Question

A rural country hospital facility provides health care services to over 35,000 citizens, with a high percentage being older Americans who have retired to this area of the country. The hospital administrator has asked the Vice President of Risk Management to attend a meeting with the senior staff next week in the Board Room. The hospital administrator has asked Vice President of Risk Management to present areas of opportunity for increasing the hospital’s risk management strategies to ensure a litigation-free environment for the facility, its patients, and its employees. During the meeting, the Vice President of Risk Management reports that all the continuous quality improvement (CQI) minutes for the past 3 months of meetings have been reviewed. Although most areas are being adequately resolved, there are some that need more attention, especially from the senior staff. Before specifically addressing those points, the Vice President of Risk Management briefs the staff on the major areas of risk for the hospital. They are: 1. Employee-driven adverse actions against the facility 2. Medication errors 3. Surgery/Treatment errors 4. Patient falls 5. Patient elopements 6. Security breaches in secured areas 7. Inaccurate coding and billing for government/insurer reimbursements Now that the senior staff is aware of the major areas of risk concern, you, as the administrator in charge of all hospital business operations, assign each of these areas of concern to the respective director, such as the Directors of Human Resources, Nursing, Medical, Social Services, and Facility Security. Their reports of assessment, along with recommendations for achieving full compliance and reducing the hospital’s litigation exposure, are due at the end of the month.

Questions: 1. While this situation has many areas of risk that are considered a top priority, focus on patient privacy and information disclosure (HIPAA violations). Which department is responsible for leading the initiative? As the administrator, describe your approach for managing this directive. Do you create a special projects team? How do you gather pertinent data for a category? What tools would you use? 2. How do you determine if you are meeting the industry standards for this area of risk? 3. Would you change any current policies or procedures? How and why? 4. How would you train the affected staff with regard to this area of risk? 5. What are the sanctions, penalties, or government investigations that could present a worst case scenario if not addressed?

Answer 1

1. All the categories are very risk but in that mainly focusing the concentration on security breaches in secured areas.because external thinks will make a confusion in the patient privacy and patients information disclosure in their treatment basis. Here HR department takes a initiative process.

How to managing means ;

Maintain a proper communcatioanl channel between the higher level to lower level.

Maintain a protocol and records and documentation

Supervise the all departments periodically

Conducting internal and external auditing

Provide proper information regarding to their condition

Provide continuing education to employees to reduce the medication errors.

Conducting the conference and seminars in current treatment and SURGICAL PROCEDURES.etc..

How to collect the data means ;

Daily supervision of the department

Bed side rounds to find out the errors

Tools are;

Feedback form

Interview method

Observational technique

Auditing

Standard quality maintanace etc

2.How to determine the risk of industry standards ;

Poor outcome from the employers

As many as impact factors

Lack of professional skills in employers work

Lack of integrity

Lack of computer skills.

To many rules and regulations make a poor standards

3.How to change the current polices and protocols are ;

Make changes in employers waste and working hrs it will make them less stress

Do some changes in PROCEDURE protocols as per the hospital standards

Provide the skill training to the employers

Conduct the group discussion to let out their suggestion in proving services

4. How to train the affected staffs are ;

Provide a induction classes to them

Orient the hospital rules and regulations

Provide continuing education

Provide the skill training to them

Assigning the topics to them related to patient care services.

5. Penalty or sanctions are;

Provide the topics to conduct the seminars regarding their mistakes

Withhold their salary for their mistakes

Suspend for short period etc...