Once perceived as a hospital-only process, risk management is now recognized as an important part of clinical decision-making and hospital operations. The greatest opportunities exist where risk management programs can be integrated into the development and implementation of guidelines, protocols and order sets that encourage adherence to valid clinical evidence and reduce unwarranted clinical variation in patient care. The limiting factors in this approach are providing the data needed to demonstrate the need for change and engaging administrators and clinicians in the development and implementation of those changes.This article describes a process for the development of hospital-specific data that can be used to evaluate the cost impact of various decisions about patterns of care - the Clinical Effectiveness Initiative - in this case used to demonstrate the cost impact of a choice between two medications used to prevent and treat a common disorder, venous thrombosis. It also describes how this data can be used to engage clinicians and administrators in a partnership focused on improving outcomes and patient safety by considering the full complement of factors - clinical, operational and risk management-related - that contribute to those costs and outcomes. This process is clinical effectiveness resource management.