Risk Management Program

Risk Management Program

Grand Canyon University: HLT 308V

Risk Management: Medical School and Healthcare Practice

Baylor College of Medicine recognizes that risks are very inherent especially in a practicing Medical college. Risk must be managed in order to fulfill its ethical and legal responsibilities under Occupational Health and Safety. The college is responsible for providing students, faculty, fellows, residents, staff, patients, volunteers and visitors with a safe environment. Baylor College of Medicine is also responsible for eliminating activities that involve risk. They are to avoid creating activities that involve risk. Trying to avoid risk all together is a hard task in itself. They need to manage liability by structuring activities and programs in ways that reduce or limit institutional risk. This would fall under prevention of risk. Risk Management departments focus is on the employees, patients and students. They also rely on reporting from staff members. RL6 reporting was recently launched that is based within our electronic medical record (EMR).

In the administrative process is the management of the healthcare facility, particularly, the directors of the facility to whom the risk manager report to. These individual have an important role to play in the development of the risk policies of the organization. Medical staff and other employees also participate in the administrative process of risk management. This is because these are the people who directly interact with patients and provide patient care. These are the individuals who are most exposed to risk and therefore need to be well appraised of the administrative procedures that need to be followed in case of an occurrence of a risky event.

Administration Steps and Processes

“The Risk management process of Healthcare Organizations follow five basic steps, including establishing the context, identifying risks, analyzing risks, evaluating risks, and managing risks” (PSQH, 2013). Healthcare Industry is considered an essential sector that affects every person. “Given this aspect, the quality of health care services offered within this industry is an important feature of the world’s health market competition, an element that denotes the need of incorporating adequate risk management procedures” (PSQH, 2013). Learning from medical mistakes is an aspect that is acceptable in health care organizations. Errors in reporting are currently a vital component in the development of safety programs. One that has been recently launched has been RL6 Reporting that actually integrates with electronic medical records (EMR). It allows for real time reporting and review of medical mistakes. There is no delay in resolving and handling risk management issues. Risk management can also think about how they can transfer either the risk or change the financial consequences of a loss to a third / another party. How they can do that is by insurance policies, release and waivers and indemnification agreements. Even after taking all the appropriate measure sometimes we have to accept the risk as it is.

Key Agencies in Risk Management

Some very important key agencies in risk management are: The Joint Commission (JCAHO); they work to ensure that healthcare organizations provide quality care. Healthcare organizations are examined and then given a score of 1-100, higher the score the better. These scores are an important factor when determining reimbursement from Medicare. Another is National Committee for Quality Assurance (NCQA); they ensure the quality of managed care plans. A large one is Centers for Medicare and Medicaid (CMS) they oversee most of the regulations related directly to health care systems. Most private insurance follows their guidelines on coverages for patients since the CMS is very strict on reimbursements and procedures that have to be followed. The Center for Disease Control (CDC) is a well-known organization that examines public health and warns of possible health threats. “The Food and Drug Administration (FDA) is a federal regulatory agency responsible for controlling the safety and effectiveness of the drug supply for both humans and animals”. “Essentially, all areas of health care, including but not limited to physicians, medical directors, health care computer technology companies, health care facilities and pharmaceutical companies, are subject to regulatory review and compliance”

(Grimm, 2014).

American Society of Healthcare Risk Management (ASHRM)

ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking and interactions with leading health care organizations and government agencies (ASHRM, 2019).This mission of ASHRM: “TO PROVIDE HEALTH CARE RISK MANAGERS WITH THE RESOURCES, KNOWLEDGE AND SUPPORT TO STRATEGICALLY AND BROADLY MANAGE RISK, REDUCE UNCERTAINTY, ADD VALUE, AND ADVANCE HEALTH AND SAFETY” (ASHRM, 2018). The operational challenges associated with drafting and maintaining comprehensive written policies place heavy demands on healthcare managers. Increasing financial pressures and the top-priority status that must be given to direct patient care, managers may find it difficult to find time to review or update policies and procedures (PSQH, 2013). Deferring policy may result in negative effects that could be detrimental. Policies and procedures may become outdated, and those who adhere to outdated policies may carry out actions that are no longer consistent with industry-recognized practices. Alternatively, they may simply elect to disregard the policy. Either choice may result in patient harm and a malpractice claim (PSQH, 2013). Hospitals must develop and implement a quality assessment and performance improvement program that will identify patient safety issues and reduce medical errors in hospitals. Sub categories may include medical necessity, deficient care, practitioner qualifications, and accuracy of quality-reporting data.

Recommendations or Changes Needed

There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance (Parand, 2014). Some changes I would recommend would be those of removing rewarding staff for reporting incidents. These tasks should be reported anyway and not rely on rewarding somebody for a job they should be doing anyway. This could lead to people falsifying reports so they could benefit a reward when one should not be given. It is important that we recognize which regulations apply to us and seek clarification as needed in order to adequately comply with those regulations. Remembering that the primary reason for health care regulation, while sometimes confusing, is to ensure that the care being provided by health care practitioners and health care facilities is safe and effective for all everyone who accesses the health care system (Grimm, 2014).

The first preference should be given to the Identification of assets that should be protected, the reports, patient’s personal information, operation procedures, the systems, the equipment all should be protected so that there is no risk involved in the life of the patient. There should be privacy maintained and proper security should be there so that there are no errors & risk.References

Grimm, N. (2014, December 1). Healthcare Regulations: Who Does What? Retrieved January 5, 2019, from http://www.yourtrainingprovider.com/blog_main/bid/203291/health-care-regulation-who-does-what

Psqh. (2013, October 13). Policies and Procedures for Healthcare Organizations: A Risk Management Perspective. Retrieved from https://www.psqh.com/analysis/policies-and-procedures-for-healthcare-organizations-a-risk-management-perspective/#

ASHRM (2019) About the American Society for Health Care Risk Management: ASHRM. (n.d.). Retrieved July 5, 2019, from https://www.ashrm.org/about-1

Parand A, Dopson S, Renz A, et al The role of hospital managers in quality and patient safety: a systematic review BMJ Open 2014;4:e005055. doi: 10.1136/bmjopen-2014-005055