Human Capital, et cetera, et cetera. These touch on a lot of the areas that Cyndi, Sharon and I have talked about before. ASHRM Exchange is another really good one. It's a great way to engage other risk managers to solve complex problems. And these are just a few of my go-to favorites.
Bill Klaproth: Yeah. And then Cyndi, how about you? Can you talk about the ASHRM resources that you have found valuable?
Cyndi Siders: Yes. Well, I've attended many conferences over the years and I find not only the educational materials, but also the opportunity to interact and network with colleagues across the country has been invaluable. As Caroline mentioned, the playbooks and other resources that are out there, even as a seasoned risk manager consultant, I purchased those books because they add value to my collection that I have.
I've also served on a number of committees, learning about ASHRM's role, but also learning from people across the country. And like Sharon and Caroline, all three of us are faculty for ASHRM, that's a great opportunity as well to reach out, to share information, but also to learn from all of the participants that are there.
Bill Klaproth: Yeah, that continuing education especially as risk management evolves is so important. And then Sharon, let me ask you the same question. What ASHRM resources have you found valuable?
Sharon Groves: I've also used the playbooks depending on what customers I'm working with. And I found them to be very valuable because they are step-by-step. It helps you understand what you need to do to get to the end process. So it's a great resource.
Bill Klaproth: Absolutely. Well, Caroline, Sharon and Cyndi, thank you so much for your time. This has really been a great discussion. Thank you again.
Cyndi Siders: Thank you.
Sharon Groves: Thank you.
Caroline Bell: All right. Have a great day, everyone.
Bill Klaproth: And once again, that Cyndi Siders, Sharon Groves and Caroline Bell. And if you'd like to join as a member of ASHRM, go to ashrm.org. That's A-S-H-R-M.org/membership. And the ASHRM Podcast was made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ashrm.org/membership to learn more and, once again, to become an ASHRM member. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. I'm Bill Klaproth. Thanks for listening.
Bill Klaproth: Welcome to the ASHRM podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ashrm.org. That's A-S-H-R-M.org/membership to learn more and to become an ASHRM member. I'm Bill Klaproth.
So are you thinking about hiring a consultant? Do you have a special need for a consultant? Do you have questions on how they work, maybe how they got their start and exactly what they can do for your organization and how they can help keep your organization safe?
Well, we've got the podcast for you as we're going to talk with Cyndi Siders, CEO and executive consultant at Siders HealthCare Consulting; Sharon Groves, patient safety and risk consultant at the Groves Risk Group; and Caroline Bell. Caroline is the principal and founder of IERM.
Cyndi, Caroline and Sharon, thank you so much for your time. It is great to talk with you. So let's learn more about each of you and how you got into consulting. So, Caroline, let me start with you. How did you launch your career as a risk management consultant?
Caroline Bell: Well, Bill, I was a nurse for about 10 years and decided to go to law school. And I wanted to enhance my career by combining both my nursing and legal background. So I was hired as a risk manager at a healthcare system in about 2002. And I worked as a risk manager in the healthcare delivery setting for several years. And then, approximately five years of that experience in that type of setting, I was prepared to transition into a consulting role with a malpractice carrier. And later, I transitioned into independent consulting.
Bill Klaproth: Okay, good story. I wonder if many kind of follow that same path, although probably not, probably everybody reaches a point where they become a consultant in different ways. So, Cyndi, let me ask you the same question. How did you launch your career as a risk management consultant?
Cyndi Siders: Thanks, Bill. I also am a nurse by background and I had an opportunity to move to the quality department. I was there for a short period of time and the risk management position opened up and it sounded interesting to me. So I moved in as the director of risk management for this health system. I hadn't had an opportunity to have formal training in risk management. And MMI Companies and the University of Health Sciences, Chicago Medical School offered a one year risk management training program. I enrolled in the program, met the folks at MMI Companies and, at the end of the program, they offered me a position as a national consultant with them. So I've worked nationally with different insurance companies and risk management companies. And about seven years ago, I started my own consulting company.
Bill Klaproth: Okay, Cyndi. Well, thank you very much. That's interesting. I love hearing these stories. And Sharon, let me ask you, how did you launch your career as a risk management consult?
Sharon Groves: Thank you, Bill. So I have a similar background to Caroline in that I'm a nurse, and I took a leap from being an intensive care unit nurse into risk management. And after many years, I left there and went to a large insurance company in actually for almost 20 years. Then, I decided, "Well, you know, I'm going to just take a break and do nothing for a while." I didn't really put a shingle out and say, "Hey, I'm a consultant," but it was like word of mouth. Somebody needed someone to do a webinar and they said, "Well, Sharon, you know, is not working anywhere. Why don't you ask her?" And then that led to, "Oh, we need some help with some policies and procedures." And then I wrote a couple of articles. And so for me, my launch into being a consultant was really word of mouth after I decided to quit working at an insurance company and that's how my path took off.
