Implementation of a sustainable enterprise risk management framework: The Administrator on Duty model

Background: Today’s health care landscape requires a new standard of service delivery aimed at quality outcomes, cost-effective provisions of coordinated treatment, and access to equitable care. This standard has brought emerging risks that pose threats to the operational and financial well-being of health care organizations, especially safety net hospitals. The establishment of enterprise risk management (ERM) programs guided by the efforts of efficacious health care managers will promote deeper risk analysis, engagement of the entire health care organization, and structured, coordinated and cohesive mitigation responses to risk exposures.Objective: To establish and implement an ERM program using the Administrator on Duty (AOD) model that will promote a patient-centric paradigm of care while optimizing organizational performance and mitigating risk and exposure.Results: The AOD model significantly contributes to all phases of ERM, particularly risk identification, risk assessment, risk response and monitoring. The model, as perceived by both AODs and hospital senior leadership, provides tremendous benefits to a health care organization. These include, among many others, a substantial leadership presence, dynamic risk mitigation efforts, continuous education to staff and facilitation of problem solving and conflict resolution.Conclusions: The AOD program is a vital constituent of an ERM endeavor. AODs are pivotal to managing the global risk terrain of a health care organization and play a substantial role in promoting patient, staff and visitor safety while working to ensure potential and actual risk issues are addressed timely and appropriately.