HLT 308V GCU Educational Risk Management Program and Nursing Discussion

PART A- Discussion Questions due by Wednesday

DQ 1 – WATCH VIDEO Plus add x1 reference

Health care organizations continually face challenges from various regulatory and government agencies while also being bound by Managed Care Organization (MCO) standards. View the video located in the study materials entitled “College of Nursing and Health Care Professions: Do We Know What Our Future Is?” for insight into the challenges of health care reform. Based on the video, describe two key reform factors that you believe will need to be addressed by future health care workers or leaders and explain why. (Note: You can download slides from this video for ease of review in developing your forum response). Additionally, what role does adherence to MCO standards play in your future health care vision? (250 words response plus x1 peer reviewed source to support response )

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Video link:

Watch the video “College of Nursing and Health Care Professionals: Do We Know What Our Future Is?”

URL:

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nur508_healthcare-reform-video-series-v1.1.php

DQ2- Research with x2 sources- peer reviewed articles

The Affordable Care Act (ACA) identifies requirements related to provider compliance with fraud, waste, and abuse laws that have been enacted to protect consumers. (250 words response) Research three of these requirements and describe the corresponding measures that your health care organization has initiated, or could initiate, to comply with the ACA. Support your analysis with a minimum of two peer-reviewed articles.

PART B -Assignments Due by Fr

Assignment #1 – Paper

Title: Reflective Analysis- Risk Management & The Role of Managed Care

The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.

Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing a 250‐500-word response that addresses the following:

What is a health care organization’s administrative role in executing risk management policies and ensuring compliance with managed care organization (MCO) standards?
What value do the regulatory statutes of a typical MCO provide to a health care organization? Consider how strategies pertaining to policies such as conflict resolution and risk management affect patients as well as employees and employers.
What MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

Required sources from: textbook (Read Chapters 18, 19, and 26 in Legal and Ethical Essentials of Health Care Administration.And you are required to support your analysis with a minimum of two peer‐reviewed references.

Prepare this assignment according to the guidelines found in the APA Style. An abstract is not required.

This assignment uses a rubric (see attached doc titled Assignment Paper Rubrics). Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Assignment #2 – PowerPoint presentation

The purpose of this assignment is to create an educational risk management presentation.

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy.Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide. However, you may include supplementary images, graphs, and data where relevant.

To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:

Introduction
Rationale
Support
Implementation
Challenges
Evaluation
Opportunities

You are required to support your statements with a minimum of six citations from appropriate credible sources.(same as outline in part 1)

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting

This assignment uses a rubric (see attached doc titled-“PowerPoint Rubic”) for Rubics. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

ASSIGNMENT PAPER RUBRICS

1. Administrative Role of a Health Care Organization in Ensuring Compliance With Managed Care Organization (MCO) Risk Management Standards (25points)
An assessment of the administrative role of a health care organization in ensuring compliance with MCO risk management standards is comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

2. Value of MCO Regulatory Statutes to a Health Care Organization (25 points)
An explanation of the value MCO regulatory statutes provide to a health care organization is present and comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

3. MCO Responsibilities Relative to ACA and CMS Focus on Fraud, Waste, and Abuse Laws (25 points)
A description of the MCO responsibilities relative to the ACA and CMS focus on fraud, waste, and abuse laws is comprehensive. The submission further incorporates analysis of supporting evidence insightfully and provides specific examples with relevance. Level of detail is appropriate.

4. Thesis Development and Purpose (5 points)
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

5. Argument Logic and Construction (5 points)
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

6. Mechanics of Writing (includes spelling, punctuation, grammar, language use) (5 points)
Writer is clearly in command of standard, written, academic English.

7. Paper Format APA STYLE (use of appropriate style for the major and assignment) (5 points)
APA style format elements are correct.

8. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)(5 points)
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Educational Program Outline Sample Paper

Introduction

Patient privacy and confidentiality in medical spas are a major concern, especially with healthcare professionals.
Patient privacy and confidentiality are essential, and literacy on the aspect is essential in promoting a quality and effective approach in the management of the patients (Schaper et al., 2016).
Patient privacy and confidentiality in healthcare are crucial since it promotes the support for patients’ rights, which is comprehensive and effective (Mehta, Jamieson & Ackery, 2019). HLT 308V GCU Educational Risk Management Program and Nursing Discussion

Rationale

There are Medical Spas such as Paradise Medical Spa located in Texas, which lacks effective management for securing patient information.
Most healthcare workers in the spas are not conscious of healthcare information management strategies (Schaper et al., 2016).
In most cases, complaints of effusion of healthcare information and management are common in the various spas.
Respect for patient information and autonomy in making decisions has not been in the highest control approaches (Mehta, Jamieson & Ackery, 2019).
Education on risk management involving patient information and data is crucial in managing the challenges and mitigation of the risks effectively (Schaper et al., 2016).
In the states and federal healthcare settings, the education on risk management for patient privacy and confidentiality will promote a quality administrative process that is significant and necessary.

