Risk Management Plan

Attached is 2 Powerpoints that give a brief summary of the required chapters for the assignment.

Final Project: Risk Management Plan

Objective:

For this assignment, you will create a Risk Management Plan for a Community Health Center of your choosing, The Risk Management Plan is designed to support the mission and vision of the Facility you choose as it pertains to clinical risk and patient safety as well as visitor, third party, volunteer, and employee safety. You are encouraged to choose any Health Care Facility: Hospital, Doctor Office, Emergency Care Center, etc. The project will be 8-10 pages long including title page and reference page.

ASSIGNMENT GUIDELINES ( 20 points/ 10%):

Students will generate Risk Management Plan for a Community Health Center to support the mission and vision of the Health Care facility as it relates to clinical risk and patient safety as well as visitor, third party, volunteer, and employee safety. The paper will be 8-10 pages long (including title page and reference page). You need to apply all the concepts studied in this plan. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page.

EACH PAPER SHOULD INCLUDE THE FOLLOWING:

1.
Introduction (50 points / 25%)
Provide a brief synopsis of Importance of the Risk management as an integral component of a healthcare (not a description), in your own words.

2.
Your Risk Management Plan (10 points / 50%)

a.
Presentation Page:

ORGANIZATION NAME

BUSINESS ADDRESS

CITY, ST, ZIP

TELEPHONE NUMBER

FACSIMILE NUMBER

WEBSITE ADDRESS

EMAIL ADDRESS

b.
MISSION STATEMENT
: Mention the organization’s mission. New Page.

c.
Purpose of your Risk Management Plan:
The purpose of your risk management program is to protect patients, staff members and visitors from inadvertent injury. New Page

d.
Authority and Role of the Risk Manager:
Mention and state the major functions and responsibilities of the Risk Manager in your organization. Job’s description.

e.
Scope of your Risk Management plan
: Under the direction of the risk manager, the risk management program provides for collaboration among all departments, services, and patient care professionals within the organization. Mention the departments will be influence by this Risk management plan.

f.
Objectives of the Risk Management Program

g.
Specific Components of the Risk Management plan

The risk management program will include the following components:

g.1 Event/Incident/Occurrence reporting

g.2 Educational activities

g.3

Management of patient and family complaints/grievances

g.4 Patient satisfaction

h.
CLAIMS MANAGEMENT:
In some organizations, claims management is a function outside the risk management program and may have a separate staff with unique policies, procedures and protocols. If the claims management function is included in the risk management plan, you should constitute of their elements.

i. REPORTS TO THE GOVERNING BODY

j. ANNUAL EVALUATION OF THE RISK MANAGEMENT PROGRAM.

3.
Conclusion ( 20 point/ 15%)

Briefly recapitulate your thoughts & conclusion to you Risk Management plan. How did this Management plan impact your thoughts on Health Care Administrator?

Evaluation will be based on how clearly you respond to the above, in particular:

a) The clarity with which you consolidate, stablish and apply your knowledge to generate the Risk Management Plan;

b) The depth, scope, and organization of your paper; and,

c) Your conclusions, including a description of the impact of the Risk Management plan on any Health Care Setting.

Chapter 16: Risk Management in Long-Term Care Institutions

Department Of Health & Human Services. (2011, February 10). A profile of older americans: 2011. Retrieved from Administration on Aging website: http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2011/4.aspx

Increasing Liability in
Long Term Care Settings
General and professional liability insurance costs have been increasing with the number of lawsuits and awards.
Though frequency of claims may have actually decreased in the last several years, the severity of claims have increased resulting in a higher than average loss per paid claim.
Tort reform has also impacted long-term care liability lawsuits and paid claims.

What is Long Term Care?
Medical and non-medical care to people who have a chronic illness or disability.
Long-term care can be provided at home, in the community, in assisted living or in nursing homes
Most long-term care assists people with support services such as activities of daily living (ADLs).

Aspects of Long Term Care
Aging population coupled with longer life and multiple medical conditions
Long term care regulations
Various types of long term care providers
Institutional/Residential Care
Subacute Care
Community-Based Care
Home Care

Nursing Facilities
These facilities provide care to people who can’t be cared for at home or in the community and provide a wide range of personal care and health services.
This care generally is to assist with support services for people who can’t take care of themselves due to physical, emotional, or mental problems.

Regulatory Enforcement of
Nursing Facilities
Oversight is split between federal and state authorities
OBRA 87 established a Residents’ Bill of Rights
Quality of Care Initiatives
State Inspections
Statement of deficiencies and Plan of Correction is a detailed report of the facility’s perceived failures to meet CMS standards
Sanctions for unmet requirements

False or Deceptive Marketing
Marketing materials can be utilized in lawsuits as evidence of the high-quality care that the facility failed to provide.
There are substantial fines for falsely advertising services or the results of services as they may be settled as a deceptive trade practice.
Malpractice insurance does not cover this.