Bill Klaproth: Yeah, that's interesting. You didn't find it. It kind of found you.
Sharon Groves: Right. And that happens a lot of times.
Bill Klaproth: Yeah, I bet. I bet. All right. So let me ask you this then, so what does a consultant do then? We probably have an idea in our minds of what a consultant does. But in reality, that might be different. So Caroline, let me start with you. What does a consultant do?
Caroline Bell: Well, Bill, I'd like to answer the question from a broad perspective and then a little bit from the operational perspective so that the folks can really understand what it is that a consultant can do for them. So, very broadly, a consultant is an expert at the application of the risk management process. He or she is a systems and process expert, and they're a master at the art of leveraging expertise to facilitate the achievement of an organization's objectives.
So generally, the risk consultant facilitates improvement through risk assessments, education, coaching and other mechanisms. For general purposes though, the consultant does assist the organization to achieve their strategic, operational and other goals. This can be enterprise risk management. It can be focused clinical assessment. It can be risk management department evaluation and restructure. It can be a number of things. But when we talk about the operational perspective, once an organization engages the consultant, that consultant then collaborates with the relevant experts and the key stakeholders within an organization world, where they will provide the services to frame those objectives and maybe the focus for the consulting services.
Bill Klaproth: Okay. So you're there to mainly help them achieve their goals, collaborate with them to achieve their goals and bring the expertise that you have and helping them do that. Is that basically right what I heard from you?
Caroline Bell: Correct.
Bill Klaproth: Got it. And I know everybody's got a little bit of different perspective on this. So Cyndi, how about you in your role as a consultant? Tell us what it is that you do?
Cyndi Siders: Consultants can work in different roles. So as we've mentioned, you can work for an insurance company and be a consultant and help the underwriters to determine if the client is a favorable risk in the practices that they have in place, so supporting the client put those best practices into place, and that might be education materials, onsite consultation. You can work as an independent consultant, as Caroline talked about several ways you can do that. Or you can work for an insurance agency. In that way, you're supporting a client with a variety of needs that they might have. So rather than doing an assessment, for example, for an insurance company, you might come in and they have a new risk manager or they have a new director of nursing, and it's so much to do their role and to understand risk management and the interface with quality. And so you're helping them to create a roadmap in their organization on what are the risks, what are the next steps, how can I manage those risks? So that's a little bit different perspective on consulting.
Bill Klaproth: Yeah, that makes sense. So basically, you're bringing your particular skills and expertise in a certain area into the organization where someone on that staff might not possess, right?
Cyndi Siders: Exactly.
Bill Klaproth: Yeah. Okay. Yeah, that's cool. Okay. Sharon, how about you? Any thoughts you want to add to that on what consultants do?
Sharon Groves: When you take it down into the next level, okay, so those were really good overviews, and I just want to bring out that when you are there with the customer, having listening skills so that they know that you're listening and giving them feedback, but understanding what it is that they really need. So listening to them and having your risk management hat on to listen for key areas that they might need help with and giving them that feedback. So listening skills throughout all of this is very important.
Bill Klaproth: So you could also be someone to help them identify needs within the organization, that they might not have time to uncover or develop themselves.
Sharon Groves: Right.
Bill Klaproth: Yeah. So it's varied the roles that a consultant can do depending on the application for the individual organization then is that right, Sharon?
Sharon Groves: Correct.
Bill Klaproth: Okay. Got it. So, when I'm hearing you talk, I'm thinking of someone outside the organization coming into the organization, but then how might someone become a consultant within their own organization? How does that work, Sharon?
Sharon Groves: Well, I think people, if they sit down and really think about their job that they do on a daily basis, they're already being a consultant within their facility. Let's say the OB department has had an issue. They call the risk manager and say, "I need some help," and that risk manager comes and listens to the problem and what issues they're having and gives them some ideas. Now, they might not be an expert in OB and you don't have to be. You don't even have to be a nurse to be a risk manager, but you can be a consultant and help other departments work through what issues they're having and plus there are other resources for you as a risk manager to help you be a consultant for them.
Bill Klaproth: So as you're all talking, I'm thinking to myself here how risk management has changed throughout the years. So I'm curious, Cyndi, let me ask you this, what are some of the recent trends then in consulting services when we think about risk management?
Cyndi Siders: Great question. Well, over the past two years, every healthcare organization from outpatient services to inpatient services have been managing the pandemic in their organization, and so infection prevention, protocols and practices, having accessibility to personal protective equipment, practice protocols, care protocols for patients, for residents, if you're in long-term care. So certainly, there has been a change in focus there.
Also, we've been hearing about staffing needs. There are staffing shortages across the country, so recruitment and retention of staff. Also, leadership turnover in organizations. So having that continuity of risk, quality clinical care and services in the organization's certainly an evolving ever-present trend.
