FTCA Application Demonstration of Compliance
Tool:
Risk Management Training Plan Edition
Purpose
Use this document to record and demonstrate r
isk management trainings that are implemented in your health
center organization and trainings that will be conducted for the calendar year. The Health Resources and
Services Administration (HRSA) does not require health centers to use this document when submitting their FTCA
application. However, health centers are encouraged to complete this user-friendly tool to make documentation
and demonstration of risk management training requirements clear and easy to understand. This document can
be submitted with other required documents that appear on the annual FTCA deeming application. Health centers
submitting FTCA deeming applications are required to provide an annual risk management plan that should be
based on identified risks including all of the required trainings outlined in the annual FTCA application. Health
centers should refer to the FTCA annual program assistance letter to determine what trainings are required for the
year.
DISCLAIMER
Information provided by ECRI is not intended to be viewed as required by ECRI or the Health Resources
and Services Administration, nor should these materials be viewed as reflecting the legal standard of
care. Further, these materials should not be construed as dictating an exclusive course of treatment or
procedure. Practice by providers varies, including based on the needs of the individual patient and
limitations unique to the institution or type of practice. All organizations should consult with their clinical
staff and other experts for specific guidance and with their legal counsel, as circumstances warrant.
This model plan is intended as guidance to be adapted consistent with the internal needs of your organization. This plan is not to be
viewed as required by ECRI or the Health Resources and Services Administration. All policies, procedures, and forms reprinted are
intended not as models, but rather as samples submitted by ECRI member and nonmember institutions for illustration purposes
only. ECRI is not responsible for the content of any reprinted materials. Healthcare laws, standards, and requirements change at a
rapid pace, and thus, the sample policies may not meet current requirements. ECRI urges all members to consult with their legal
counsel regarding the adequacy of policies, procedures, and forms.
Name of health center:
Location:
Contact name:
Contact phone and email:
Oversight of Risk Management Training Plan
The following staff member is ultimately responsible for developing and carrying out the health center's risk
management training plan:
☐
☐
☐
☐
☐
Risk manager
Education manager
Executive director/chief executive officer (CEO)
Chief medical officer
Other – please specify:
Please provide any other information about oversight of the risk management training plan
:
The governing board reviews and approves the risk management training plan.
☐
☐
Yes
No
If "no," please specify who reviews and approves the risk management training plan:
Time Frame
New employees: New employees receive risk management training within________________ days of hire.
☐
☐
☐
☐
30
60
90
Other – please specify:
Existing employees: The health center sets the plan for ongoing risk management training on the following
schedule:
☐ Annually
☐
☐
☐
☐
Annually, but we may revise the training plan throughout the year based on new risks or priorities
Every six months
Every quarter
Other – please specify:
If "Other" was selected, please provide information regarding the risk management plan time frame
:
Training Topics
The risk manager identifies areas of highest risk within the context of the health center's risk management plan
and selects risk management training topics. Risk managers should use available data and information in order to
select topics. The following sources of information are used for determining training topics (select all that apply
and use the space provided to describe the processes and data used for each source):
☐ Risk assessments
Please describe:
☐ Event reports
Please describe:
☐ Claims
Please describe:
☐ Culture-of-safety surveys
Please describe:
☐ Patient safety leadership walkrounds
Please describe:
☐ Quality measures and data
Please describe:
☐ Uniform Data System measures
Please describe:
☐ Patient feedback and complaints
Please describe:
☐ Employee feedback
Please describe:
☐ Healthcare literature
Please describe:
☐ Claims trends from similar healthcare settings
Please describe:
☐ FTCA deeming application or site visit feedback
Please describe:
☐ State licensure surveys
Please describe:
☐ Consultants' reports
Please describe:
☐ Other—please specify:
All Health Center Staff
The required trainings for all health center staff include the following topics based on Chapter 21 of the Health
Center Program Compliance Manual
:
☐ Health Insurance Portability and Accountability Act (HIPAA)
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Medical record confidentiality requirements
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Basic infection prevention and control issues *
*Content includes bloodborne pathogens, hand washing, and personal protective equipment
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
Other topics included in the annual risk management training plan for all health center staff include the following
(select all that apply) (recommended but not required by HRSA):
☐ Event reporting
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Sexual haras
sment
and misconduct in healthcare
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Cultural sensi
tivit
y
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Communic
ati
on
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Culture of saf
ety
Cour
se Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Teamwork strategies
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Other—please list additional course titles below.
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Please provide any additional information about annual risk management training topics for all staff:
Specialty Services
The required trainings for staff serving in clinical roles include the following topics based on Chapter 21 of the
Health Center Program Compliance Manual
:
☐ Sterilization of equipment
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Other topics included in the annual risk management training plan for staff serving in clinical roles include the
following (select all that apply) (recommended but not required by HRSA):
☐ Tracking referrals
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Tracking diagnostic tests
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Tracking hospital admissions ordered by health center providers
Course Title:
Source:
Format:
Date:
Deadline:
Course Data:
Total Completed: Total P
ending:
☐ Other—please s
pecif
y:
Course Title:
Source:
Format:
Date:
Deadline:
Course Data:
Total Completed: Total P
ending:
Clinical Specialty: Obstetrics
Health centers that provide direct obstetrical services must provide training for clinical staff in identified high-risk
areas specific to the setting. Health centers that do not directly provide obstetrical services such as labor and
delivery but provide prenatal and postpartum care must provide relevant training to clinical staff. Risk managers
should use available data and information in order to select the appropriate topics. If the health center provides all
obstetrical services, including prenatal and postpartum care to patients through direct referral to another provider,
training is not applicable.
