HLT 308V Grand Canyon University Risk Management Program Analysis

HLT 308V Grand Canyon University Risk Management Program Analysis

HLT 308V Grand Canyon University Risk Management Program Analysis

The purpose of this assignment is to analyze how an organization’s quality and improvement processes contribute to its risk management program.

This assignment builds on the Risk Management Program Analysis – Part One assignment you completed in Topic 1 of this course.

Assume that the sample risk management program you analyzed in Topic 1 was implemented and is now currently in use by your health care employer/organization. Further assume that your supervisor has asked you to create a high‐level summary brief of this new risk management program to share with a group of administrative personnel from a newly created community health organization in your state who has enlisted your organization’s assistance in developing their own risk management policies and procedures.

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Compose a 1,250‐1,500 word summary brief that expands upon the elements you first addressed in the Topic 1 assignment. In this summary brief, address the following points regarding your health care organization and its risk management program:

  1. Explain the role of your organization’s MIPPA-approved accreditation body (e.g., JC, ACR, IAC) in the evaluation of your institution’s quality improvement and risk management processes.
  2. Describe the roles that different levels of administrative personnel play in healthcare ethics and establishing or sustaining employer/employee-focused organizational risk management strategies and operational policies.
  3. Illustrate how your organization’s risk management and compliance programs support ethical standards, patient consent, and patient rights and responsibilities.
  4. Explain the legal and ethical responsibilities health care professionals face in upholding risk management policies and administering safe health care at your organization.
  5. Relate how your organization’s quality improvement processes support and contribute to its overall journey to excellence.

In addition to your textbook, you are required to support your analysis with a minimum of three peer‐reviewed references.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Risk Management Plan Sample Paper

A risk management program at a healthcare business has one major purpose: to safeguard patients, staff, new employees, and visitors from safety risks that could result in unintended injury (Carroll, 2019). A risk management program also safeguards the healthcare organization’s assets, the organization’s reputation, and people’s perceptions of the community. Under the direction of the risk manager, the program develops rules, standards, and protocols to address anticipated situations that may hold the firm or its employees accountable. In this situation, the risk management plan should aid in the assessment and identification of risks, as well as the investigation and reaction to safety issues and other compensable events that may arise. A risk management program’s objectives are to promote excellent patient care that results in patient satisfaction, to reduce or prevent the incidence of adverse events, and to create a culture that encourages awareness to help staff recognize and report risky circumstances.

Summary of the Risk Management Plan

The risk management plan acts as a tool for the effective implementation of the risk management program. This is because it acts as a guide for the business processes that ensure patient safety and quality care of patients (Carroll, 2019). The plan provides an ongoing and systematic approach for reducing an organization’s exposure to patient safety risks. Baylor College of Medicine is based in Houston, Texas, and the organization is aware that risks are inherent. In this case, the institution recognizes the need for risk management to ensure that it fulfills its legal and ethical obligations on patient and worker health and safety. Through its risk management program, the facility provides students, residents, hospital staff, and patients with a safe environment by identifying and eliminating eminent risks. In this case, the risk management department in the organization focuses on enhancing the safety of its patients and staff and relies on reports from the institution stakeholders.

In this case, the risk management program chosen for analysis deals with the reduction of unsafe practices that increase the risk of patient falls, especially among elderly patients. In this case, the program ensures that patients at high risk of falling and injuries are identified, and intervention procedure is documented. According to Carroll (2019), prevention of falls is crucial in ensuring the safety of patients in a hospital setting. This is because data shows that over 45% of patient falls in the U.S resulting in serious injuries and harm, which in turn results in a cost of approximately $15,000. In this case, reducing maintaining patient safety by reducing falls will help healthcare provider institutions reduce harm and ensure they receive maximum reimbursement from insurers. HLT 308V Grand Canyon University Risk Management Program Analysis

Standard Steps and Processes in a Risk Management Program

The administrative process refers to the policies that a hospital has put in place to mitigate risks. In a hospital setting, the first step in risk management is to ensure the organization has a qualified risk manager, who carries all the risk management administrative activities, including risk financing, procurement of insurance coverage. He/she is also responsible for conducting risk management training and education and also managing litigation claims, among others (Carroll, 2019). Also, the risk manager develops organization policies associated with risk in collaboration with other stakeholders, as well as ensuring that the policies and operations are compliant to the safety accreditation bodies. 

In addition, the management of the healthcare facility is crucial in the administrative process since it is the directors of the organization that the risk manager report to. Also, the medical staff and other workers must be involved in risk management since they are the ones who interact directly with patients. Also, the staff and patients are the most exposed to safety risks and must be appraised on the communication and other administrative protocols to be followed in case of an occurrence of a risky situation. In most healthcare organizations, the risk management process follows five steps, which involve the establishment of the context, risks identification, risk analysis, evaluation, and management of the risk (Farokhzadian, 2015). Reporting risks is also a crucial part of risk management and should be integrated with the electronic medical record systems to ensure real time reporting and reviewing of medical mistakes.

