How Risk Management Programs Operate Within Health Care Organization

Interview Questions:

  1. Risk management strategies used in the organization’s risk control program, along with specific examples.
  2. How the facility’s educational risk management program addresses key professional, legal, and ethical issues, such as prevention of negligence, malpractice litigation, and vicarious liability.
  3. Policies the facility has implemented that address how to manage emergency triage in high‐risk areas of health care service delivery (e.g., narcotics inventories, declared pregnancy policies, blood-borne disease sector, etc.).
  4. Challenges the organization faces in managing and controlling high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4 narcotics/opioids, etc.).
  5. Strategies the facility utilizes to monitor, evaluate, and maintain compliance within its risk management program.
  6. An assessment of the organization’s risk management program, including how it attends to high-risk health care and legal concerns.

Action steps you would take to improve one area of the organization’s risk management program, along with your rationale for doing so

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The purpose of this assignment is to gain real-world insight into how risk management programs operate within health care organizations.

In your interview, address the following:

  1. Risk management strategies used in the organization’s risk control program, along with specific examples.
  2. How the facility’s educational risk management program addresses key professional, legal, and ethical issues, such as prevention of negligence, malpractice litigation, and vicarious liability.
  3. Policies the facility has implemented that address how to manage emergency triage in high‐risk areas of health care service delivery (e.g., narcotics inventories, declared pregnancy policies, blood-borne disease sector, etc.).
  4. Challenges the organization faces in managing and controlling high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4 narcotics/opioids, etc.).
  5. Strategies the facility utilizes to monitor, evaluate, and maintain compliance within its risk management program.
  6. An assessment of the organization’s risk management program, including how it attends to high-risk health care and legal concerns.
  7. Action steps you would take to improve one area of the organization’s risk management program, along with your rationale for doing so.

 

Sample Answer

 

Risk Management Operation within Health Care Organization

Introduction

Health care organization experiences a significant number of healthcare risks. Several risks are critical hence are difficult to prevent or control. Although some of the risks are relatively impregnable. Therefore, healthcare organization efficiently manage or prevent the risks from affecting the organization reputation. According to Fabri (2019), critical risk experienced at healthcare organizations includes healthcare illness or disease outbreak, compliance lapse, physical attacks and cyber threats. The explosion of diseases or infection is the principal risk in the healthcare sector. They affect not only patients but also health care providers and the management team. Especially when there is an outbreak of a specific virus. The virus can be transmitted from one patient to another or from patients to the physicians. Due to different change and development in term of technology in healthcare organizations, it results in cyber threats which could threaten most critical operations within the organizations. Healthcare organization reputation and standards can be damaged by cyber-attack through data breaching and gaps. Compliance lapse is also an essential risk for the healthcare industry. Healthcare providers should always be aware of the laws and regulation governing them and patient healthcare, e.g. patient’s consent. Basing on several risks experienced at a healthcare organization. An interview was conducted on the topmost management team of a specific hospital in the United States, and the various question was administered.

Risk Management Interview Questions

First Question

The question was about risk management strategies used by healthcare organization program. Risk management program or plan primarily aim at regulating risks by, detecting risk, report, and correct probable problems the hospital associated with healthcare provision. According to interviewee response, various strategies were being employed to mitigate risks in the Hospital. Some strategies used risk management include; First, employment of accredited or professional employees. For example, specialized microbiologist to conducted day-to-day examinations of patients. This will help in the detection of an outbreak of disease infections in the hospital. Secondly, Installation of auto screening machine in the hospital to detect outbreak disease infections. The device carries out auto screening of disease-causing pathogens such as viruses and bacteria. The third strategy involved pieces of training and educating risk management committee on how to respond and prevent risks. The fourth strategy, entailed sound communication from the management in advance to make all the stakeholders aware of the risk by use of poster display on noticeboards (World Health Organization, 2017)

Furthermore, the hospital also enhanced high standard hygiene within hospital premises through thorough cleaning and purchase of essential laboratory disinfectants. Patients ward were kept clean to reduce the buildup of pathogens which are responsible for disease infection. Patients were given separate departments room in cases of chronic symptoms of disease infections. Lastly, all the high-risk patients are tracked to trace appointments which made sure no missed appointment could occur due to system cyber-attack and data breaching. All patients’ records were well stored in case there was need a further prescription, and the hospital also follows up on any missing files (Fabri, 2019). Therefore, the organization has incorporated the risk management strategies in health care facilities that helped in correcting, reporting and controlling potential risks.

