The Management of Risk and Quality in the Field of Health Care - Assignment Example

Risk and quality management is an important arena where all business units are looking at. Risk management is a process through which steps are taken to reduce the adverse effects and ensure mechanism for growth. (Risk Management, 2006) The management of risk and quality gets magnified in the field of health care. Risk management in health care organization has undergone phenomenon changes due to changes in training process. The importance of risk management increases due to involvement of patients in health organization. Since, health care doesn’t guarantee positive results (Miller, 2010) the problem magnifies for health organization Health care organizations look towards risk management and quality management through different areas. One such is leadership and governance. Leadership and governances looks into the aspect as below Risk Management: Health care organizations look into this area in the following methods Ensure commitment from the management so that there is proper risk management Ensuring that the organization’s mission is communicated clearly and is documented Prioritize the risk and take effective steps to reduce those Development of risk management plans Quality Management: Health care organization needs to influence quality management through following Motivate the work force so that the actions are guided towards the goals of the organization Aligning activities and duties so that the goals can be achieved easily Ensure that proper communication process between the department Ensure proper direction towards the goal and work in a unified manner by treating all as one. The problem for health care organization is to identify the risk involved in managing their daily business, the manner in which the risk can be mitigated and the training and education policies that will help to reduce the risk. Reviewing the risk involved in health care identifies risk involved in health care management as: Risk management in health care organization is “the clinical and administrative activities that are taken to reduce the injuries to patients, employees and visitors at the same time ensuring that the organization doesn’t have the risk of loss”. (Miller, 2010) It identifies risk for health care organization through two ways 1. Reactive where organizations react and take steps after the health care organization has already faced the situation (Kavaler, 2003) 2. Proactive where the organization take steps before hand to reduce the risk (Kavaler, 2003) The above risk measures highlights the importance of risk management in health care organization due to the following reasons 1. Transfer cost which is the cost associated with insurance of the patients (Daniels & Tisdell, 2010) 2. Retention cost which is the cost associated with insurance premiums and other charges on the premium (Daniels & Tisdell, 2010) 3. Administrative cost which is the cost involved on clerical work on paper, fees and other charges. (Daniels & Tisdell, 2010) The above reasons falls in line as hospitals continuously deal with patients and have to take steps to ensure proper risk management strategy. The importance of risk management in health care industry increases as they face the risk associated with property and insurance programs which have an effect on the future of the organization. (Daniels & Tisdell, 2010) The organizational performance in health care organization also gets influenced through philosophy and culture is provided below Risk Management: Risk management gets influenced in health care units due to culture in the following ways Ensure that different culture understands the risk in the same manner (ICH, 2006) Integration of culture towards risk management by conducting training and workshops. (ICH, 2006) Proper communication in a language easily interpreted by all the cultures. (ICH, 2006) Understanding the different culture through body language and tools to improve the effectiveness. (ICH, 2006) Quality Management: Culture effects quality management and steps should be taken to ensure proper management Proper communication to the different culture to make them understand the importance of quality (ICH, 2006) Documentation of the projects and ensuring communication is all possible direction. (ICH, 2006) Proper motivation techniques for the different culture to ensure proper delivery of service. (ICH, 2006) Clearly stating the vision and mission and aligning the cultural interest towards those. (ICH, 2006) Risk management and quality management effects stakeholders in a health care organization in the following way Risk Management: The effect on stakeholders is as follows Identifying the stakeholders by being creative and including different sects of customer. (Brown, 2008) Identify the threats and opportunities which can affect stakeholders by conducting a proper analysis of the environment. (Brown, 2008) Prioritizing the risk and impact it will have on stakeholders by differentiating the risk appetite. (Brown, 2008) Proper documentation and communication both ways to ensure that the risk management policy is explained to the stakeholders. (Brown, 2008) Quality Management: the effect on stakeholder is as follows Justify the projects by conducting a test which shows the effect on stakeholders. (Brown, 2008) Take measures which reduces the risk associated with the goals of the organization (Brown, 2008) Develop personal relation with the stakeholders to be able to communicate the project and identify the risk potential. (Brown, 2008) Ensure communication with all the stakeholders to reduce the risk and improve communication (Brown, 2008) Health care industry needs to ensure proper risk management strategy needs to assess risk through different mechanism. For this health care industry needs to look into information safety, communication safety, medication safety, diagnostic safety, treatment safety, and environmental safety. (Shukla, 2001) They need to diagnose the risk involved in these areas and ensure that a mechanism is devised to mitigate those. To improve quality in patient care Health care industry looks to integrate different concepts and approach and bring changes in quality management while rendering services. The different approach used by Health care industry for quality management is as follows Credentialing: Health care industry through this approach looks toward attaining a minimum standard while delivering patient care for the ill. In this approach Health care industry