And then we know during the pandemic people needed different options to have healthcare. So there was very much an expansion of telehealth and telemonitoring and how we could access care. And then we heard about how there were some access issues, availability, affordability, health equity concerns that people are addressing. And of course, you've probably noted in the media that there's stress, there's fatigue, there's burnout in the healthcare field. So while that's a small list of things that people are dealing with including financial risks with all of the items I've mentioned, I think that that's been top of mind for most healthcare organizations.
Bill Klaproth: It sounds like the pandemic has brought a full suite of additional consulting services. Would that be fair to say?
Cyndi Siders: Certainly, there's been a need to how to manage these different areas that are coming up and resources. So, yes, I agree.
Caroline Bell: This is Caroline, and I'd like to add to what Cyndi has already stated and she's spot on with those particular issues. But when I think about recent trends within a risk management department specifically, that the trend is to convert to a more proactive than a reactive risk management program. So I'm getting a lot of requests for assistance and converting those programs and guiding risk management programs to become more proactive and also to make them more standardized.
Bill Klaproth: Yeah, that's an excellent point to add in. And Caroline, let me ask you this then, since you were talking about clients reaching out to you to ask for assistance, and I know they do that with real time issues, can you share some examples of issues you've recently assisted your clients with?
Caroline Bell: Sure. And first of all, it's important to state that the consultant really should serve as a coach to assist their clients to reach the proper conclusion on their own, unless it is that the client specifically requests research on a particular topic. So the consultant can serve as a coach by asking some probing questions like, "Why do you think that is? When have you done something like this before? Do you feel that is right? What policies already exist to address the problem?" Those are just some examples. So the consultant can coach the client to determine what policies procedures or maybe committees that might already be in place at their organization to manage the issue.
For example, early in the COVID pandemic, I received several questions on how to manage patients or families that request ivermectin, which was something that wasn't available. So the consultant should ask, "What policies are in place to address ivermectin administration? Have you managed this question before? And if so, how was it addressed? Whom in the organization is best suited to educate the patient and/or the family on the organization's policy or existing protocols if they exist?" Many times, somebody is reaching out just to confirm their existing thoughts, what they think that they should do or how they should handle a particular issue. And so, the consultant can be that second opinion, so to speak, for those real time issues.
Sharon Groves: This is Sharon. And so I just would like to add a couple of examples. One, I was working with a company that is a non-emergency care transport company. And in interviewing the different staff, it came to be that they really didn't have a safety program. And so I worked with them, listened to them and helped them write a safety program. And it gave them the framework of what they needed to do to get better results, to decrease falls, people falling from the transportation vehicle. That would be one example.
Another example in a hospital, I had five hospitals in the system that they were having punctures during abdominal surgery, and they were trying to figure out why is this happening. So I observed in several ORs, I watched them, I talked to the different staff and came to find out what was the problem and I worked with them to help them decrease this issue and then they had a good outcome and the numbers got better. So listening and helping them, like she said, be a coach to help identify what the issue is because they know, in a lot of cases, trying to get this fixed is really important.
Bill Klaproth: What an important role you played in working on that safety program and the punctures issue as well. So I'm thinking what are some of the other ways you've achieved value for your clients? Caroline, let me ask you that.
Caroline Bell: Generally, the consultant contributes value by facilitating the creation of early warning systems. And this can be through the establishment of risk indicators, so that the organization can implement necessary measures to timely control or even eliminate risk. So when they establish those key risk indicators and they're prepared to take timely action, it directly results in value in terms of revenue savings or sometimes even revenue generation, claims control and so on. So even further, the risk consultant can drive value by facilitating risk prioritization. Also, the implementation of cost effective and efficient measures to control or eliminate risk, and also by coaching the key stakeholders to achieve their stated goals within their organization.
Bill Klaproth: Well, thank you for sharing that, Caroline. And again, it really makes sense when you put it that way to understand the real value that a consultant can bring. And I know there's different styles and different ways of working with people. So, Cyndi, what are some examples of consulting styles and what styles have you used?
Cyndi Siders: Great question. As you've indicated, there are certainly different styles and people develop their own consulting style. My style is I work with different groups, whether it's an insurance company or I'm contracted individually, is to understand the client's needs and to best represent them in the reports. So what are the risk issues that we're seeing? How are they managing those risks? And as we make recommendations, suggestions, how would they can actually put it into play, how it makes a difference in their organization and how it can impact risk. And I find that that adds additional value. Sometimes people don't understand all of the requirements, accreditation, licensure, regulatory agencies, why are those in place? And so being able to coach and mentor why they're there, why they're a risk and how these practices that we're suggesting can add value to the organization and reduce risk, reduce time, move your model more proactively, as Caroline mentioned, is a style that I use and I found that to be very effective. People like that. They're the expert and we're providing them with additional assistance on how they can support their work.
