Risk Management in Health Care Institutions - Essay Example

? Risk management in health care s affiliation Risk management in health care s Risk management is an important tool in many organizations. Risk management ensures that any issue that may cause great losses and destruction in an organization is forecasted (Florence &Allen, 2003). Depending on the operations an organization carries out, an organization can be exposed to many risks. Risks have different depths of destruction. For instance, a certain organization may go up in flames while another organization may be robbed. The level of destruction between the two organizations is different. Risks with the capability of causing great losses are given the first priority when it comes to risk management. Since risks cannot be fully avoided, the risk management programs are aimed at mitigation. Mitigation is the process by which the effects of risks are reduced. According to Gary (2000), good risk management programs should be able to forecast any form of risk that may occur and creating a proper mitigation process. In medical and health care institutions, there are numerous numbers of risks. In most cases, the risks involved are related to patients (Florence &Allen, 2003). Medical practices deal directly with their patient which provides very sensitive working conditions. In regards to patients, many risks are due to legal challenges. For instance, if a patient dies under the care on a medical institution and there is a slight evidence of neglect, the probability of closure of the business is very high. Apart from the legal consequences, its patients will seek alternatives when it comes to the accessing of medical service. Apart from the normal health care facilitation risks, medical institutions may also face risks related to billing errors. According to Dana (2009) billing errors exposes an organization to the risk of bankruptcy. Bankruptcy is a definite sign of closure of an organization. Methodology Risk management in health care practices involves the safeguarding of the assets in the institution, agencies, and individual providers from losses. A strategic arrangement can result in considerable cost savings (Gary, 2000). In risk management in medical organizations, a strategic plan provides governing boards, C.E.Os, administrators, and health students the chance to organize and come up with a successful risk management program. Experts in risk management have supplied comprehensive, up-to-date syntheses of related topics to aid with practical risk management plans. Risk management can be categorized as proactive and reactive. Proactive is preventive while reactive reduces damages and reducing loss. Dana (2009) argues that general risk management rules apply, but every organization must make certain its risk management plan includes modified efforts, specifically planned for each institution. Coming up with safety procedures and courses of action, including proper preparation and qualifications, where warranted, while making sure supervision, oversight and compliance, is a requirement and an excellent basis upon which to erect. Florence & Allen (2003) suggest that means should be provided so as employees can even anonymously report problems or concerns to management without their fear of retaliation, reprisal or punishment. Conducting regular discussions with appropriate personnel to review and to gain knowledge from adverse occurrences will aid in re-designing procedures for better deterrence, while assisting in minimizing damage and loss. All medical practitioners: doctors, nurses, clerks, who have direct contact with patients, should be appropriately trained and appropriately licensed (Dana, 2009). All employees; medical and non-medical, must be fully expertise about and adequately educated concerning privacy issues, and must follow proper procedures for handling all features of patients' needs; for instance, medical records, supplies like syringes and bandages, medication, food and clothing. Employees assigned to patient relations can make available communications ways for patients and patients' relatives and families to express their problems to the management, in order to resolve complexities and avoid preventable deaths or court cases (Gary, 2000). As many other organizations, medical institutions use the strategic objectives at risk (SOAR) as a methodology. The foundation principle of the SOAR methodology is to apply data to predict the possible results that may occur as an effect of the pursuit of an institution strategic goals (Florence & Allen, 2003). Through a closely controlled database management; the risk manager can satisfactorily influence the possibility distribution of probable outcomes. A possibility distribution that is better to the organization is one that is taller and thinner and situated closer to the preferred outcome than the initial distribution. Using the SOAR methodology in enterprise risk management has several advantages. By design, the technique centers on the management of risks linked with tactical plans and strategic goals. This stresses that the ERM administrators and strategic goals stakeholders use the same hub and a degree of order that they would then be doubtful to apply. Gary (2000) claims that, another benefit is that the methodology incorporates an iterative procedure that entails data-based decision making and this procedure is distinctive to the SOAR methodology. Application The institution requires sufficient contact to legal counsel, which keeps administration fully knowledgeable of restructured regulations and laws, which have an effect on the institution's delivery of medical care. The management must make sure that all legal and accounting formalities are filed in a timely manner (Dana, 2009). Non profitable hospitals must provide adequate charity care to sustain the institution's tax free position. The management must be alert to make certain that all regulations are adhered to. The institution must have a financial arrangement to cover insurance risk, as well as the acquiring of sufficient insurance coverage. Hospitals, medical organizations, clinics and medical practitioners must take proactive measures to make sure the minimization and eradication of medical faults. Despite the professional skills needed by medical professions and officers, a sound clinical management and clinical risk management structure and practices must be fixed within the overall clinical operations and administration in health care organizations (Florence & Allen, 2003). The American Society of Healthcare Risk Management (ASHRM) defines risk management as: The recognition, analysis, and assessment of risk and the choosing of the most beneficial method of treating it (Gary, 2000). The execution of Clinical management and clinical risk management in health care organizations will improve the provision of health service and enhance the quality of patient care. Additionally, it will result in boosted confidence heights in patients and their relatives. An example of a risk management procedure; following the happening of an unpleasant event, the risk administrator began to build up the points that could be used by defense team in the occurrence that a lawsuit was filed. Interrogation with staff was conducted individually. There was no council meeting to talk about the event and the possible origin. There was no effort to bring