Core Competencies

3.22 Risk Management

© 2017 Society of Hospital Medicine

Risk management seeks to reduce hazards to patients through a process of identification, evaluation, and analysis of potential or actual adverse events. Hospitalists should strive to comply with applicable laws and regulations, avoid conflicts of interest, and conduct the practice of medicine with integrity and ethics. Hospitalists should also take a collaborative and proactive role in risk management to improve safety and satisfaction in the hospital setting.

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Hospitalists should be able to:

  • Explain the legal definition of negligence and the concept of standard of care.

  • Describe the components of informed consent.

  • Describe Health Insurance Portability and Accountability Act (HIPAA) regulations related to patient confidentiality.

  • Explain requirements for billing compliance.

  • Describe laws and regulations relevant to the practice of hospital medicine, including the Emergency Medical Treatment and Active Labor Act (EMTALA), the Patient Safety and Quality Improvement Act, and credentialing and licensing.

  • Explain how ethical principles can be applied to risk management.


Hospitalists should be able to:

  • Ensure patient confidentiality and comply with HIPAA regulations in day-to-day practice.

  • Conduct medical practice and complete chart documentation to meet patient care needs and billing compliance.

  • Reduce risks through effective communication with all involved parties on the healthcare team.

  • Elicit and appropriately document informed consent from patients or surrogates for treatment plans and procedures when indicated.

  • Provide adequate supervision of members of the patient care team, which may include physician assistants, fellows, residents, or medical students.

  • Apply guidelines of clinical ethics to patient care and risk management.

  • Compare and minimize hazards of diagnostic and treatment management strategies for the individual patient.

  • Use appropriate systems to identify and report potential areas of risk to patients, families, or healthcare providers.


Hospitalists should be able to:

  • Apply ethical principles, which may include autonomy, beneficence, nonmaleficence, and justice, to promote patient-centered care.

  • Recognize the importance of prompt, honest, and open discussions with patients and families regarding medical errors or harm.

  • Respect patient wishes for treatment decisions and plans, including those that may not resonate with personal beliefs.

  • Respect patient confidentiality.

  • Collaborate with risk management specialists to review and/or address adverse events.

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