The Quality And Improvement Processes In Risk Management Assignment

The Quality And Improvement Processes In Risk Management Assignment

Risk management is a fundamental part of any human undertaking. In healthcare provision, risk management serves to protect patient safety and ensure the provider complies with legal requirements and standards of practice of the profession. This is what risk management programs are designed for. Having a comprehensive risk management program has its benefits while the lack of one has tremendous costs beyond the financial. Risk management initiatives help to protect the rights and privileges of patients and ensure care providers observe ethical and legal guidelines in their practice. Accreditation bodies enforce risk management via standards of compliance and quality. As such, this summary brief outlines the role of accreditation bodies, patient rights and responsibilities, and the responsibilities of hospital administration and healthcare practitioners in risk management and quality improvement. The Quality And Improvement Processes In Risk Management Assignment

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Role of NCQA in Evaluating Quality Improvement and Risk Management Processes of an Organization

I work in the trauma unit of Inova Fairfax, Virginia. One of the accrediting bodies for my organization is the National Committee for Quality Assurance (NCQA). NCQA is a non-profit organization dedicated to improving the quality of healthcare in the United States. NCQA provides accreditation for health plans, case management, disease management, managed behavioral healthcare, health and wellness, and accountable care. NCQA maintains the Healthcare Effectiveness Data and Information Set (HEDIS) measures that provide healthcare clients with information they need to reliably compare the performance of different health plans. HEDIS measures are standardized measures that providers use to track the success of quality improvement strategies, monitor their improvement, and identify opportunities to improve performance (Lacourciere, 2020)The Quality And Improvement Processes In Risk Management Assignment.

NCQA uses the HEDIS measures to rank top performing providers and thus drive competitiveness in quality improvement. The standardized nature of the measures enables inter-organization comparison and before-and-after evaluation of the success of risk management initiatives. In the case of my topic, fall risk management, the Care for Older Adults measure would be useful in determining the effectiveness of implemented interventions and areas where improvements are due. Similar measures for colorectal cancer, antidepressant medication management, high blood pressure management, medication reconciliation, preventing harmful drug-to-disease interactions inspire quality improvement in all facets of care provision (Lacourciere, 2020)The Quality And Improvement Processes In Risk Management Assignment. Inova Fairfax prides itself in being one of the top healthcare providers in the United States. As such, I am confident Inova is keen on ranking among the top performers in all HEDIS measures.

Administrative Roles

The layers to administrative personnel are the board of directors of the hospital, the director of nursing affairs, nurse supervisors, and charge nurses. Each person in these levels plays a role in establishing and maintaining risk management strategies and policies. Charge nurses deal with task assignment in the day-to-day operations in their units. They are the first people to recognize a gap in risk management and in the quality of care provided. Moreover, they are who nursing staff can first approach to broach a subject. Nurse supervisors are also well placed to observe gaps and need for changes in risk management policies on the floor (Karami et al, 2017). Together with charge nurses, nurse supervisors can then bring those issues to the attention of the director of nursing affairs and the board of directors.

The director of nursing affairs acts a bridge between the board of directors and nursing staff. They translate high level goals to actionable objectives for quality improvement and acts a conduit for assessing the success of quality improvement initiatives. The director of nursing affairs and the nurse supervisor plan, organize, direct, evaluate and coordinate the implementation of risk management policies and promoting ethical conduct (Kojima et al, 2019)The Quality And Improvement Processes In Risk Management Assignment. The role of the board of directors is to authorize, plan and finance the implementation and evaluation of risk management initiatives and promote awareness of the organization’s code of ethics.

Support of Patient Rights and Responsibilities by Risk Management Programs and Quality Improvement Processes

Risk management and compliance initiatives at Inova Fairfax factor in the ethical standards, rights, and responsibilities of patients. Contemporary care provision is highly enabled by electronic health records and specialized health information systems. Notably, the hospital has a risk assessment and compliance system that ensures that providers act within ethical standards in providing care, handling patient data, administering medication and most importantly, safeguarding patient safety. Patients have the right to informed consent and as such, Inova utilizes forms to guide care practitioners with regard to providing information on benefits and risks to treatment, assessing the mental competency of patients, preexisting patient preferences in the event patients cannot make choices on what they want at present, and their next of kin. The principles of beneficence and nonmaleficence are observed, a case in point being the fall prevention program, which was implemented to safeguard patient safety (Gurney et al, 2017)The Quality And Improvement Processes In Risk Management Assignment. There are numerous off-the-shelf and customized compliance programs that a new health care provider can utilize. It is also important to have a competent risk and compliance manager in the hospital administration.

