Typically risk-management strategies have been applied to the inpatient setting. In 2003, a comprehensive risk-management program was introduced to ProHealth Physicians, one of the largest primary-care practice groups in Connecticut. The program included strategies for education, practice change, incentive and compliance. Performance metrics for clinician participation and compliance were prespecified. Clinicians' attitudes and behavior change were assessed after introduction of the program. Audits were conducted by external reviewers to assess compliance. Financial data from before-to-after program implementation were compared. Results showed fewer claims and substantial cost savings. A strong commitment to the implementation of a comprehensive risk-management program can create a culture of safety in an outpatient setting.
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