Risk Support

SMPH Risk Management provides risk management support to SMPH employees including clinical providers. SMPH Risk Management partners with the UW Office of Legal Affairs on legal proceedings, contacts regarding the legal process and claims management. In addition, SMPH Risk Management works very closely with UW Health (UWH) Risk Management/Legal Department, UWH’s Patient Safety and UWH Patient Relations on efforts to improve patient safety and quality of the care provided within the UW Health organization, and to assist SMPH providers when they are involved in these processes. On March 1, 2022, the Insurance Verification and Claims History Program transitioned to SMPH Risk Management and Faculty Services.

Some of the areas of support provided by SMPH Risk Management include:

1) Support with clinical events:

• Event investigation and review
• Working with UWH Patient Relations to support SMPH providers with patient/family complaints and grievances
• Questions/resources for disclosure discussions
• Assisting with disruptive patients and behavior planning, and “no further service” requests, in conjunction with UWH Patient Relations and UWH Risk Management

2) Assisting SMPH-employed providers in their roles as treating providers when contacted by outside counsel seeking:

• Telephone discussions or informal meetings
• Reports
• Depositions or trial testimony
• Review of subpoenas, notices of deposition and other similar paperwork
• Requests for independent medical expert reviews, including proper documentation for Independent Medical Exams
• Questions about document production, ability to disclose protected health information in legal settings
• Working closely with UW Office of Legal Affairs regarding legal process and requests

3) Risk Management support for clinical and professional issues, including:

• Event review and trending
• Risk management education on system-wide along with Department/Division specific topics
• Support for reviewing and reinforcing processes that support peer review privileged nature of quality improvement functions including M&M conferences and Quality Review committees
• Supporting and participating in the UWH-wide Peer Support Program

The list above are just some of the more common types of support SMPH Risk Management provides for SMPH employees in clinical and professional settings. SMPH Risk Management can be contacted at:

• Bob Ebbe: rebbe@wisc.edu, (608) 263-2914
• Christa Neuser: clneuser@wisc.edu, (608) 263-7663
• Please send insurance verifications and claims history requests to: smph-rm@med.wisc.edu
  

SMPH-employed providers may receive contacts from outside organizations and individuals indirectly related to professional services they provided or care in which they were involved through their SMPH-employment. Below are some examples of the types of contacts you may receive and a list of appropriate resources you can reach out to.

It is important for SMPH providers to be familiar with UW Health’s confidential Healthcare Event Reporting Online (HERO) incident reporting platform.

• One important reason to log in to the HERO platform is that this allows Patient Safety, Risk Management and others to consult individuals on specific HERO reports in order to inform and get feedback from those individuals. If someone has not yet logged into HERO, their name currently does not show up on the list of people who can be consulted about a HERO report)
• While HERO reports are reviewed regularly, they may not be immediately seen. If you need immediate assistance, due to safety or security concerns or need to alert someone of an urgent issue, you should reach out directly first and then enter a HERO report.
• HERO reports are confidential and privileged communications within the UW Health systems. HERO reports should not be shared with anyone outside of the UW Health system. Questions should be directed to UW Health Patient Safety
• HERO reports are not clinical charting and are not included or referenced in an individual patient’s chart.
• Information about how to access HERO, including educational resources, can be found on U-Connect by searching “HERO” and going to the “Resources” tab
• Faculty can review UWH Policy 1.3.2 “Sentinel Event Determination and Event Reporting” for more information about the purposes and scope of HERO event reporting.  The UWH U-Connect page for HERO reporting also includes contact information for any questions about using the HERO reporting system

Quality Improvement Committees and Mortality & Morbidity (M&M) programs are examples of some of the confidential, peer-review privileged mechanisms used to help improve the quality of care within the UW Health system.  SMPH Risk Management is available to support Department/Division quality improvement committees and M&M programs.  For example, reach out to SMPH Risk Management for:

• Assistance in developing or updating committee/program charters or other organizing documents
• Review of confidentiality/peer review privilege language used for committee/program documents, templates and other communications
• Recommendations for meeting “ground rules” and program/committee processes
• Analysis of how committee/program materials are stored, managed and released
• Establishing/updating expectations for “remote” or video attendance at meetings
• Educational resources/presentations on how confidentiality and peer-review privilege protections for QI Committees and M&M programs.