Bill Klaproth: Yeah, you used the words coach and mentor. Cyndi, is that kind of the best way consultants or generally the way most consultants work with their clients is as a coach and mentor?
Cyndi Siders: I would guess so. I know that sometimes depending on who you're working for and the job you're assigned, some consultants may use more of a surveyor-type style where we're looking for non-compliance. I prefer the collaborative let's look for best practices where you have best practices and where are there opportunities.
Bill Klaproth: Yeah, collaborations are so important. So let's talk about reaching other stakeholders, people that you also have to engage, such as leadership, physicians, the governing board. How do you deal with those stakeholders?
Caroline Bell: Yeah. Well, first, it is important that participating leaders understand the purpose of the consultant services. We learn the hard way that assumptions can be made. So it's important for the consultant to control that narrative either through verbal or written invitations that explain the role of the consultant and the goal of the visit, that the services are meant to include all relevant leaders, stakeholders, and it helps the organization achieve its goals. So they have a stake in the game.
We know too that it can be challenging for C-suite leaders to participate in the process, so a consultant can demonstrate to leaders their stake in the process. So, for example, with one organization, I helped them to design their communication and resolution program. And so it was important to present to the board what is this and what is it that the organization needs from the board, what are some of those indicators or those success measures for the program, and what questions should the board be asking of leaders of the organization so that they know that the program is working the way as intended through their oversight.
And we know that the leaders within an organization are best positioned to drive change within that organization. So without active participation by key leaders, stakeholders, physicians, they won't achieve the maximum value for the process. So to clearly communicate that and control the narrative of that is really important for a consultant to do for the organization.
Cyndi Siders: This is Cyndi and I totally agree with what Caroline has said. Bringing information that supports the current strategic, financial, operational, those domains of enterprise risk management to the organization, so they can understand current state of risk where there's potential risk, how they can prioritize that risk, being a support to the organization. And I, like Caroline, have worked with boards of directors and what is their role with risk management? Many of them have not had formal risk management training. So to be able to understand what is risk management, what is enterprise risk management, what are the right questions that I should be asking to understand our level of risk in the organization and how we can support that in our decision-making, I think it's critical.
Bill Klaproth: Absolutely. Well, this has been a great discussion on how you became consultants and how you work with your clients. So I'm just curious what ASHRM resources have you found valuable to support your role as a consultant. Caroline, let me start with you.
Caroline Bell: Sure. So it does depend on what it is that you would use the resources for. They're all stellar. They've all been developed by seasoned risk managers, risk management professionals. But if I were to choose some of my favorites, I would say that the ERM resources such as the ERM Playbook, they do provide excellent information and tools that can be used to implement ERM, and even conduct an enterprise risk assessment.
If somebody's looking for specific clinical areas, there are various playbooks, such as OB, Physician Office, Human Capital, et cetera, et cetera. These touch on a lot of the areas that Cyndi, Sharon and I have talked about before. ASHRM Exchange is another really good one. It's a great way to engage other risk managers to solve complex problems. And these are just a few of my go-to favorites.
Bill Klaproth: Yeah. And then Cyndi, how about you? Can you talk about the ASHRM resources that you have found valuable?
Cyndi Siders: Yes. Well, I've attended many conferences over the years and I find not only the educational materials, but also the opportunity to interact and network with colleagues across the country has been invaluable. As Caroline mentioned, the playbooks and other resources that are out there, even as a seasoned risk manager consultant, I purchased those books because they add value to my collection that I have.
I've also served on a number of committees, learning about ASHRM's role, but also learning from people across the country. And like Sharon and Caroline, all three of us are faculty for ASHRM, that's a great opportunity as well to reach out, to share information, but also to learn from all of the participants that are there.
Bill Klaproth: Yeah, that continuing education especially as risk management evolves is so important. And then Sharon, let me ask you the same question. What ASHRM resources have you found valuable?
Sharon Groves: I've also used the playbooks depending on what customers I'm working with. And I found them to be very valuable because they are step-by-step. It helps you understand what you need to do to get to the end process. So it's a great resource.
Bill Klaproth: Absolutely. Well, Caroline, Sharon and Cyndi, thank you so much for your time. This has really been a great discussion. Thank you again.
Cyndi Siders: Thank you.
Sharon Groves: Thank you.
Caroline Bell: All right. Have a great day, everyone.
Bill Klaproth: And once again, that Cyndi Siders, Sharon Groves and Caroline Bell. And if you'd like to join as a member of ASHRM, go to ashrm.org. That's A-S-H-R-M.org/membership. And the ASHRM Podcast was made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ashrm.org/membership to learn more and, once again, to become an ASHRM member. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. I'm Bill Klaproth. Thanks for listening.