Support

Safe and quality healthcare administration involves maintaining patient privacy and confidentiality (Mehta, Jamieson & Ackery, 2019).
Most healthcare professionals require to satisfy the patients’ needs and reduce all the risks in various healthcare settings.
Management of the challenges requires that precision and quality are implemented in supporting and eliminating the challenges (Mehta, Jamieson & Ackery, 2019).
Approximately 95.7% of the patients require that their information remain confidential until they consent in various areas (Schaper et al., 2016).
Patient information respect is one of the major aspects that require improvement and promotion for quality healthcare to be accomplished.
The work environment should respect the patients’ decisions and focus on the promotion of their healthcare needs, which is essential for supporting their decisions and key aspects as recommended (Mehta, Jamieson & Ackery, 2019).

Implementation

The proposed strategy implementation includes healthcare workers’ sensitization on the maintenance strategies for patient information confidentiality and privacy.
Improvement of technology in healthcare records helps maintain confidentiality and privacy (Mendelson & Wolf, 2017).
Enhancement of restricted access strategies to promote a fundamental aspect that helps in maintaining effective techniques as required.
Supporting integral practices that enhance patient literacy on their rights to improving privacy to their information.
Promoting electronic healthcare record safety whereby the medical spas websites are reinforced with firewalls helps manage the challenges and threats (Schaper et al., 2016).
The process of implementation involved are:
- Assessment of the need for change.
- Identification of options and alternatives to help accomplish the process.
- Management of the adverse situations which is necessary in the success process.
- Implementation of the educational program to foster patient information privacy and confidentiality.
- Evaluation of healthcare workers for literacy and changes in such aspects.

Challenges and navigation

Threats of inadequate finance and capital to execute the program is a potential challenge.
Inadequate time of completion of the program’s execution due to the inconvenience of crush programs in the medical spas for educating the healthcare professionals (Mehta, Jamieson & Ackery, 2019).
Poor compliance of the medical professionals in the medical spas due to lack of commitment and resisting of the changes implemented.
Navigation through the challenges requires that adequate capital preparation is made to foster a smooth execution (Puppala et al., 2016).
Secondly, reinforcing active management rules to help reduce the risks and manage competent strategies is a necessary approach as required.
Hiring additional human resources to promote the educational program and sensitization of the healthcare workers in the spas regarding privacy and confidentiality (Hosseini-Ghavam-Abad et al., 2019).

Evaluation

Evaluation of long-term goals includes checking for healthcare professionals’ changes when it comes to controlling and mitigating the risks (Demirsoy & Kirimlioglu, 2016).
Evaluation of management aspects, such as record keeping and the level of security, is a crucial approach as required.
Checking for updated systems in the electronic health systems is required to support the change and assess implementations as required.

Opportunities

Implementation of evidence-based practice is an opportunity to enhance security as necessary (Hosseini-Ghavam-Abad et al., 2019).
Control and management of the patients’ adverse situations and risks are useful in the control of patient risks and other aspects involved in healthcare.
Strategic control metrics are useful in eliminating adverse situations that improve the fundamental and strategic policies as needed.
Improvement of healthcare technologies such as the enhancement of biometrics is a useful approach in promoting patient information privacy and confidentiality. HLT 308V GCU Educational Risk Management Program and Nursing Discussion

References

Demirsoy, N., & Kirimlioglu, N. (2016). Protection of privacy and confidentiality as a patient right: physicians’ and nurses’ viewpoints. Retrieved from: https://www.researchgate.net/profile/Nurdan_Kirimlioglu/publication/310445113_Protection_of_privacy_and_confidentiality_as_a_patient_right_Physicians’_and_nurses’_viewpoints/links/5ef06d0f458515814a74a2f9/Protection-of-privacy-and-confidentiality-as-a-patient-right-Physicians-and-nurses-viewpoints.pdf
Hosseini-Ghavam-Abad, L., Asghari, F., Bandehagh, A., Najafipour, S., & Bigdeli, S. (2019). Patient privacy: Awareness and attitudes of Iran University of Medical Sciences medical students. Medical journal of the Islamic Republic of Iran, 33, 12. Retr https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6504990/
Mehta, S., Jamieson, T., & Ackery, A. D. (2019). Helping clinicians and patients navigate electronic patient portals: ethical and legal principles. CMAJ, 191(40), E1100-E1104. Retrieved from: https://www.cmaj.ca/content/191/40/E1100?utm_campaign=later-linkinbio-gpllm_uoftlaw&utm_content=later-4401214&utm_medium=social&utm_source=instagram
Mendelson, D., & Wolf, G. (2017). Health privacy and confidentiality. Health Privacy and Confidentiality. Retrieved from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2952275

Attachments Below

nurs_hlt308v__powerpoint_presentation.pptx

nurs_hlt308v_organizational_risk_managment_interview_copy.docx