The Washington State Joint Underwriting Association (JUA) is committed to supporting safe, high-quality midwifery care throughout Washington State.

Professional liability coverage is only one component of risk management. The JUA also provides guidance, tools, and educational resources designed to support clear communication, consistent documentation, and sound clinical decision-making.

Our approach recognizes that most adverse outcomes do not arise from a single mistake, but from a combination of clinical complexity, communication challenges, and documentation gaps. Risk management resources are intended to support thoughtful practice and reduce misunderstandings that can lead to complaints or claims.

How the JUA Supports Safe Practice

Practical Guidance

Policyholders have access to guidance addressing common areas of professional liability exposure, including:

• informed consent discussions and documentation
• clinical charting practices
• consultation and referral considerations
• communication with clients and other providers
• development of practice policies and procedures
• privacy and HIPAA compliance considerations

Materials are designed to be practical and adaptable to individual practice settings.

Educational Resources

The JUA periodically develops educational materials addressing topics that frequently arise in claims or risk consultations. These may include:

• documentation considerations in complex clinical situations
• communication practices that reduce misunderstanding
• managing transitions of care
• maintaining clear and consistent office policies
• recognizing situations that may benefit from consultation

Educational resources are intended to support continuous quality improvement rather than prescribe specific clinical approaches.

Structured Practice Review

The JUA offers an optional practice review process for policyholders who would like individualized feedback.

A review may include:

• chart documentation practices
• informed consent processes
• practice policies and procedures
• clinical workflow considerations
• communication practices
• office systems affecting continuity of care

Recommendations are intended to support clarity, consistency, and defensibility of clinical decision-making.

Participation in a practice review is collaborative and educational in nature.

Incident Reporting Guidance

Timely communication with the JUA when an unexpected outcome occurs allows appropriate support to be provided.

Policyholders are encouraged to report incidents when:

• an unexpected clinical outcome occurs
• a client expresses dissatisfaction related to care
• medical records are requested by an attorney
• a complaint is filed with a regulatory body
• a situation may reasonably result in a claim

Early reporting allows the JUA to provide guidance and support when it is most helpful.

Focus on Communication and Documentation

Across many areas of healthcare, common themes in professional liability claims include:

• incomplete or unclear documentation
• differences in understanding between provider and client
• inconsistent informed consent discussions
• lack of clarity regarding consultation or referral decisions
• gaps in practice policies or office procedures

Clear communication and documentation help demonstrate the clinical reasoning that supports care decisions.

Policyholder Portal

Detailed guidance, tools, and educational resources are available to policyholders through the secure Policyholder Portal.

Portal resources include:

• documentation guidance
• informed consent considerations
• sample policy topics
• incident reporting forms
• educational materials
• updates related to regulatory or practice considerations

Policyholders may access the portal using the login link at the top of this page.

Collaborative Approach

Risk management is most effective when it supports professional judgment rather than replacing it.

The JUA’s role is to support policyholders in maintaining clear, consistent, and well-documented practices that reflect the care they provide.

Questions about risk management resources or incident reporting may be directed to the JUA through the Contact page.