Risk Management Program for Healthcare Organizations - Term Paper Example

Risk Management Introduction Gaining control and visibility on medical external and internal health care risks is among the top priorities and essentials of health care organizations. With the recent increase in medical needs, regulations and increasingly active health care malpractice, many organizations have increasingly been sensitized to control their operations and identify areas of risks among their medical staff. Medical staffs have the mandate to deal professionally when addressing the unlimited variants of medical cases with high risk task involvement. In consideration is the fact every risk undertaken by a staff irrespective of the department in which the medical case falls, the reputation of the health care institution as a whole is at stake. As a chief executive officer, the organization seeks to redefine, centralize, and streamline the current risk management program. Risk Management Program Health care organizations are seeking to systemically identify prioritize, measure and respond to all types of health care risks facing the organization by putting in place a highly effective and co-coordinated system which harmonizes departmental risks. The Compliance 360’s Risk Management Solution is an ideal proposition which will go a long way in assisting the organization to coordinate key elements of each department with regards to organization wide risk management. Compliance 360 systems automate processes with regards to risk assessment and monitoring alongside risk response management strategy. The system links risk management data to activities of compliance while providing a global insight to all risk prone activities via an executive dashboard. The management team is able to assess the problematic areas quickly and proactively adjust activities to respond to the problems and track response progress through automated alerts and reports. Compliance 360 Risk Management solutions basically facilitates all facets of risk management while including features such as customized solutions, visual risk framework representations and workflow enabled risk control tests and assessment processing with executive level reporting and visibility. The systems seek to be beneficial to health care organizations that are rapidly growing and being assessed with respect to their risk management capabilities. Health care organizations are from time to time assessed by rating agencies to ascertain their bond and credit ratings. The Compliance 360 risk management solution will generally go a long way in helping the organization to proactively demonstrate initiatives to risk management and help improve and preserve its ratings as compared to other health care organizations in the market. Compliance 360 risk management solutions provide real time reports and graphical representation on a home page that configurable with the capability of highlighting exceptions to compliance. The systems capability examines detailed specific activities in breach and compliance of set out laws, standards and regulations. The tool enables executive update by providing real-time tools for reporting comprehensive information in a centralized manner. Although, executives may use this in decision making and organization wide coordination, the information is highly relevant to centralized risk management professionals functions. Through the system, the professionals can effectively carry out risk management and quality control functions among the health care staff. The centralization of risk management is alluded to the position of risk management professional whose task are basically emphasize on developing operating procedures and standards of the organization as a whole. These tasks are best performed in a centralized system that would enable promotion of health care quality, quality improvement initiatives, handling patient’s complaints, monitoring and evaluating staff credentials. Risk management functions require high level efficiency and harmonization through centralized control by the executive body and risk management professional. More so, departmental unit functions needs to be standardized through the central system to enable organization wide quality assurance and risk management (Carroll, 2009, p.71). In addition to assisting coordinating departmental risk management measures into an executive and centralized point of view, the compliance 360 risk management solutions improves operations efficiency. More so, the system will also go a long way in identifying key areas with distinct opportunity of enhancing cost reduction. Other than key area cost reduction opportunity, the compliance 360 risk management solutions centralizes clinical and operational functions thus reducing costs. The systems centralization of clinical and operational functions enables nurse transcription and scheduling. The executive insight of risk management of the organization as a whole enables health care organizations to take full advantage of practice enablers that are leading. Practice enablers may include service level agreements evident within an environment of shared services, increased centralized management functions transparency and improved client service capabilities between internal customers and centralized functions. Compliance 360 risk management solutions has been widely used and proved to be effective in providing coordinated and efficient risk management solutions. Compliance 360 risk management solutions will enable the organization to manage all risk and compliance activities thereby facilitating increased focus on key processes of providing quality health care. The graph below indicates the average compliance to medical follow to one-pill daily medication of antihypertension.   Source: scielosp.org Compliance 360 risk management solutions would provide key capabilities such as policy and procedure management. Policy and procedure management would enable full life-cycle procedure and policy management such as easy keyword search, automatic email reminders and customized workflow for approval and collaboration activities. Policy management system would also enable version control monitoring activities, employee survey and full audit capabilities to ensure the medical staff have read and understood the existing policies. The capability also enables procedure and policy organization with regards to regulations impacting the institution thus enabling executive access of real-time compliance evidence. Compliance 360 key capabilities also include regulatory intelligence and content management, virtual evidence room, adverse event management automated self assessment, surveys, claims auditor, contract management, executive dashboard, project management and comprehensive reporting. Regulatory intelligence and content management capabilities enables gathering of existing regulations and laws into a central content repository. The system then provides automated alerts with regards to changes then disseminates information to relevant individuals concerned within the organization. On the other hand, the virtual evidence room provides a central place where all activities are tracked and linked to the existing relevant standards and regulations. The capability facilitates various types of surveys and audits with respect to standards, laws and regulations (Gitman & McDaniel, 2008, p.401). Through adverse event management module, the organization is able to manage a wide variety of issues such as potential fraud, slips, hotline tips, legal issues among many other unforeseen happenings. The module gathers and stores such information and allows staff from the five departments personnel to collaborate on compliance-related incident information and track progress of investigations. All adverse incident information is represented graphically and on reports to demonstrate board and committee meetings presentations. Executive and centralized risk management professionals can easily access this information since it is represented in an easily interpretable. The system will go a long way in facilitating a coordinated workforce with centralized organization wide risk management from risk managerial functions from the professionals. The risk management professionals carry out medical staff control alongside ensuring quality control and risk management, However, Risk managers of each departmental unit will need to forward individual practitioner information such as knowledge of adverse outcomes, malpractice claim history, and incident reporting data to the centralized committee to evaluate medical staff competence alongside necessary credentials. Centralization of risk management medical data enables easy collection and analysis of data for the organization as a whole. More so, the organization is able to uphold particular performance levels at a whole since quality assurance and control is done from a central point of view with harmonious standards and law (Kavaler and Spiegel, 2003, p.8). Centralized risk management functions by professionals will be the top management hierarchy in which licensed staffs credentials will be verify. The basis of verification will be based on practitioner information forwarded by departmental units managers. However, board executive and centralized risk management professional function may conflict in the long run since there exist a thin line between centralizes professional functions and executive functions. The organization therefore puts in place a provision for separation of centralized functions in case of conflicts. The provision will sought to streamline executive board towards leadership and visionary functions while centralized risk management functions will tend to focus on risk management and quality assurance alongside verification of licensed staff credentials. Conclusion The compliance program will basically enable effective coordination of all organization’s activities through centralized functions. Through the centralized functions, the organization is able to gain control and visibility on medical external and internal health care risks. Although, medical staff have the mandate to deal professionally when addressing the unlimited variants of medical cases with high risk task involvement, the organization is responsible as a whole for the safety of its patient. A system such as compliance 360 is just but a necessity to health organizations which also goes a long way in ensuring the reputation of the health care institution is maintained. References Carroll, R. (2009). Risk Management Handbook for Health Care Organization. Jossey-Bass Publishers. Gitman, L.J. & McDaniel, C. (2008). The Future of Business: The Essentials. OH: Cengage Learning. Kavaler, F. and Spiegel, A.D. (2003). Risk Management in Health Care Institutions: A Strategic Approach. NY: Jones and Bartlett Publishers, Inc. Read More