Question

Please provide 1-2 example for each domain and then apply next tables's risk control or risk finance techiques to each example.

Table - 1

Domain	Description / Example
Operational	The business of healthcare is the delivery of care that is safe, timely, effective, efficient, and patientcentered within diverse populations. Operational risks relate to those risks resulting from inadequate or failed internal processes, people, or systems that affect business operations. Included are risks related to: adverse event management, credentialing and staffing, documentation, chain of command, and deviation from practice.
Clinical / Patient Safety	Risks associated with the delivery of care to residents, patients and other healthcare customers. Clinical risks include: failure to follow evidence based practice, mediation errors, hospital acquired conditions (HAC), serious safety events (SSE), and others.
Strategic	Risks associated with the focus and direction of the organization. Because the rapid pace of change can create unpredictability, risks included within the strategic domain are associated with brand, reputation, competition, failure to adapt to changing times, health reform or customer priorities. Managed care relationships/partnerships, conflict of interest, marketing and sales, media relations, mergers, acquisitions, divestitures, joint ventures, affiliations and other business arrangements, contract administration, and advertising are other areas generally considered as potential strategic risks.
Financial	Decisions that affect the financial sustainability of the organization, access to capital or external financial ratings through business relationships or the timing and recognition of revenue and expenses make up this domain. Risks might include: costs associated with malpractice, litigation, and insurance, capital structure, credit and interest rate fluctuations, foreign exchange, growth in programs and facilities, capital equipment, corporate compliance (fraud and abuse), accounts receivable, days of cash on hand, capitation contracts, billing and collection.
Human Capital	This domain refers to the organization’s workforce. This is an important issue in today’s tight labor and economic markets. Included are risks associated with employee selection, retention, turnover, staffing, absenteeism, on-the-job work-related injuries (workers’ compensation), work schedules and fatigue, productivity and compensation. Human capital associated risks may cover recruitment, retention, and termination of members of the medical- and allied-health staff.
Legal / Regulatory	Risk within this domain incorporates the failure to identify, manage and monitor legal, regulatory, and statutory mandates on a local, state and federal level. Such risks are generally associated with fraud and abuse, licensure, accreditation, product liability, management liability, Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (CoPs) and Conditions for Coverage (CfC), as well as issues related to intellectual property.
Technology	This domain covers machines, hardware, equipment, devices and tools, but can also include techniques, systems and methods of organization. Healthcare has seen an explosion in the use of technology for clinical diagnosis and treatment, training and education, information storage and retrieval, and asset preservation. Examples also include Risk Management Information Systems (RMIS), Electronic Health Records (EHR) and Meaningful Use, social networking and cyber liability.
Hazard	This ERM domain covers assets and their value. Traditionally, insurable hazard risk has related to natural exposure and business interruption. Specific risks can also include risk related to: facility management, plant age, parking (lighting, location, and security), valuables, construction/renovation, earthquakes, windstorms, tornadoes, floods, fires.

Table - 2

Risk Control Techniques	Risk Financing Techniques
1. Avoidance 2. Prevention 3. Reduction 4. Segregation 5. Non-Insurance Transfer	1. Retain – Self-insure 2. Transfer – Insurance 3. Non-Insurance Transfer

