...Healthcare Risk Control Risk and Quality Management Strategies 4 Executive Summary VOLUME 2 July 2009 Key Recommendations Assess current activities in risk management and quality improvement to evaluate their effectiveness in addressing overlap. Establish a structure to ensure that patient care activities are addressed in a coordinated manner involving risk management and quality improvement functions. Seek legal counsel to ensure that the structure for risk management and quality improvement activities maximizes legal protections granted by state and federal statutes while allowing for the flow of information. Align risk management and quality improvement plans with the strategic goals of the organization. Educate stakeholders on the role of risk management and quality improvement functions. Design systems to coordinate and streamline data collection, analysis, monitoring, and evaluation. Risk Management, Quality Improvement, and Patient Safety In the past, the risk management and quality improvement functions often operated separately in healthcare organizations and individuals responsible for each function had different lines of reporting—an organizational structure that further divided risk management and quality improvement. Today, risk management and quality improvement efforts in healthcare organizations are rallying behind patient safety and finding ways to work together more effectively and efficiently to ensure that their organizations deliver...
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...BELLA HEALTHCARE INDIA Project Plan Centennial College Juliana Goes – 300685822 Maria Chernobrovkina – 300675947 Timothy Jogbodo – 300673137 Virendra Sabbanwar – 300677485 PMGT 428 – 103 Bob Xourafas June 18, 2012 Table of Contents PROJECT INITIATION 1 Project Charter |Prepared by: Maria Chernobrovkina |Date: Jun 15, 2012 | |Project Title: Bella Healthcare India | |Project Start Date: Jun 18, 2012 |Project Finish Date: Jul 25, 2012 | |Budget Information: The project’s budget is $ 100. | |Project Manager: Virendra Sabbanwar – +1(647) 721-0678 – vsab@my.centennialcollege.ca | |Project Objectives: | |Choosing an international project topic; | |Receiving approval of the international project topic – “Bella Healthcare India”; | |Elaborating...
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...Transformation Population Health Management A Roadmap for Provider-Based Automation in a New Era of Healthcare Acknowledgements Alide Chase, MS Senior Vice President for Quality and Service Kaiser Foundation Health Plan, Inc. & Kaiser Foundation Hospitals Connie White Delaney, PhD, RN, FAAN, FACMI School of Nursing Professor & Dean Academic Health Center Director, Biomedical Health Informatics (BMHI) Acting Director of the Institute for Health Informatics (IHI) University of Minnesota Don Fetterolf, MD, MBA Principal Fetterolf Healthcare Consulting Robert Fortini VP & Chief Clinical Officer Bon Secours Health System Paul Grundy, MD, MPH Global Director of Healthcare Transformation IBM President Patient-Centered Primary Care Collaborative Richard Hodach, MD, PHD, MPH Chief Medical Officer Phytel Michael B. Matthews Chief Executive Officer Central Virginia Health Network Margaret O’Kane President National Committee for Quality Assurance Andy Steele, MD, MPH, MSC Director, Medical Informatics Denver Health 2 Dear Colleagues, Population health management has been around for a while, but only recently has it gained serious attention from mainstream healthcare organizations. The reason is simple: healthcare reimbursement is changing, and hospitals, healthcare systems, and physician groups must adapt to a new world in which providers are rewarded for meeting quality objectives for their entire patient panel, and not just those actively seeking healthcare. The emphasis clearly is...