Second Question

The question involved in the interview was trying to understand how the educational risk management program addresses critical legal, ethical and professional issues. According to the interviewee, essential matters that needed to be addressed include malpractice litigation, vigorous liability and preventions of negligence. All hospital professional health providers have a responsibility to make sure that there are no cases of negligence. Therefore, medical malpractices were addressed as a measurable element to enhance the maximization of hospital management efficiency. This move helped the hospital to eliminate high risks in the hospital and educating hospital employee and physicians critical preventive strategies which specifically relate to essential risks of healthcare. The risk management team and management took a liable responsibility of education and training of hospital stakeholders through seminars and conventions in the hospital about risk and risk management. Sessions were organized and scheduled periodically every month to educate the employee on how to control, respond and prevent threats (Bahr, 2018).

Furthermore, the hospital gave patients and other hospital stakeholder fliers and hanging poster on the noticeboard to ensure the information is widely spread about the exiting risks and potential preventive measures of the risks. Specialised hospital health professionals incorporated quality and improved legal services in the hospital to ensure strategic risk management measure are in place for malpractice prevention which usually holds a hospital liable. Therefore, the organization attends to the legal concerns and high-risk healthcare through implementing preventive measures such as training of the staff to prevent any cases of negligence. This is premised on the fact that in case of any legal suit, the hospital will be liable to pay compensation to the affected party (Bahr, 2018).

Third Question

The interviewer also asked about policies implemented by the hospital to discourse emergency triage in most vulnerable areas to risks in the hospital. According to the responses of the interviewee, various strategies were executed by the risk management committee in the hospital. For high risk such as the chronic spread of infectious diseases, hospital management developed bloodborne sector that was principle preventive measures of disease spread within the hospital through termination of all body fluids and drops of blood. Hospital management also implemented Portability and Accountability Act (HIPAA) and Emergency Medical Treatment and Active labour Act (EMTALA) policies. EMTALA policy ensured that equal quality improved healthcare services were implemented across the board. Therefore, all healthcare facilities and physicians were to meet a certain standard accredited by Joint Commissions bodies for physician qualification to carry out surgery in case of emergency during pregnancy. The policy eliminated any potential risk that can occur due to employees and facility incompetency. EMTALA policy ensured that there are accredited health facilities such as emergency room and other critical clinical theatres that are compliance with EMTALA. The system also provided that continues the use of durable and updated equipment in hazardous areas (Gressick & Jackson 2019).

Furthermore, another policy implemented involved use of utilization triggers that primarily focused on pharmaceutical prescriptions and elimination of outdated materials to minimise contamination risks. The patient was also trained about patient consent act to make sober and right decision to allow the physician to carry out a medical procedure. This policy played a significant role in protecting physicians, and the hospital for being held responsible in case of risk occurs during operations. The system also mentioned hospital reputations and standards.

Question Four

The question explore the challenges the hospital face during control and management of high risk in the hospital. The principal problem faced by the hospital according to the top manager response was to control severe dangers in health care such ask diseases infections. Because most infectious diseases spread very faster. The rate of infectious diseases was higher, and the available hospital facilities and personnel were inadequate to mitigate the problem (Haque, 2018).

Moreover, the primary cause of high-risk diseases infection spread was because of a frequent number of undiagnosed patients entering the hospital, which generated a significant challenge in the Hospital. However, continues detection, employment of more health professional and purchase of high standards equipment is relatively expensive for any hospital. Therefore, these challenges contributed to inefficiency in risk management. A significant percentage of hospital procedures are done using radioactivity. Due to lack of enough funds to purchase radioactive facilities, nuclear medicines such as x-rays was not effectively conducted hence putting a lot of expectant mothers at risk. Other challenges affecting healthcare provision involve failure on time risk management on a real-time basis which in turn affect the hospital to mitigate and control hazards at an early stage before it becomes severe (Haque, 2018).

Question Five

The fifth question was about strategies the organization utilized in monitoring, evaluating and maintenance of compliances inside the risk plan. According to the response of the management, procedures involved include; risk identification, regulatory of the patient population and regular assessment of hospital facilities.