Legal and Ethical Responsibilities of Health Care Professionals to Uphold Risk Management Policies and Administer Safe Health Care

The ANA code of conduct lays out the parameters for the legal and ethical provision of healthcare. There are numerous requirements in the guideline. Care practitioners are legally and ethically required to observe discipline not to discuss the specifics of patients’ condition with others without express authorization. There are notable exceptions to this such as in gunshot injuries and outbreaks of infectious disease, where healthcare professionals are required to promptly make reports to relevant authorities in the interest of the greater good of the society.

Data protection is a sensitive issue with regard to patient privacy. Data breaches are a costly endeavor to hospitals both in finances, lawsuits, and reputation loss (Hockey, 2020)The Quality And Improvement Processes In Risk Management Assignment. Care providers are therefore burdened with the responsibility of properly storing and securing patient information and being careful with their passwords and access details. The hospital administration has the responsibility of ensuring patient data is encrypted and secured both in storage and transmission. Finally, as much as healthcare professionals have to safeguard patient safety through their actions, they have to ensure that non-action does not result in harm. This often entails going beyond the requirements laid out by accrediting bodies, such as by assigning guides to patients with impaired mobility and vision for the entire period of time they are at the hospital.

How Quality Improvement Processes in a Health Care Organization Support Its Journey to Excellence

Quality improvement processes guide an organization to excellence on the basis that continual improvement is the only way to get better in the delivery of safe effective care. There are wrinkles to iron out with the implementation of any risk management program. This is because there are several dimensions to any initiative, such as financing, ethical concerns, staff training, and optimally utilizing the time of care practitioners (Kojima et al, 2019)The Quality And Improvement Processes In Risk Management Assignment. The organization should always have its focus on advancing the welfare of both patients and staff since these are the major stakeholders. Notably, quality standards from organizations such as NCQA provide frameworks through which organizations can assess and improve the quality of care provided. Continual evaluation and improvement of risk management programs and quality improvement policies in any organization, new or old, is the way to excellence.

References

Balestra, M. L. (2017). Electronic health records: patient care and ethical and legal

implications for nurse practitioners. The Journal for Nurse Practitioners, 13(2), 105-111.

Gurney, D., Gillespie, G. L., McMahon, M. P., & Kolbuk, M. E. (2017). Nursing code of

ethics: provisions and interpretative statements for emergency nurses. Journal of

Emergency Nursing, 43(6), 497-503.

Hockey, A. (2020). Uncovering the cyber security challenges in healthcare. Network

Security, 2020(4), 18-19 The Quality And Improvement Processes In Risk Management Assignment.

Karami, A., Farokhzadian, J., & Foroughameri, G. (2017). Nurses’ professional competency

and organizational commitment: Is it important for human resource management?. PloS one, 12(11), e0187863.

Kojima, G., Liljas, A. E., & Iliffe, S. (2019). Frailty syndrome: implications and challenges

for health care policy. Risk management and healthcare policy, 12, 23.

Lacourciere, J. (2020). HEDIS Measurement Year 2020 & Measurement Year 2021 Volume

2 Summary Table of Measures, Product Lines and Changes.

The purpose of this assignment is to analyze how an organization’s quality and improvement processes contribute to its risk management program. This assignment builds on the Risk Management Program Analysis – Part One assignment you completed in Topic 1 of this course. Assume that the sample risk management program you analyzed in Topic 1 was implemented and is now currently in use by your health care employer/organization. Further assume that your supervisor has asked you to create a high‐level summary brief of this new risk management program to share with a group of administrative personnel from a newly created community health organization in your state who has enlisted your organization’s assistance in developing their own risk management policies and procedures. Compose a 1,250‐1,500 word summary brief that expands upon the elements you first addressed in the Topic 1 assignment. In this summary brief, address the following points regarding your health care organization and its risk management program: Explain the role of your organization’s MIPPA-approved accreditation body (e.g., JC, ACR, IAC) in the evaluation of your institution’s quality improvement and risk management processes. Describe the roles that different levels of administrative personnel play in healthcare ethics and establishing or sustaining employer/employee-focused organizational risk management strategies and operational policies. Illustrate how your organization’s risk management and compliance programs support ethical standards, patient consent, and patient rights and responsibilities. Explain the legal and ethical responsibilities health care professionals face in upholding risk management policies and administering safe health care at your organization. Relate how your The Quality And Improvement Processes In Risk Management Assignment organization’s quality improvement processes support and contribute to its overall journey to excellence.

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In addition to your textbook, you are required to support your analysis with a minimum of three peer‐reviewed references. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: BS Health Sciences 3.3 Explain the ethical and legal responsibilities of health care professionals related to risk management assessment and policies The Quality And Improvement Processes In Risk Management Assignment