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Associate Vice President, Risk Management
United Educators Insurance
Chevy Chase, Md.

Vice President, Risk Management
United Educators Insurance
Chevy Chase, Md.

Worrying About Education and Educating Others About Worry

Some people are born worriers. Constance Neary, vice president, risk management, and Bob Baird, associate vice president, risk management for United Educators Insurance in Chevy Chase, Md., are two such people.

"They're deep thinkers about what to worry about," said Gary Langsdale, university risk officer at Pennsylvania State University in University Park, Pa. "Higher education is a different kettle of fish than other institutions. For a lot of smaller colleges that don't have a risk manager, they provide a tremendous depth of resources. For large institutions like Penn State, their model is not just risk transfer but an emphasis on how to manage and mitigate risk in a way that is tremendously appreciated by higher ed risk managers. It's something we all appreciate a lot."

Neary and Baird are responsible for ensuring that their 1,160-member independent schools and colleges have the information and tools to make smart, strategic decisions about risk management programming and insurance purchasing.

In their lead roles for the United Educators risk management department, Neary and Baird developed a first-of-its-kind benchmarking tool so that its members could compare their risk management and insurance purchasing practices against the entire book of business. Even more valuable, the tool Campare@UE allows members to benchmark against a self-defined group of peer institutions that are United Educator members.

Launched in March, the tool was developed through collaboration with United Educators' data warehouse manager, an outside consultant for information technology programming and an internal steering group. Member completion of its Electronic Application Form provided the data set from which to form the comparisons.

More than 78 percent of the company's members completed the detailed form, which is used for making underwriting decisions and developing risk profiles. The data collected ranges from full-time enrollment numbers to whether the institution has a swimming pool, armed security guards and regular employee training about harassment and discrimination.

To simplify the launch of the benchmarking tool, Neary and Baird assessed data that would be most valuable to include and areas in which data seemed most "clean"--that is, most accurately representative of member activity.

The tool launched with data on such things as tenure, discrimination training, harassment training, campus safety and security, motor vehicle record checks, counseling and medical accessibility, contract reviews and policy limits, and other areas of interest.

Initially, Neary and Baird invited a group of members to pilot Compare@UE so that they could get feedback and modify the tool as appropriate. Feedback has been positive and the tool is refined continually to make it easier for members to establish peer groups and to include more data for comparative purposes.

"They both are exemplars," Langsdale said. "Others try to replicate what they do, but no one comes close."

Langsdale said the two are on top of all the hot topics that concern institutions of higher learning today and have "a library to beat all."

They hold webinars and roundtable discussions and issue white papers galore. They tackle such topics as transporting sports teams to games, analyzing and developing risk management techniques to keep campuses safe from shooting incidents--such as the one that shattered Virginia Tech in 2007--how to make sure bleachers are safe for commencement exercises and protecting students with mental health challenges or that might be suicide risks.

"We also can ask them about issues that are around the corner," Langsdale said. "They're just miles ahead of what others do."

--Julie Liedman

Senior Director, Loss Control and Education, Risk Management Division
Stanford University Medical Center
Palo Alto, Calif.

Digging Into the Cause of Loss Through Decision Analysis

Ed Hall, senior director, of loss control and education in the Risk Management Division at the Stanford University Medical Center, likes to focus on the "upside of risk." In doing so, he transformed the way the institution identifies risk opportunities and approaches risk management decisions and developed a way to measure return on risk management investments.

Hall developed a patented total value creation decision analysis model that demonstrates financial return on risk management investments by quantifying loss control benefits and costs. Data analysis identifies patterns and trends and focuses leadership strategy to areas where practical risk solutions can be applied.

But that is just the first step.

Believing that the future of risk management depends on the ability to recognize risks and also to quantify risk management trends and exposures, Hall developed an innovative decision analysis model. It assures that risk management initiatives create the greatest value for patients, staff and the community. It does this by allowing the Stanford University Medical Center to understand the key value drivers that increase total program value and allow it to analyze its risks strategically to make informed decisions.

The model is improving the Stanford Univeristy Medical Center's bottom-line performance and shifting the culture of how risks and uncertainty are perceived within the organization by addressing traditional risk management concerns and strategic opportunities. This process enhances company value by identifying and proactively managing risks and opportunities.

The proprietary method provides tested means of making high-quality decisions in instances of uncertainty by producing a transparent and defensible understanding of total program value and a means of identifying how to increase that value.

Central to its approach is identifying, structuring and quantifying all factors bearing on the costs and benefits of a particular decision, which leads to creation of new alternatives for increasing value.

Through Hall's leadership and use of risk-management data, the medical center was able to understand the causative factors behind medical malpractice and workers' compensation claims. The result is evidence-based information that helps understand the root causes of medical errors and employee injuries; and that leads to the creation of solutions to prevent them.

Better understanding of cause and loss drivers helps Stanford target specific control points that will reduce loss and provide a return on risk management investments. Using data to proactively target loss areas, rather than waiting to react to loss is what builds value for the organization's risk program and allows the medical center to achieve measurable and sustainable returns on its risk management investments.

The Stanford center uses the CS STARS enterprise dashboard to present information, identify trends and report results to senior leadership. The risk team then uses that information to articulate the total value of risk for any given program or intervention solution.

The result has been demonstrated reductions in overall losses related to patient and employee safety. the center has experienced a more than 75 percent reduction in claims-related costs and a more than 25 percent reduction in the frequency of workers' compensation claims. In fact, Stanford Hospital and Clinics and Lucile Packard Children's Hospital, both part of the university medical center, are the top two hospitals in California measured by decline in the frequency of workers' compensation claims.

"Ed is a man before his time," said Jeff Driver, the center's chief risk officer. "He has a fertile mind for new risk management ideas. We have enjoyed tremendous results from his total value decision analysis tools. We've been able to force out a lot of workers' compensation costs.

"I'm chief risk officer here; technically, I'm his boss. But he inspires me. He's constantly pressing towards the edge."

--Julie Liedman

Seeing the Future That is Now

Ed Hall has seen long into the future, and has recognized that it is already here.

The nation's population and workforce is aging. That means there are more patients with limited mobility admitted to hospitals, which is a crucial issue facing the healthcare industry, including elite hospitals like Stanford University Medical Center.

Patient handling encompasses all the ways in which to transport patients, and while safe patient-handling programs install machines to lift, turn and transport patients, they don't come cheap.

Hall and his team at Stanford University Medical Center, however, have reduced patient falls and the costs--lawsuits included--associated with those accidents.

"Ed is a man before his time," said Jeff Driver, the center's chief risk officer. As a result, patient satisfaction has increased, and staff injuries have gone down along with workers' compensation costs.

Hall and his team have transformed the way other institutions approach risk management. The methodology has caught the eye of the Veterans Administration and the American Nurses Association, which asked Stanford for help in designing a template for their organizations.