Physiology of Aging
Decreases or declines in:
brain weight – cognitive ability
immune response – thermal response
renal/pulmonary function – glucose tolerance
Changes in absorption, metabolism and clearance of drugs
Lower ability to detoxify alcohol
Changes in sight, hearing, taste, touch and smell
Nocturnal waking
Sundowning

Risks for the Elderly
Accidents: Fall and Nonfalls
Medication Errors
Infection Control
Pressure Ulcers
Dementia
Elopement/Wandering
Restraints
Therapy and Dietary Services
Disaster Planning and Fire Safety

Elder Abuse and Violence
Elder Justice Act of 2009
Elder Abuse consists of:
Physical abuse
Sexual abuse
Psychological abuse
Financial exploitation
Neglect

Employee Risks
Risks posed by employees may be avoided with appropriate and thorough hiring practices
Proper screening of applicants
Background checks
Credential verification
Risks posed to employees may include
Abuse or violence from residents
Ergonomics
Occupational Hazards

Subacute Care
Subacute care is considered a transitional phase designed to return patients to independent living quickly and at a lower cost.
It focuses on patient who need assistance after a serious illness or injury, but who do not require the full services of a hospital setting.
Subacute units/facilities may be subject to different licensing requirements than nursing facilities.

Home Health Care
Assistance at home from family, friends, volunteers or paid healthcare workers.
Some home care can only be given by licensed health workers
Home healthcare services must be ordered by a physician and are subject to regulation
Agencies receiving payment from Medicare or Medicaid must meet CMS requirements

Home Health Care Risks
Risks from the home environment
Informed consent
Termination of care
Incident Reporting
Falls
Use of Technology in the home
Home Health Employees
Negligence
Safety of Employees

Hospice Care
Palliative Care for patients who are within six months of death as determined by the physician
Performed in the home, hospital, nursing facility or other long term care facility
Risk mirrors those found in home health and long-term care facilities.

Summary
Population is getting older with increasing poor health
Family/friends care availability is very limited – therefore, methods of providing long term care other than family/friends is needed
Most long term care facilities/organizations are highly regulated though some of the newer agencies/services are not yet under as strict regulation

Chapter 17: Risk Management in Office Based Surgery

Office Base Surgery (OBS)
Invasive procedures requiring general anesthesia and deep or moderate sedation which are performed in a doctor’s office separate from a hospital or ambulatory surgery center (ASC).
Technological advances and economic incentives led to a shift from hospital to ASC and now to office based surgeries.
Decrease in invasiveness of surgical procedures
Decrease in invasiveness of anesthesia

Concerns with OBS
Safety and ease of a procedure may entice physician to perform procedures they are not familiar with
Regulation of OBS is voluntary though is mandated in some states
As CMS did not allow facilities fees for procedures performed in OBS, they did not participate in regulating OBS practice as was done with other emerging healthcare entities

Sources of Risk in OBS
Informed Consent and Breach of Contract
Bleeding, Thromboembolism and Infections
Perforation of Viscus and Drug Toxicity
Interference with Pacemakers
Anesthetic Complications
Infection Control
Preexisting Condition Complications
Incorrect surgical procedure
Unplanned hospital admission from complications
Death

Legal Requirements for OBS Practices
Naming Designation
Corporate Designation
Referrals
Contracts between physicians and hospitals

Other Requirements
Some states require OBS to follow ASC regulations while others have established OBS specific regulations. In general OBS should:
Seek accreditation
Follow personnel requirements for education, training, licensing, board certification, hospital privileges and scope of practice
Select appropriate procedures to perform
Track and report adverse events

Accreditation and Clinical Guidelines
Currently there are 3 accrediting organizations for OBS facilities with very similar standards:
AAAHC
AAAASF
TJC
Clinical Practice Guidelines developed by professional associations should be adopted by the OBS as applicable

Management Practices
OBS facilities should have effective and efficient management practices in the following areas:
Personnel Management
Facility Management
Medical Records Management
Quality Management
Communications with patients

Clinical Practice Safety
OBS facilities should have effective and efficient clinical practice safety in the following areas:
Preoperative Practices
Intraoperative Practices
Postoperative Practices

Summary
The number OBS facilities continue to grow due to satisfaction of patients and practitioners
Risk management is an important consideration for the OBS facility as ease and safety of procedures may lead towards inappropriate selection of services