The hospital risk management committee ventured in identifying possible risk within the hospital while focusing on how to maintain compliance through administering a piece or pieces of training to patients. The education aimed at helping the patient on how to manage risks themselves. Another strategy involved population regulation. Risk stratification model was the primary technique used inpatient population regulation. Healthcare care provider was held responsible for identifying the level of risk concerning the patient. After identification of the risk, patients were assigned a different status level to enhance risk care; hence the stratification techniques personalised patients care and assigned specific care subgroups. Patient’s information was recorded, and the same data was replicated in the entire hospital to care for other patients. The data collected from and the individual patient was saved a critical for development and implementing risk control for the whole population (Ginter & Swayne 2018)

Hospital facilities were also evaluated frequently basing on accreditation criterion of MIPPA-approved accreditation bodies.  Agencies from these bodies were invited regularly in the hospital to assess hospital facilities to ensure continuous quality improvement hence controlling risk occurrence during medical procedure execution. The authorities also provided availability of professional healthcare providers who can discover the existence of disease infections in advance. The physician was also responsible for quality health provision, especially to reduce pregnancy risks in an emergency room. Finally, general risk management model was implemented for monitoring and evaluations of risk management and set relative response toward mitigation of the risk (Ginter & Swayne, 2018).

Assessment of Hospital’s Risk Management Program

A risk management program can be adequately assessed using Risk Management Assessment Framework. The framework assesses hospital risk management basing on evidence. The model is essential in the evaluation of the risk management program to enhance efficiency. The model help to identify the areas where risk management was poorly conducted and stronghold of the administration. Criterions used to assess the hospital risk management are; First capabilities that involve leadership support, how the management equipped for risk handling, availability of clear risk strategy does. Finally, risk handling and outcome (Gama et al., 2020).

Therefore, basing on the model techniques, hospital risk management program handled potential perfectly, although other parties of risk management were not well conducted. For example, the top management participated well in the execution of the program through sound communication and direction of roles. Hospital risk management program was capable of handling the risk since it identified potential high risk in the facility in advance, and strategic responses were administered accordingly. Hospital leadership also offered physical and ethical support for risk management.  Consider, the scenario of the outbreak of disease infection. Risk management team examine patients and used stratifications technique to contain the risk. Patients were grouped in small strata basing on the level of risk. However, some of the dangers were not handled well. For example, radioactive medicine facilities were not installed to mitigate risks that occur during x-ray examination (Gama et al., 2020).

Action Step

The hospital should put more concentration in engagements with the target group of patients, especially with high risk such as disease infections. Secondly, the risk management team should build more technical risk management aspirants by building specific skills essential for the handling of the risk. The hospital creates a follow-up system that will trace different levels of high risk, which will help locate the risk management program. Employment of more risk management specialist during risk peak period. For example, the hiring of more microbiologists when there is an outbreak of the virus in the hospital. This strategy will increase workability aimed at mitigating the risk.

Conclusion

In conclusion, the potential risk associated with healthcare is; disease infections, abortions, nuclear medicine and cyber-attack. According to the response of the hospital chief manager, the organization implemented various strategies in controlling and management of the risk in the hospital. Some of the policies the hospital implemented tom mitigate the chances are bloodborne termination and negligence prevention. However, the organization experienced some challenges during program execution. Some of the difficulties are infections and abortions. The hospital utilised various strategies for risk management. Some the plans are; risk identification, regulatory of the patient population and regular assessment of hospital facilities. Risk assessment framework was used to assess the program used by the hospital to manage the risk to identified poorly and correctly handled threats and give the next move for the hospital and areas of emphasis.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Bahr, N. J. (2018). System safety engineering and risk assessment: a practical approach. CRC press.

Gama, Z. A. D. S., Saturno-Hernandez, P. J., Caldas, A. C. S. G., Freitas, M. R. D., Mendonça, A. E. O. D., Medeiros, C. A. D. S., … & Soares, D. P. (2020). AGRASS Questionnaire: Assessment of Risk Management in Health Care. Revista de Saúde Pública, 54, 21.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care organizations. John Wiley & Sons.

Gressick, K., & Jackson, J. S. (2019). The Emergency Medical Treatment and Active Labor Act (EMTALA): Assisting physicians to honour medical oaths. The American journal of emergency medicine, 37(7), 1391-1392.

Haque, M., Sartelli, M., McKimm, J., & Bakar, M. A. (2018). Healthcare-associated infections–an overview. Infection and drug resistance, 11, 2321.

World Health Organization. (2017). Patient safety: making health care safer (No. WHO/HIS/SDS/2017.11). World Health Organization.

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