1) Define the steps in the risk management process. Analyze vulnerability to unforeseen loss that may conflict with a hospital mission, aspiration and intention. Next, they must inquire about other tenable recourse to risk management ways to oversee these potential exposures. After this, the team has to cull the best way to fix the unrealized hazard. Succeeding the last step, the team has to bring about and carry out concept. Lastly, the organization must track the aftermath to see if the changes made are valid.
2) Discuss the relationship between quality patient care and quality management in risk management. All things roll down hill, what is meant by this is that; the Chief Executive Officer with the assistance of the management and administrative staff have to enlist the help of the rest of the staff for support and involvement in the mission. The link between quality patient care and quality risk management is to ensure safety and quality care for all. They also have to have information relative to the mission on risk management and quality care. 3) Explain how JCAHO was formed and its responsibilities.
The Commission on Accreditation of Health Care Organizations was formed by a group of hospitals that felt that together they could ensure a standard of care and practice. The group of hospitals are really observing themselves to make sure quality assurance and risk management are in place. By doing this, patient can see how well the hospitals are doing with the care of patients. 4) Give examples of the 15 areas of risk management. A cap on noneconomic and punitive damages is basically stating that there will be a limit will be set on how much compensation a person my get for person injury.
Spiraling health care cost can be patients who demand too much care; doctors who practice defensive medicine because they fear being sued; aging boomers, and finally, everyone’s favorite the insurance companies. A designation of liability by which members of a group are either individually or mutually responsible to a party in whose favor a judgment has been awarded. 5) What are the responsibilities of the risk management committee? This committee is responsible for a multitude of areas and some cross over into other areas. They define the responsibility to recommend and implement corrective actions with issues.
They also maintain professional competences of the professionals that work in the hospitals. With this being done, they have to comply with the regulations and codes for each professional standard. The committee aids in preparing material and people for legal defense. The aid in settling claims, and obtaining liability releases. 6) Give examples of federal, state, and local city and county legislative controls. Regulation of the health has been a matter of concern of federal, state, and local city. States have a responsibility of licensing health care professionals.
Some states are involved in risk management and the education of risk management. They are involved with patient grievance procedures as well. Some of these governing bodies are into the sharing of information and incident reporting systems. These are just a few of many that these particular bodies are on legislative control. Local city and county do often times adopt to federal and state regulation and law but some guidelines like sanitation, hazardous and waste, and water treatment is something that they do on their own. 7) Discuss practice guidelines and their impact on the health care professional.
The practiced guidelines are what are set by JCAHO, HIPAA, and OSHA just to name a few. If a hospital is not in compliance with these agencies it could mean loss of revenue in many forms. If a hospital fails to gain accreditation with JCAHO its reputation would be on the line. Which means loss of revenue on the hospital’s end. If the people that pay for the care, like Medicaid, Medicare, HMO’s see that they do not have the approval of this particular agency they will suffer for it. Because the standard of care has not been met but what has been deeded so by these agencies.
Money is the motivation for staying in the lines of JCAHO, HIPAA or OSHA. 8) What effect did September 11, 2001 have on the insurance industry? For starters, the insurance industry lost nearly 8 billion dollars compared to 20. 6 billion dollar gain the previous year. Since they took this massive loss, they increased their rates for the cost of coverage. They no longer cover certain risk, which makes them very judicious and scrupulous in their requirements. The areas that were hit directly by the attacks have to come up with better disaster preparedness in any future unfortunate event of this magnitude.
These areas also have to take a good at their spending plan and fiscal estimates because they were not ready for a disaster of this degree. 9) How did this affect the health care industry? The industry had to take a look at their makeup, amplitude, and locale of the disaster. They without deviation, impinge the role of the facility in how they treat patients. In turn, they have to brace for a convergence of a rise in patients and visitors, and in come cases reporters. They now have to be fast on the draw for anything.
Examples of this is power outages due to natural disasters like downed telecommunications, flooding, and gas leaks. Also, a increase in security measurements. This maybe needed for traffic measures and increased perception. 10) What is enterprise risk management? This is a course of action of planning, methodizing, ushering, and dealing with the scheme of an organization in order to minimize the effects of risk on the organization’s bottom line. Enterprise risk management bolster the mechanism to include not just risk associated with unexpected losses, but also financial, strategic operations and other contingencies.