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ac8WEdի2{9ۄxyA'|6<37)#'`;chW+=5'ppy /{ML|d`("-ml#SyV+h"/4= XW==4鶯yF;M$U9UT;`:f*F7w87~-q”x) K~Rb3_h zzԌkNiE'g%3v.L }8ar, mUɰ(Oc|G~<'pDJ@Y>ۃH=a#p~#LNA}뒯+-GiyLz$An:e WuُvQUZ{;; l<,erj!DŽ~)yv Tӌ׏]IME4U80`ūݙIs &'R?EZ 쟊L7.CLථ^yCHl0¤`$fз7!P^w~8iΞ \ ӋB>L,iȻEZ%p4 UT9Ey @@yX3ڍM%3L8   v*>A J[r8 vx6h␅'Lj @UaQ,KIENDB`J( l  uU "PowerPoint.Show.80BMicrosoft PowerPoint PresentationcNEXTeNEXT/ 00DTimes New Romanxv 0( 0DArialNew Romanxv 0( 0" DWingdingsRomanxv 0( 00DArial Narrowanxv 0( 0"c0.  @n?" dd@  @@``   H(   ""  AS( $   !"#$%&'+* 31AA   $b$H7 iU?Ʃ*r$wq1v&i*b$8!ܢsilF+b$BN[YXAqb$ƌc=4yag6.$$b$˼-GdCex]@G 0e0e A@A5%8c8c     ?1d0u0@Ty2 NP'p<'p@A)BCD|E?@8!"7R ʚ;/f8ʚ;g44d4dv 02ppp@ <4!d!d` 0Ld<4dddd` 0Ld <4BdBd 0L ___PPT10DTimes New Romanķ0ķ:A 0DArialNew Romanķ0ķ:A 0" 6#___PPT9nMZ4&3SwкPNG  IHDRdPLTEϚe3fhhΙFtRNSS cmPPJCmp0712TIDATm 1 J78@h!tQyDAP9rORHFz Component Two: Analyze the Data The Risk Management Committee?!$2%!Risk Management Committee Mission=Meet monthly to identify and reduce potential risk within the organization at all levels of service Respond to individual events Request investigations Request consultations Identify trends to reduce risk Identify methods to reduce risk Take necessary actions including new policies, risk management initiatives, etc.$dZZ>'H Component Three: Deepen Our Understanding and Develop Safety StrategiesII( The Risk Management Committee requests investigations on: All high risk/high damage incidents All allegations of abuse and neglect All significant Human rights violations All significant trendsv;ZZ:$ % ( [D8Component Four: Translate Learning to Safety Mindfulness99(Talking about What is Expected Safety, Medication, Crisis Management, Clinical Consultation & Human Rights Trainings Instructive, Practical, Regularly Updated Policies & Procedures Modeling Safety Mindfulness at Senior Staff Levels Information and Investigation SharingfP W A 3 &rTWhy Clinical Consultations?Understand Medical/Clinical Issues of Individuals Served Provide Support and Education to Direct Support Professionals Identify Appropriate Interventions and Strategies Improve Quality of Care Provided Assess Risk Issues and Resources Needed *sU@How Do We Identify Individuals Who Require Clinical ConsultationAA$7Program Staff, Nursing, Clinical Staff, and Senior Management Review of Risk Data Critical Incidents, Medication Errors, Complaints and Investigations Analysis of Outcomes Data Base Trends age, frequency medical conditions, interventions, etc Requested by Family Members/Guardians Requested by Funding Agency SPEPP=PCPPSE=  DtVThe ConsultationWho Participates and Why? Internal and External Providers; Program Staff; Family/Guardians Covers All Possible Risk Issues Behavioral, Medical, Psychiatric, Forensic, Problematic Sexual Behaviors, Systems Issues, Substance Abuse, Guardianship bA yA y uW The Outcome,Additional collaboration with external individuals or organizations Review/revise behavioral, service or crisis plans Need for medical and psychiatric follow-up (inpatient, outpatient, rehab) Guardianship reviewed Staff training Family engagement Alternative placements/resource allocations reviewed -P-vX The Follow-UpSenior Managers Receive Copy of Consult Recommendations Specific Recommendations designate  Person Responsible Copy of Consult in Individual s Confidential Record Follow-up at regularly scheduled consultations or as needed ZwY Case StudyDD is a 22 year-old Caucasian individual with the diagnosis of PDD, Moderate MR, Seizure Disorder, Intermittent Explosive Disorder and Psychotic Disorder NOS. Multiple food allergies listed. Question of Celiac Sprue. Parents: guardians. Increase in restraints for assaultive behaviors and food stealing at Day Program. Similar issues in Residence (non-Vinfen). On severely restrictive diet with significant weight loss. Consult reviewed patterns of behaviors, medication management, medical issues, family/guardianship issues.PyZ Case StudylExternal risk review with DMR, residence, guardians held Full GI and Allergy work-ups recommended and undertaken. Allergist found limited found allergies: peanuts and chicken. No evidence of Celiac Sprue, Crohn s Disease, IBS. Healed duodenal ulceration in one area. Resumed more normal diet with significant decrease in assaults, restraints, food stealing. Gained 26 pounds in one month. No other GI SX. Affect brighter, less fearful. Pz[$Medical Flagging System: Case Study%%(LR is a 24 year-old Caucasian individual with Down Syndrome, Moderate MR, Morbid Obesity, history of Pneumonia with Respiratory Distress and Intubation. Had symptoms of developing URI. Sister took her home for Christmas vacation. Sister did not seek medical care for four days. Individual admitted with Pneumonia, in severe respiratory distress. Individual was intubated and remained in coma for more than thirty days. .P P {\$Medical Flagging System: Case Study%%(In reviewing LR s Case, Vinfen identified the following systemic needs: To determine those individuals at specific medical risk To train staff in recognition of medical symptoms To define appropriate responses to specific medical concerns PHH |]lMedical Flagging System:  Risk Management in Action 77(In response to the needs identified in this risk review, Vinfen s MR Nurses developed a Medical  Flagging System Medical issues of individuals served identified using Outcomes Data Base Color-coded label affixed to spine of confidential record in program One page narrative outlining symptoms to be monitored and appropriate responses developed. Symptom Identifiers were placed in the front of the individual s Medication Book and confidential record fileP}^-Medical Flagging System: Symptoms identified..(cSevere Allergies (including Food/Drink) Cardiac/Circulatory Issues Choking/swallowing difficulties/dysphasia Diabetes Hydration/Dehydration Severe Sensory Impairment Severe Gait Impairment Respiratory problems (breathing) Seizures Temperature Regulation Medical Devices (list)___________________________ Medical issues (list)_____________________________dPd~_Medical Flagging System/Sample Symptom Identification and Response PagecbJ Questions?/6z$ ` @AvffJff` @AvffJff` MMM___` BBb"eIIn>h` @Av́q~דg` ́ޤ^ד` MMMŞffJff>?" dd@,? 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