Analyzing A Health Care Risk Management Program Assignment

This assignment uses a rubric, will attach the rubric and also the course material to it. I work in the trauma unit at INOVA FAIRFAX HOSPITAL in USA, Virginia.

https://www.nso.com/Learning/Artifacts/Sample-Risk-Management-Plan/Sample-Risk-Management-Plan-for-nursing-businesses

Risk Management

Risk management deals with limiting exposure to, and minimizing incidence of, serious problems in an organization that can cause loss or death. Risk management entails identifying threats an organization is exposed to, categorizing them, assessing likelihood of occurrence and weight of impact of each risk, making a plan to mitigate the risk, and finally, evaluating the risk management plan for effectiveness. The risk management process can take various forms such as avoidance, acceptance, transfer, sharing, or reduction. Usually, a risk management program combines multiple methods. In healthcare, risk management is particularly sensitive because of patient safety, safety of healthcare workers, regulatory compliance and medical emergencies such as infectious disease outbreaks. Given the importance of risk management, this  discussion analyzes the risk management plan of Inova Fairfax hospital in the context of regulatory compliance and compares it to risk management plans of other healthcare providers.

Summary and Rationale for Risk Management Plan

The selected plan is the Inova Fairfax risk management plan for patient falls. Falls are a significant health concern and many patients are unaware of the risk. Fall risk is especially true in the trauma unit of the emergency department where patients are distressed, confused, and in poor health. The trauma unit is a fast-paced environment where diverse patients are taken in and have to be rapidly assessed and triaged by physicians who may never see them again. Accurately evaluating fall risk in such a dynamic environment is challenging and understanding this, the hospital has its own risk management plan.

The plan has the following components:

Risk assignee – these are patients, and handled by all medical staff.

Probability – evaluated as high in acute care settings.

Risk score – evaluated as high risk.

Response – use of alarms, signs, having  bed rails up, and blocking access to wet floors. If a fall happens, to alert physician, notify risk manager, and treat injury as appropriate.

Reporting, controlling and monitoring – informing risk manager, falls tracking, follow-up, and staff training (Ortelli, 2018).

I selected the falls management plan for Inova Fairfax because it is a risk I have seen occur all too often. Moreover, I have good understanding of the care setting because it is where I work.

ORDER HERE

Description of Organization and the Role of Risk Management

Inova Fairfax is a 923-bed medical campus located in Northern Virginia. The campus is an agglomeration of numerous specialized divisions such as women’s hospital, children’s hospital, heart and vascular institute, and teaching programs for Georgetown University, University of Virginia and George Washington University. The focus of this discussion is the hospital’s trauma unit, which is the only level 1 trauma center in Northern Virginia (Doerflinger, 2019).

Inova acknowledges that falls are the leading cause of death in people aged 65 and above (Doerflinger, 2019). As such, risk management serves to prevent the occurrence of falls and provides mitigation pathways in the event a fall happens. Given that it is a trauma center, treating patients for falls related injuries is common. As such, providers are trained on rapid assessment and treatment of injuries. The risk management plan helps protect patient safety and facilitate effective care delivery.

Standard Administrative Steps and Processes in Typical Risk Management Programs

The standard administrative steps and processes in a typical healthcare organization fall risk management program involve the following parts:

Assessment – required of patients within 24 hours of being admitted, on a quarterly basis, and with change of condition. The assessment includes gait and balance, orthostatic blood pressure, underlying issues such as fall history, fall-inducing medication, medical conditions, and environmental factors.

Care plan – SMART goals for managing fall risk and preventing injury, interventions for addressing fall risk factors identified during assessment, review and update of interventions based on patient condition, recording date and time of fall, and causative factors.

Outcomes – implementation of personalized interventions as per care plan, evaluation and monitoring of care interventions on case-by-case basis (LeLaurin & Short, 2019).