looks to produce quality through identity, protecting the public and the hospital and ensure the integrity of the profession (TQM, 2010) Licensure: Health care industry ensures licensing by entering in a contract between profession and state (TQM, 2010). In this approach a set of regulation and scope is set and the provider of service needs to take steps to match those. Accreditation: Health care industry follows international standards and the provider needs to deliver care by following the standards which has already been created (Healthcare consulting, 2010). Ensuring this approach, delivers service, which are approved internationally and matches the already set standard. Audit: Health care industry audits the nursing care provided to the ill. (TQM, 2010) This is done on a regular basis to find the manner in which health care was rendered. Health care industry is thus able to establish criteria and draw findings. This helps the hospital to develop their future course of actions to improve quality in health care. Health care industry needs to devise a strategy where special focus is laid on risk management tactics. For this health care industry needs to set up a committee which works in this direction. The committee needs to continuously monitor the performance and take necessary steps depending on the situation. The committee should ensure that risk management strategy involves both reactive and proactive measures. The committee helps to identify the following risk faced by health care industry. Confidentiality: Health care industry faces the risk of confidentiality regarding the information of the patients. The hospital faces the risk that the information regarding the patients’ health, illness, insurance and other details might be leaked. This could have a long term effect of relationship with the customers. (Ferris, 2008) They might lose trust on the hospital regarding the medication and preservation of personal details. This could affect the future business of the hospital and bring ill name to their hospital. Quality of service: Health care industry also faces the risk associated with care; delivered to patients and the care givers. Since people are admitted to hospitals so that the best medical attention can be given to the patients so any compromise on this frontier brings ill name to the organization. It is difficult to identify a service as good or bad so there is a risk associated with service. Some people prefer certain service high and others vice versa. This makes it important that the hospital renders service which has uniformity in service to differentiate them. This could otherwise have an ill effect as patients might slowly move out of hospitals and get their near ones admitted elsewhere. (APS, 2010) Malpractices: Health care industry faces risk associated with malpractices in various medical operations. (Sullivan, 2010) The hospitals faces risk that in some cases the doctor might enter into malpractices which would go against the reputation of the organization. This will have a bearing on all stakeholders like customers, employees, suppliers of medicinal equipments and even the government agencies. This could lead towards ill name and might affect the long term growth potential for health care industry. Employee compensation: Health care industry faces another issue related to the employee compensation. This is a serious issue and has an effect on the risk management policy. This could lead towards strikes which can have a long effect on the hospital as patients might find it difficult to get the required care. It effect various stakeholders like employees, customers and unions as it will create an impression where the hospital won’t be able to deliver services that will help them to improve the condition of the patients. (Ledue, 2010) Health care industry needs to take steps that help them to mitigate risk. The following steps will help health care industry Health care industry should continue using the Advanced Practice Strategies that looks into the minute details of providing the best care facilities to the patients and the care givers. Using this strategy has helped Health care industry to reduce the risk associated with prenatal health care by 48%. (APS, 2010) In this program the hospital looks towards reducing risk by looking towards patients’ safety. Health care industry should also look towards developing a strategy where the confidential information related to patients is safeguarded. The hospital should ensure that they have in place a system which looks towards preserving the vital information. Health care industry should ensure that only authorized person are allowed to open the files and use the data related to patients so that the information doesn’t fall into wrong hands and helps to build long term relationship. Health care industry should look towards imparting training and education to the employees regarding the manner in which they need to execute their responsibilities. Special attention and focus should be laid while designing the training and educational program. This will help health care industry to throw light on matter which are important Using the above strategy will help health care industry to identify the risk and take appropriate strategy to mitigate those. This will help them to develop long term relationship with the stakeholder. It highlights the short-term and long-term goals which Health care industry wants to achieve through it. Differentiating the goals into short-term and long-term is helping Health care industry concentrate on the short-term objectives, which will gradually transform into long term objectives. The short-term goals of Health care industry are Ensuring sufficient resources so that Health care industry can use the resources to quality management. Health care industry wants to ensure that in the short run the hospital has sufficient resources, which will help them to transfer quality care Ensuring that the hospital has efficient pool of doctors, nurses and employees who help the hospital to deliver quality service. This is an important aspect of quality management in Health care industry and developing a pool of doctors will ensure that even in emergencies the hospital can meet international standards Health care industry in the short run lay importance to maintenance. Health care industry needs to ensure equipments and other devices for care facilities as it is difficult to define quality and differs based on individual. The short-term goals shapes way for the long-term goals that