Emergency Care Research Institute that Improving Patient Care - Coursework Example

Week 3 Executive Summary of chosen organization The organization chosen is ECRI Institute. It was previously known as Emergency Care Research Institute. It is non-profit company which does researching for finding the best way to improve patient care. It is an international organization which has its offices in United Kingdom, Malaysia, United Sates and United Arab Emirates. It has it’s headquarter located in Plymouth Meeting, Pennsylvania. It holds modern facility with medical library, instrumented laboratories and offices. It was founded by Joel J. Nobel, M.D. in 1968. They have around 400 full-time employees who belongs to different backgrounds like nursing, biomedical science, epidemiology, medicine, physics, social science, healthcare management, information technology, patient risk and safety management, medical informatics, and other areas. Their mission is to help the patient treat them by providing highest standards of cost-effectiveness, quality and safety. To attain this they do research, provide education and engage in consultancy. It has been given a federal patient safety organization by department of Health and Human Services of U.S (Kongstvedt, 2012). Purpose of risk and quality management in health care organizations In today’s world the quality improvement and risk management efforts in a healthcare organization are now falling behind patient safety and ways to deliver medical care more effectively and efficiently so as to ensure that the healthcare organization can deliver high quality and safe care of the patients. The American Society for Healthcare Risk Management have described that there is great importance in the evolution of quality improvement and risk management. They pointed out that information between the quality managers and risk managers are too rarely exchanged between them. Hence the collaboration between them is nonexistent and very minimal. In Past times, organization had legal department and chief operating officer handling the risk management. Chief medical director is concerned with looking after the patient safety issues. Because of organizational hierarchy overlap of quality functions and risk management is not possible between them and it does not allow any sharing of data to occur between them. Risk management deals with examining a particular issue like increase in the number of emergency department claims. After analyzing a number of Emergency department claims, it might be seen that the cause of increase in claims is due to inadequate communication of instructions given to the patient at the time of discharge (Wolper, 2010). Again after evaluation of quality improvement it can be seen that printed discharge instructions are now used inconsistently and they are outnumbered. If the quality and risk departments are not aware of findings of each other, their attempt of improving the communication between the ED staff and patients will result in failure of strategies. Hence it will require the input from everyone to solve the discharge problem. Until 1970s the risk prevention activities were informal and decentralized in the healthcare organization. Risk management was not considered to be a distinct profession in healthcare industry. It came into focus as number of settlements, judgments and malpractice claims against the hospitals and physicians increased. This resulted in lack of hospital liability insurance. In response to it, healthcare companies have created their own pool programs like hospital owned insurance companies which provided the patients with insurance. The function of risk management was to protect the reputation and financial assets of any organization. Previously instead of focusing on underlying design faults, they would focus on defense of their claim. But this idea was changed and it was seen that bad systems and not bad people creates majority of the injuries and errors in healthcare. Risk management professionals are now integrating the risk management activities into the processes and system of healthcare work. According to ASHRM the present day role of risk management has shifted. The major functions of risk managers are loss prevention, Education, Risk evaluation and identification and Patient safety. The company hence needs to realign their focus on the safety standards. They participated in the root cause analyses of events and plans to implement improvements. They administer program to focus on improving the outcomes of healthcare delivery systems (ECRI Institute, 2009). They also evaluate the customer satisfaction and performance improvement function so as to improve their service delivery. Description of the key concepts of risk and quality management in the organization ECRI hospital used initial quality functions known as quality assurance programs which were applied in the healthcare setting. Hospital committee was previously comprised of nursing employees and medical staff leaders. ECRI had to meet the legal requirements of the hospitals by imposing structural requirements on the nursing and medical staff committees. Then ECRI established quality assurance standards as a systematic and formal program so as to measure the care which is given to the patients against established criteria. The program has been revised incrementally on quality standards, leading ECRI in the direction of coordinated and integrated hospital wide efforts to improve their performance continuously. ECRI has established specific quality related objectives so as to measure the processes and outcomes of an organization. They have identified the opportunities for continuous improvement. Risk manager assists in disclosure of event to the family and patient and alert the insurance carrier in case of any potentially compensable event. They do a root cause analysis of all the events and hence prepare a plan of action for preventing same situations from further happening. The quality manager will construct a timeline to implement an action plan and thus suggest a way of monitoring the impact of a plan on the outcomes of patient. Risk management and quality improvement collaborates on the performance of ECRI in meeting the quality indicators (ECRI Institute, 2001). Steps the organization