Hospitals face a growing threat from a new variant of Creutzfeldt-Jakob disease (vCJD), the human version of “mad cow disease,” the killer infection that decimated British cattle herds in the 90’s. Swiss Re has issued a focus report entitled: “Prion infection on the rise? Hospitals in need of modern risk management,” which illustrates “how important comprehensive risk management is in hospitals, not only to improve patient safety but also to guarantee the insurability of hospitals in the long term.”
It notes that “Liability insurance for hospitals is becoming ever more problematic for insurers. Extensive premium increases in recent years have failed to prevent the insurability of hospitals being called into question,” and it warns that the new vCJD risk will require hospitals “to change their safety practices and introduce comprehensive risk management methods.”
“The risk of being infected with vCJD in hospital has increased,” said the report, which was written by Swiss Re’s technical insurance unit, the Chief Underwriting Office. “The occurrence of vCJD means that it is not just operations on the central nervous system (brain, spinal cord and eyes) which are problematic but also those on the lymphatic organs, e.g. the spleen, tonsils and appendix. As a result the risk of transmission has spread to many more operations.
“It is not yet known how many people are already infected, or have been infected, by contaminated instruments. Furthermore, it will be a few years before current studies will be able to answer these questions. As long as the extent of the problem is unknown and the requisite risk-minimisation measures are still undergoing implementation, an increased risk of infection will persist.”
The report details the steps needed to minimise the risk, calling them “known and practicable.” While focusing on standard sterilisation procedures it points out this is “not sufficient in itself: a rethinking process in hospitals is also needed,” and it states that “risk management principles must become part of the corporate culture, despite the additional costs that introducing comprehensive risk management will impose. In this respect, demands for costs to be reduced in the healthcare system are in clear contradiction to risk-reducing efforts.”
Swiss Re points out that “liability insurers in all the major European countries are still in deficit and some insurers have therefore pulled out of the market. This trend will not change without the systematic incorporation of risk management into corporate culture.” It also indicated that a “hospital that does implement risk minimisation measures, should receive a better insurance rating than those which ignore the known risks or do not do enough to counter them. The insurance industry is responsible for ensuring that hospital managers are supported in implementing risk minimisation measures. What is needed is both advice and the creation of financial incentives.”
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