Health care industry wants to accomplish. The short-term goals therefore helps to identify the long-term goals that Health care industry wishes to accomplish by ensuring proper service and quality management. The long-term objectives are Improving the brand image of the hospital by making the necessary changes from time to time. Bringing regular changes will help Health care industry to ensure that they can take steps to improve the brand image. This will help the hospital to grow and transform them into a bigger brand. Establishment of more hospitals at different locations. Health care industry on this front looks to do so by ensuring quality service. Delivering on the promises and caring for the patients will gradually help Health care industry to increase their presence at the same time will improve their image. Matching the international standards concerning quality management in health care units on a consistent basis. Health care industry can thus transform the manner in which business is conducted by the hospital. Matching international standards will help Health care industry to increase their patients’ base and will help the hospital grow their business. The short and long-term goals of Health care industry depend on the environmental factors, which influences the quality outcomes. The environmental factors include both the internal and external environment. The internal factors, which affect quality management for Health care industry, are The manner in which the executive team takes decision and includes senior leadership and the board. (Glickman, Bagget, Krubert, Peterson and Schulman, 2007) This has a long-term bearing on the manner the hospital can deliver quality service. Organizational design identifies the hierarchical level which defines the time and manner in which decision will take place (Glickman, Bagget, Krubert, Peterson and Schulman, 2007). It is important that to ensure quality management the health care facilities are delivered quickly. The incentive structure plays a role in ensuring that the employees can deliver quality health care service (Glickman, Bagget, Krubert, Peterson and Schulman, 2007) The use of technology plays an important role in identifying the manner in which Health care industry can deliver quality health care facilities to its patients (Glickman, Bagget, Krubert, Peterson & Schulman, 2007) Availability of sufficient finance, which helps the hospital to continuously bring changes in the process of quality management. Health care industry needs to take steps to ensure that they can deliver quality service. Health care industry needs to consider the short and long term goals and the environmental factors while devising a policy. This will help them in quality management. Health care industry can ensure quality management through the following ways Agile and responsive operation: Health care industry needs to gain transparency by identifying the key areas of health care and continuously up grading the care facilities by developing key performance indicators, which acts as a guide (SAP, 2010) Greater nursing productivity and patient satisfaction: Health care industry should look toward identifying detail analysis regarding patients’ readmission rate, infection rates and patients’ pain while going through the treatment process (SAP, 2010). The hospital should look at developing a plan, which reduces the cost of executing the care treatment by optimizing the staff levels, which will help in quality management. Accurate and complete reimbursement: Health care industry should look at the revenues and expenses from every angle and develop a strategy where they do not face a liquidity crunch. (SAP, 2010) This will help Health care industry to ensure delivery of quality service. Thus Health care industry can benefit greatly by using different techniques and tools, which will help to improve health care facilities and help in quality management. This also helps Health care industry to identify the manner in which risk management plays an important role in quality management. Health care industry by ensuring proper risk management techniques can ensure proper quality management as risk has a bearing on quality and improving risk measures will finally lead toward improving the quality of service and develop a long-lasting relationship. References APS. 2010. APS launches prenatal safety initiative in Florida. Retrieved on September 25, 2011 from info@aps-web.com Brown, T. 2008. Project Management: Stakeholder Risk Management. Project Planning & Project Risk Management, Learning Alliance Corporation Daniels, G. & Tisdell, S. 2010. Your hospital strategy for managing total cost of risk. Healthcare Financial Management. 12 (7), 13-18 Ferris, J. 2008. Amendment 7 and confidentiality. Benedict & Associates, Inc Garud, A. 2000. Quality Initiative in Healthcare Management. Retrieved on September 25, 2011 from http://www.expresshealthcaremgmt.com/20040331/qualitymanagement01.shtml Glickman, S. W. Bagget, K. A. Krubert, C. G. Peterson E. D. & Schulman, K. A. 2007. Promoting quality: the health care organization from a management perspective. International Journal for Quality in Health Care, 19 (6), 341-348 Healthcare Consulting. 2010. Healthcare Consulting. Morison Menon. Retrieved from http://www.morisonmenon.com/morison-menon-healthcare-consulting.php ICH. 2006. Quality Risk Management. European Medicine Agencies Inspection, London Kavaler, F. (2003). Risk management in health care institutions: a strategic approach. 2nd edition. Jones & Bartlett. Brooklyn Ledue, C. 2010. Healthcare union members to protest HCA labor practices. Healthcare Finance News Miller, J. 2010. The definition of risk management in health care organizations. eHow Contributor Risk Management. 2006. Risk Management Guide. Performance Review and Audit Section, AusAID, Australia Sullivan. 2010. Creating opportunities for medicine malpractices Insurance companies. The Sullivan Group Shukla, S. 2001. Mitigating Risk in Healthcare. Express Healthcare SAP. 2010. SAP Business Objects Analytic Application. Retrieved on September 25, 2011 from http://www.sap.com/solutions/sapbusinessobjects/large/industries/healthcare/quality-management/index.epx TQM. 2010. Total Quality Management in nursing care. Healthcare Management. Retrieved on September 25, 2011 from http://currentnursing.com/nursing_management/total_quality_management_health_care.html QA. 2010. QA in Healthcare. Retrieved on September 25, 2011 from http://www.qaproject.org/methods/resqa.html#systems Read More