☐ Training is not applicable as the health center provides all obstetrical services including prenatal and
postpartum care to patients through direct referral to another provider.
☐ The training for staff serving in clinical roles related to prenatal care and postpartum care include the
following topics:
☐ Prenatal care
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Postpartum care
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Maternal health and safety (e.g., substance use disorder, intimate partner violence)
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐
☐
The training for staff serving in clinical roles related to obstetrical services include the following topics:
Shoulder dystocia
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐ Electronic fetal monitoring
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐ Operative vaginal delivery
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐ Other – please specify:
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
Please provide any additional information about annual risk management training topics for clinical staff providing
prenatal, postpartum, or obstetrical services:
Clinical Specialty: Dental
Health centers that provide dental/oral health services should provide training for clinical staff in identified high-
risk areas specific to the setting. Risk managers should use available data and information in order to select
topics. The training for staff serving in clinical roles related to dental services include the following topics:
☐ Infection control for aerosolized procedures
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Sterilization of dental equipment
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Medical emergenc
ies
in the dental office
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Informed consent for dental
Course Title:
Source:
Format:
Date:
Deadline:
Course Dat
a:
Total Completed: Tot
al Pending:
☐ Other – pl
ease s
pecify:
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Please provide any additional information about annual risk management training topics for clinical staff providing
dental services:
Clinical Specialty: Behavioral Health
Health centers that provide behavioral health services should provide training for clinical staff in identified high-
risk areas specific to the setting. Risk managers should use available data and information in order to select
topics. The training for staff serving in clinical roles related to behavioral health include the following topics:
☐ Screening and assessment
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐ Patient communication/coaching
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: T
otal Pending:
☐ Opioid risk management/medication-assisted treatment
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Substance use disorder assessment and/or treatment
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐ Patient suicide assessment and/or treatment
Course Title:
Source:
Format:
Date:
Deadline:
Cours
e Data:
Total Completed: To
tal Pending:
☐ Other – please specify:
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Please provide any additional information about annual risk management training topics for clinical staff providing
behavioral health services:
Clinical Specialty: Other Clinical Specialties
Health centers that provide other clinical specialty health services should provide training for clinical staff in
identified high-risk areas specific to the setting. Risk managers should use available data and information in order
to select topics. The training for staff serving in clinical roles related to other clinical specialties include the
following specialties and topics:
☐ Clinical specialty (please specify):
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Clinical specialty (please specify):
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
☐ Clinical specialty (please specify):
Course Title:
Source:
Format:
Date:
Deadline:
Course Data: Total Completed: Total Pending:
Please provide any additional information about annual risk management training topics for clinical staff providing
other specialty health services:
Managing and Monitoring Training
Supervisors allocate time for staff to complete required trainings (recommended but not required by HRSA):
Yes
No
When possible
If "no" or "when possible," please specify when staff complete trainings:
The health center uses the following format for training programs (select all that apply):
☐
☐
☐
☐
☐
Instructor-led training
Train-the-trainer programs
Online training (e-learning)
Webinar training
Other – please specify:
The health center tracks staff completion of training using the following method:
☐ The health center uses a centralized Excel file or Microsoft Word file, such as the
Staff Training
Completion Tracking Tool, to record and track training.
☐ The health center uses an alternate method to record and track training.
Which alternate method to record and track training is used?
☐
☐
The health center uses a web-based program to record and track training.
The health center has a learning management system where staff completion of trainings is either
automatically or manually uploaded.
☐ Employees are responsible for tracking their own training and signing an attestation to verify
completion.
☐ Other – please specify:
If the health center does not use the Staff Training Completion Tracking Tool
to record and track training, please
attach the tool used to this document or as a separate file. Is the tracking tool for staff training attached?
Yes
No. Please explain why it is not attached:
Please provide any additional information about processes for tracking staff completion of training:
The health center has processes to address cases in which providers and/or staff do not complete training by
required deadlines.
Yes. Please specify process:
No. Please explain why such processes are not in place:
Please provide any additional information regarding addressing cases in which providers or staff do not complete
training by required deadlines:
The health center sets metrics for staff training (for example, 100% completed trainings by December 31) and
monitors progress toward meeting goals.
Yes
No
Please provide any additional information about metrics for staff training:
The health center includes the following information in reports to the board (select all that apply):
☐
☐
☐
☐
☐
List of required trainings by area or department
Metrics related to risk management training (e.g., percentage of courses completed)
Challenges identified related to the risk management training plan
Plans for changes to the risk management training plan, when applicable
Other – please specify
The health center reports staff training information to the board:
☐
☐
☐
☐
Monthly
Quarterly
Annually
Other – please specify:
Please provide any additional information about reporting risk management training information to the board:
Attestation
As noted earlier, HRSA does not require health centers to use thi
s document; however, health centers are
encouraged to complete this tool to document demonstration of risk management training requirements. If the
health center chooses to use this document for official submission to FTCA, please complete this attestation.
I agree, as evidenced by my signature (regular or electronic signature), that the information provided in this
document is accurate, complete, and based on implemented health center policies and procedures.
Signature: _______________________________________________________________________________
Title: ____________________________________________________________________Date:___________
Reviewed by (governing board or designee):________________
________________________
____________
Title: ____________________________________________________________________Date:___________
Information provided by ECRI is not intended to be viewed as
required by
ECRI or the Health Resources and
Services Administration, nor should these materials be viewed as reflecting the legal standard of care. Further,
these materials should not be construed as dictating an exclusive course of treatment or procedure. Practice by
providers varies, including based on the needs of the individual patient and limitations unique to the institution or
type of practice. All organizations should consult with their clinical staff and other experts for specific guidance
and with their legal counsel, as circumstances warrant.