In the selected risk management plan, the standard process in a risk management program starts with the identification of the persons or assets that need protection (Alam, 2016). In this case, this is the elderly patients who are prone to falls. The other step involves the identification of threats that these people face, in terms of the impact of the risk and likelihood of the risky situation happening. This is the risk assessment stage. The other step involves the management of the risks by applying controls in a layered manner to ensure the probability of the risk is reduced (Alam, 2016). In this case, the intervention should ensure that tasks do not overlap and ensure attention to detail since the health and safety of the people should not be compromised. The other step involves testing the effectiveness of the process by carrying out an evaluation. Lastly, transfer of liability is a crucial step that ensures that the risks are transferred to a third party, probably through an insurance program. In addition, new employees should be made aware of the risk management program to ensure they understand their roles and ensure they apply the guidelines in their daily activities.

Agencies Involved in Administration of care

The Centers for Medicare AND Medicaid (CMS) is a crucial agency in risk management since they oversee the policies and regulations that guide healthcare organizations. The CMS has strict guidelines that organizations must comply with to receive reimbursement. Also, the Food and Drug Administration is an important agency that regulates and approves drugs, as well as the medical equipment used in patient and animal care (Alam, 2016). In this case, the medical equipment is categorized in classes that determine the regulatory requirements that apply to them, as well as the level of risk they pose to patients (Alam, 2016). The CDC is also a key agency that ensures the prevention of diseases, disability, and injuries that threaten the safety of patients. The agency also warns in case of an event that threatens people’s health and safety. The agency for healthcare research and quality (AHRQ) is an agency under the HHS and helps improve quality, efficiency, and effectiveness of care to ensure patient safety. The agency supports innovations and research to help healthcare providers offer evidence-based and better care.

Compliance of the Risk Management Plan with MIPPA-Approved Accrediting Body: American Society of Healthcare Risk Management (ASHRM)

Established in 1980, ASHRM is a member of the American Hospital Association, where members address issues of patient safety, risk management, finance, law, and insurance. ASHRM is important to the risk management plan since it promotes efficiency and innovativeness in the development and implementation of risk management strategies (ASHRM, 2020). This is because the initiatives developed by the program aim to ensure the implementation of practices that ensure safe care and working environments.

The risk management program of the organization complies with the ASHRM guidelines. The organization has implemented policies that align with ASHRM requirements and ensures it has adequate staff to ensure risks are managed effectively. Also, the organization’s risk management plan focuses mainly on patient safety. It has also made efforts to transfer some risks to third party companies by taking insurance covers to avoid liability that could hinder its productivity. Additionally, the institution has employed a risk manager who is well trained in the field and also ensures other staff are trained regularly to keep up to date with the risk management program of the organization in case of changes. Some of the interventions that the organization undertakes to comply with ASHRM include ensuring they perform injury and fall risk assessment during and after patient admission, identifying daily changes in patient outcomes, implementing patient-specific interventions to injuries. Also, the organization maintains effective communication and reporting of identified safety risks and develops post-injury/fall interventions that aim to prevent future injuries.

Recommendation for Changes

According to Carroll, 2019 the time and work that a risk manager do can influence the quality, safety, and clinical outcomes significantly. In this case, I would recommend that more resources should be allocated to the department of risk management. In this case, adding more financial and human resources to the office of the risk manager will ensure that claims are solved faster, and risk management strategies get implemented effectively, resulting in better and quality care. Also, delayed handling of safety claims can create reputation problems for the organization.

The other recommendation is that there is a need to institute change in how evaluation of risks is handled. Although the risk manager is responsible for this, it is crucial to involve actuaries in the evaluation of risk exposure to ensure the data is accurate. This will help the organization use resources efficiently and ensure crucial assets are protected from adverse risks. Also, conducting regular audits on the frequency of falls and other safety-related risks is crucial in ensuring interventions are put in place to protect patients from injuries. Lastly, a more effective monitoring and evaluation program should be developed to ensure the risk management program works as needed, and the objectives of the program are achieved.

References
  • Alam, A. Y. (2016) Steps in the Process of Risk Management in Healthcare. Journal of Epidemiology Preventive Medicine, 2(2): 118.
  • ASHRM. (2020). About the American Society for Health Care Risk Management. American Hospital Association. Retrieved from https://www.ashrm.org/about-1
  • Carroll, R. (2019). Risk Management Handbook for Health Care Organizations (5th Ed). Jossey-Bass.
  • Farokhzadian, J., Dehghan Nayeri, N., & Borhani, F. (2015). Assessment of Clinical Risk Management System in Hospitals: An Approach for Quality Improvement. Global journal of health science, 7(5), 294–303. https://doi.org/10.5539/gjhs.v7n5p294

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