everybody together to talk about each person’s task in the patient’s care and in the end outcome. Everyone was gathered into a room, quizzed, and reminded not to argue the “case” with anybody. The medical staff was directed on how to communicate to the patient about the unanticipated result. Any arguments were too brief and unclear. No one was asked to be insincere when communicating with the patient but, in contrast, no one was asked to be totally and fully honest and straightforward. Even with data indicating that more patients were provoked to sue since they did not believe that the physician had provided a full clarification of what transpired, complete revelation is a hard sell for the risk manager and for legal team for the medical institution (Florence & Allen, 2003). Although legal counsels do not advocate for dishonesty when talking to the patient, they are reluctant to agree to a formal policy that dictates the medical staff to disclose medical errors or any treatment that results in an unpleasant outcome. An official policy may not be required, but it gives a way of communicating what the institution wants its employees to do in the occasion of an unexpected result. Besides applications dealing with legal procedure, medical institutions also deal with internal wrangles and issues. For instance, there is the billing errors and theft of medical clothing and tools. To tackle this specialization is the preferred way out. According to Gary (2000) the risk management chief should suggest a competent individual to deal with financial matters. This ensures accountability if there is any occurrence of theft or fraud. The staff with the responsibility of dealing with financials should be grilled regularly to enhance transparency. In the issue of theft of assets, these should be tackled from the onset of the purchasing process. The supplier and the institution should have transparent record of all purchased assets and their quantities. A follow up is then done on a monthly basis to determine the assets that have been used. With every used asset, recording should be made. This bars any possibility of theft. If there is any occurrence of theft the risk manager should come up with a methodology that provides alternatives. For instance, if there is a theft of syringes in medical institution it may cause a great height of losses. To curb this, fast alternatives should be on standby to provide alternative sources of syringes (Dana, 2009). Analysis Florence & Allen (2003) indicate that an analysis of the risk management program should be done. The analysis should be done in a timely manner either annually or monthly. The analysis is a display of numerical results between one and ten. It is based on performance and the feedback from the staff. If a methodology is able to mitigate effects of a risk to its very minimum is then rated at around 9 over 10. The analysis also provides a determination on whether the current methodology is efficient or another methodology needs to be introduced. In a health institution, the perfection of a methodology is measured at the performance in the legal confrontations. Mitigation levels are measured by the determinacy of the number of patients seeking medical care from the practice. The analysis is also done on the performance of the risk management staff (Gary, 200). If the staff is doing an exceptional job then they are retained. However, if the risk management staff is vague and underperforming, then a possibility of reshuffling and replacements is considered. Challenges Health care organizations face various difficulties during the execution of appropriate risk management procedures and practices process. They include; the fear among the staff and practitioners that they would be needed to perform additional and tiring paperwork: filling up forms, provision of more factual reports and unlearning past procedures. Gary (2000) says that executing accountability without blaming individuals is challenging. Support of full participation and staff involvement will give a feel good judgment for the staff, where persons would be aware of the importance of everyone’s participation and contribution in the provision of quality health services to the patients. Vital to the successful execution and procedure of clinical risk management is the commitment and dedication of the Board and senior management (Dana, 2009). Additionally, the establishment of an efficient communication means between health care practitioners and health care administrators is very significant to guarantee a society of clinical risk management. According to Dana (2009) there should also be efforts to incorporate the lower level medical employees in discussions and negotiations during creation of rules and regulations when coming up with clinical practices and procedures. Conclusion There is no perfect and complete secure intervention or plan for attaining best practices in clinical risk management in agreement with the internationally accepted practicing principles. Every organization has to function within its own short comings. Blending of strategies have been proven to be more efficient than single ones, mainly when actions to improve and boost health professionals’ knowledge and consciousness are joint with measures to assist and strengthen standards-based routines in everyday practice (Florence & Allen, 2003). Finally, clinical risk management is essential for health care organizations and should be put into practice to guarantee that the provision of quality patient servicing and safety conforms with the values of care that are anticipated in these modern days. Indeed, this should be a crucial and vital part of the healthcare delivery structure. Although the practice of good clinical governance and clinical risk management does not assure occurrences of adverse events, effective risk management procedure and guidelines allow a rational practice across the institution and allows one to follow the next line of action in a clearly distinct way that would guarantee the minimization of risk to patients and other parties directly involved in the institution (Dana, 2009).or dysfunctions Clinical risk management entails the involvement of all individuals in the institution. Everyone in a clinical environment is has the responsibility of managing risks. It should be an all round thread throughout the whole institution. Each staff member and volunteer should be given the duty of risk management, and persons must be accountable for incorporating all components of the program. In medical institutions, this duty is usually assigned to the risk manager. These are some of the significant aspects that would eradicate defensive responses which would then deter the success of the implementation of a good risk management program. According to Florence & Allen (2003) the objective is to attain a culture of risk consciousness in which everyone contributes and everyone gains. This will make certain that in an efficient health care delivery system where persons take pride in their efforts and take pleasure in the synergy cooperation. References Dana, C. (2009). Legal and ethical aspects of health care information management. Boston: Cengage learning. Florence, K., Allen, D. (2003). Risk management in health care institutions. Massachusetts: Jones and Bartlett learning Gary, P. (2000). Health care risk management. New York: Beard books Read More