To prevent occurrence of falls in the care setting, standard steps include keeping walk areas properly lit, keeping unneeded items off the floor, storing frequently used items in lower drawers and cabinets, asking for help to reach an item or using a grabber, use of motion-activated lights and regular checkups to ensure functionality, avoiding multitasking (for example, texting on the phone) while walking, avoiding medication known to slow reaction times or induce drowsiness, and use of wheelchairs to aid mobility. According to Doerflinger (2019), the steps, processes and interventions in use at Inova Fairfax match the standard administrative steps and processes used by other healthcare providers.

Analysis of Key Regulatory Agencies and Organizations

The agencies regulating healthcare organizations with regard to risk management include:

Agency for Healthcare Research and Quality (AHRQ). This agency is part of the Department of Health and Human Services and it provides a toolkit of best practices in terms of fall prevention. The toolkit is designed for a diverse audience and accompanied by an implementation guide to hospitals.

National Committee for Quality Assurance (NCQA) establishes reporting requirements for healthcare providers on discussion and management of fall risk. The parameters include age, reported problems with walking or balance in the last 12 months, and whether or not they received fall risk intervention after reporting the concern to a care provider. Centers for Disease Control (CDC) STEADI initiative (Stopping Elderly Accidents, Deaths and Injuries) provides a coordinated framework to providers to implement the American and British Geriatrics Societies Clinical Guideline for preventing falls. STEADI addresses three main areas: screening patients for risk, evaluating adjustable risk factors, and intervening to minimize risk via clinical strategies. The objective is to reduce falls, lower healthcare costs and improve health outcomes. STEADI also offers continuous education to providers through online sessions.

Inova’s risk management plan compliance to AHRQ

In the context of compliance, this discussion looks into how Inova Fairfax’s falls risk management program complies with AHRQ’s toolkit of best practices. The toolkit requires the implementation of universal fall precautions. These precautions apply to all patients, whether or not they are assessed to be at risk. They include familiarizing patients with the environment, having patients demonstrate how to use a call light, keeping call lights reachable, locking bed brakes, ensuring patients use well-fitting nonslip footwear, promptly cleaning up spills, having clean and dry floors, installing supplemental lights, having sturdy handrails in rooms and walkways, locking the wheels of stationary wheelchairs, and keeping care areas free of clutter (Ortelli, 2018)

From my work experience at Inova Fairfax, I can ascertain that these precautions are implemented and strict observance enforced by nursing staff during hourly rounds. Hourly rounds are an excellent strategy for meeting patients’ personal and clinical needs, and providing opportunities to proactively prevent falls (Alert, 2015). The AHRQ toolkit recommends additional fall risk management measures in units where patient needs fluctuate or patients are in movement (Ortelli, 2018). The interventions include annual fall prevention education for staff, direct line of sight to patients, a 1:1 ratio of staff to patients assessed at high risk of falls, patient sitters for patients who have previously experienced falls, and quarter hour rounds. On these, I have not observed compliance with the use of patient sitters or a 1:1 staff ratio. Notably, the hospital is compliant with the other elements of the toolkit.

Recommendations

Based on the above compliance gaps, one of the recommendations is to have a 1:1 ratio of staff to selected patients. This is relatively easy, given that the hospital’s current policy is to dress fall risk patients in yellow gowns for identification and visibility. The second recommendation would be use of patient sitters for fall risk patients. Trained volunteer staff can be utilized for this purpose given the financial constraints associated with hiring new staff for the job. Three, continuous monitoring and review of falls rate and location of incidents to quickly institute corrective action would help to improve patient safety

ORDER TODAY

References

Alert, S. E. (2015). Preventing falls and fall-related injuries in health care facilities. The Joint Commission, 55, 1-55.

Doerflinger, D. M. C. (2019). INOVA Fairfax Hospital NICHE. NICHE: Nurses Improving Care for Healthsystem Elders, 313.

Ortelli, T. A. (2018). AHRQ Resources for Preventing Falls in Hospitals. AJN The American Journal of Nursing, 118(5), 63-64.

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283 Analyzing A Health Care Risk Management Program Assignment