may take to identify and manage their risks ECRI needs to take steps to indentify and manage their risks. They need to first do risk identification. This step involves putting in place a system which captures such risk quickly and reports to the hospital. The source of the risks can be either internal or external to the system. Then Risk Control needs to be done. This involves loss reduction or loss prevention. Through Risk control the management needs to reduce the risk or prevent it altogether by analyzing the root cause analysis. It involves a number of processes like Risk financing, Review of Contract, Claims management, Safety and Security of the system, regulatory and corporate compliance, Accreditation compliance, Mandatory event reporting. They must also look after the Compensation paid to the workers and Bioethics. Identification of at least three typical or actual risks in the organization The risks faced by an ECRI are increase in average claim processing time. This results in drop of reserves of medical malpractice claims. Regulatory scrutiny continues to have an impact on them. With increasing regulatory scrutiny, the organizations face high costs, difficulty to comply, and increasing complexity. Maintaining proper electronic health records and using them meaningfully on a timely basis is a significant challenge. Improving performance of an organization is a long term priority for healthcare organizations. With change in both marketplace and regulatory requirements needs them to step up their performance. For it to achieve it they must try to improve their overall cost structure. Without appropriate cost structure they will suffer loss in profitability. This will definitely affect the quality of medical services provided. Without appropriate governmental regulation they will not be able to run their service. Identification of at least three internal and external factors that influence quality outcomes in the organization Three internal factors which affect the quality outcomes of an organization are the cost structure, quality of employees and availability of funds. If the cost structure of the organization is not set right it will decrease the profitability. If the staffs of the organization are not properly trained and are able to handle pressure situation then the quality of the organization will be affected and the customer service level will decline. Similarly lack of funds will not allow them to buy new material which is needed for new improved surgeries. External factors are State taxation issues, Technology issue and Natural Disaster. Any increase in State Taxation will raise the cost for general public. Hence general public will refrain from going to the organization. Technology is another issue. With adoption of technology the cost decreases significantly as they have to deal less with paper work. Natural disaster cannot be controlled by human because of which their entire building structure may collapse which entails significant cost for them. Three of the organization’s long-term goals and at least three short-term goals Three long term goals of the organization are improving the medical and healthcare facilities to the patients. They provide highest standards of cost-effectiveness, quality and safety. They aim to become one of the top rank healthcare service providers. They also aim to comply with the regulatory and governmental regulations so that they can adopt with new rules and regulations quickly. Three short term goals are improving the customer query time. This will improve the customer service level. They also need to keep themselves updated with latest use of technological innovation in the field of healthcare. Last short term goal is to have good quality of physicians, surgeons etc. This will attract large number of patients. Identification of at least three fundamental risks and quality management policies Three fundamental risks faced by the healthcare organizations are number of lack of adequate infrastructure, inability of comply with the governmental regulations and improving the performance of level of medical service provided. They all need to improve so that the organization can increase their level of performance. Explanation of the relationship between risk management and quality management in the organization Risk management and quality management programs may vary from organization to organization. Though each of the department addresses matters separately they also share the responsibilities. Risk manager has to assists in the disclosure of the event to the family and also alert the insurance company for compensation. Risk manager assists in disclosure of event to the family and patient and alert the insurance carrier in case of any potentially compensable event. They do a root cause analysis of all the events and hence prepare a plan of action for preventing same situations from further happening. The quality manager will construct a timeline to implement an action plan and thus suggest a way of monitoring the impact of a plan on the outcomes of patient. Risk management and quality improvement collaborates on the performance of ECRI in meeting the quality indicators. For example if in the hospital’s CEO receives a report on blood infections rate which is found to be on the higher side. In that case CEO contacts the quality manager. If the quality manager indicates that the infections are occurring in Intensive care unit because of central line insertions. After doing a root cause analysis, it is seen that the infection occurred due to masks and sterile gloves. It is seen that these are provided by central supply department which becomes unavailable at times in the ICU. Hence CEO decides to make available the necessary kits in ICU during emergency situation. References ECRI Institute. (2001). Are You Connected. Retrieved from: https://www.ecri.org/Documents/Reprints/Are_You_Connected(TechNation).pdf. ECRI Institute. (2009). “Risk Management, Quality Improvement, and Patent Safety”, Journal of Healthcare Risk Control, Vol. 2 (1). Kongstvedt, P.R. (2012). Essentials of Managed Health Care. Burlington: Jones & Bartlett Publishers Wolper, L.F. (2010). Health Care Administration: Managing Organized Delivery Systems. Burlington: Jones & Bartlett Publishers Read More