Answer 1

Domain	Description / Example	Risk Control Techniques	Risk Financing Techniques
Operational	The business of healthcare is the delivery of care that is safe, timely, effective, efficient, and patient-centered within diverse populations. Operational risks relate to those risks resulting from inadequate or failed internal processes, people, or systems that affect business operations. Included are risks related to adverse event management, credentialing and staffing, documentation, chain of command, and deviation from practice.	Avoidance (100% control meaning you avoid risk completely-For example putting in systems and checking processes to ensure 100% avoidance of risks)	Professional indemnity and insurance covers to protect against potential litigation and malpractice cases.
Clinical / Patient Safety	Risks associated with the delivery of care to residents, patients, and other healthcare customers. Clinical risks include failure to follow the evidence-based practice, medication errors, hospital-acquired conditions (HAC), serious safety events (SSE), and others.	Prevention(It limits rather than eliminate loss-Patient care can be taken but fatality cannot be avoided 100%)	Self-insuring against potential legal cases can reduce potential loss but litigation and other losses are not covered. Professional indemnity can be taken by medical practitioners
Strategic	Risks associated with the focus and direction of the organization. Because the rapid pace of change can create unpredictability, risks included within the strategic domain are associated with brand, reputation, competition, failure to adapt to changing times, health reform or customer priorities. Managed care relationships/partnerships, conflict of interest, marketing and sales, media relations, mergers, acquisitions, divestitures, joint ventures, affiliations and other business arrangements, contract administration, and advertising are other areas generally considered as potential strategic risks.	Reduction(A technique which assumes risk is part of the business and can occur as a consequence of nature of business like storing inflammable material as it is required for business but has a potential risk)
Financial	Decisions that affect the financial sustainability of the organization, access to capital or external financial ratings through business relationships or the timing and recognition of revenue and expenses make up this domain. Risks might include: costs associated with malpractice, litigation, and insurance, capital structure, credit and interest rate fluctuations, foreign exchange, growth in programs and facilities, capital equipment, corporate compliance (fraud and abuse), accounts receivable, days of cash on hand, capitation contracts, billing, and collection.	Prevention (Limit the risk not eliminate it completely-For example some risks associated with foreign exchange fluctuation and currency devaluation can be prevented but not 100% avoided)	Hedging and financial covers. Cover again foreign currency fluctuations and devaluation by forwarding booking.
Human Capital	This domain refers to the organization’s workforce. This is an important issue in today’s tight labor and economic markets. Included are risks associated with employee selection, retention, turnover, staffing, absenteeism, on-the-job work-related injuries (workers’ compensation), work schedules and fatigue, productivity, and compensation. Human capital associated risks may cover recruitment, retention, and termination of members of the medical- and allied health staff.	Combination of Prevention and Duplication (Manpower and its management are critical for organizations survival. The management needs to put in systems to ensure risk-free processes and systems to manage all related issues like selection, retention etc. Back up plans are required to ensure work continues without disruption)	Taking insurance covers for employees and ensuring against potential litigation by taking an insurance cover. Medical insurance covers all employees.
Legal / Regulatory	Risk within this domain incorporates the failure to identify, manage and monitor legal, regulatory, and statutory mandates on a local, state and federal level. Such risks are generally associated with fraud and abuse, licensure, accreditation, product liability, management liability, Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (CoPs) and Conditions for Coverage (CfC), as well as issues related to intellectual property.	Avoidance (Organization can put in systems to ensure 100% avoidance and also take a risk cover for potential frauds etc)	Insure against legal risks. Cover against potential risks.
Technology	This domain covers machines, hardware, equipment, devices, and tools, but can also include techniques, systems, and methods of organization. Healthcare has seen an explosion in the use of technology for clinical diagnosis and treatment, training and education, information storage and retrieval, and asset preservation. Examples also include Risk Management Information Systems (RMIS), Electronic Health Records (EHR) and Meaningful Use, social networking and cyber liability.	Duplication( Back up plans are critical for ensuring that systems are protected and normalcy of work is restored)	Contractual risk transfers such as indemnity and transfer of loss to a third supplying party. Also, insurance covers to ensure against potential loss of equipment and hardware.
Hazard	This ERM domain covers assets and their value. Traditionally, insurable hazard risk has related to natural exposure and business interruption. Specific risks can also include risk related to facility management, plant age, parking (lighting, location, and security), valuables, construction/renovation, earthquakes, windstorms, tornadoes, floods, fires.	Segregation(In case of calamity, the affected area can be separated and the risk of the work can continue normally, other business can also be transferred to safe areas to avoid too much damage)	Retain-Self insure to cover the loss amount as predefined. The insurer pays before so the loss can be covered. The organization can take cover against hazards and natural calamities to cover the future loss.