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...Discussion Question 2: In order to identify and report elements that define an adverse event, medical error and near miss, it is important that the nurse have adequate understanding of patient safety and how it has transitioned from being risk management. However, for the nurse to have understanding of what errors are and how to mitigate them, he or she must promote a system to prevent errors that is patient centered. Having a proper understanding of how errors happen can minimize risk but also set a better course for patient quality care centered on his or her needs. The nurse must have adequate understanding of process management, chain of command and knowledge management. The Institute of Medicine or IOM published a report called Crossing the Quality Chasm (2001) which outlines patient centered quality care. It involves understanding how routine and deviating from automatic processes could cause errors and increase risk. James Reason suggests sometimes this happens because of outside events but other times events happen on the inside of healthcare that he believes can be better controlled. The IOM suggests patient care can be controlled if they are center to the process. Knowledge of healthcare strategies, open communication and partnership between patients, his or her families and healthcare professionals should be the design for minimizing errors. The IOM’s (2001) report suggests safety begins with continuous, customized and controlled care for the patient as this...
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...the United States of America. Their main job is to advise both international and domestic policies by using formula and analysis on economic research and empirical evidence, using the best data available to support the president in setting out nation’s economic policies. After years of research, reports revealed that the market failure in the current healthcare system has imposed tremendous economic burdens on families, employers, and government at every level. One in every six Americans was without health insurance, healthcare spending was quickly skyrocketing, medical errors were excessive and administrative cost was enormous ("About cea.") The CEA reports also found that authentic healthcare reform has considerable benefits if slowing the growth of healthcare cost has the following components: Increase the standard of living by improving efficiency if resources are freed up that can be used to make other goods and services. Prevent dreadful budgetary ramifications and raise national savings. Finally, slowing the growth of health care cost would raise employment and lower unemployment now and later on without prompting inflation (whitehouse.gov) Labor A second component of healthcare reform, would increase the overall economic welfare of the uninsured extensively more that the costs of insuring them. In addition, it would increase labor supply that would reduce disability and absenteeism in the work place and boost the labor market. The coverage expansion will phase out stipulations...
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...treatment 34 ‘‘Black box’’ 101: How the Food and Drug Administration evaluates, communicates, and manages drug benefit/risk Shirley Murphy, MD, and Rosemary Roberts, MD Silver Spring, Md A prominently displayed boxed warning, the so-called ‘‘black box,’’ is added to the labeling of drugs or drug products by the Food and Drug Administration when serious adverse reactions or special problems occur, particularly those that may lead to death or serious injury. Healthcare providers are often not knowledgeable about the origin, meaning, and implications of these ‘‘black box’’ warnings. In this review, our goal is to provide insight into how the Food and Drug Administration evaluates, communicates, and manages drug benefit/risk. We discuss drug labeling, the emphasis on safety throughout the drug approval process, legislative initiatives for safe use of drugs in children, and postmarketing safety surveillance. In addition, we encourage health care providers to report drug reactions to the Food and Drug Administration’s MedWatch program. A discussion of new Food and Drug Administration initiatives to improve drug safety processes and methods to serve the public better are highlighted. (J Allergy Clin Immunol 2006;117:34-9.) Key words: Food and Drug Administration, adverse drug reactions, MedWatch, ‘‘black box’’ warning, drug labeling, drug benefit/risk, risk management, postmarketing surveillance, drug development Abbreviations used AERS: Adverse Event Reporting System CDER: Center...
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...Risk management in the health care in the past risk management and quality improvement job was separate in the health care organization. Even though, the job function may have been different the goal was the same. As up today they have close the gap to provide a better, and safety quality patient care. Rationale What is risk management any way not everyone has the same meaning. It can be define as such Risk management is a process for identifying, assessing, and prioritizing risks of different kinds. Once the risks are identified, the risk manager will create a plan to minimize or eliminate the impact of negative events. A variety of strategies is available, depending on the type of risk and the type of business. Outline Risk Management and Patient Safety: The Synergy and the Tension Integrating Risk Management, Quality Management, and Patient Safety into the Organization Benchmarking in Risk Management Risk Management Strategic Planning for a Changing Health Care Delivery System Using Never Events to Reduce Risk and Advance Patient Safety Governance and Board Responsibility to Assure Safety in Health Care Organizations 1. Introduction What is the goal or the idea behind risk management one of their focus is to reduce the financial risk other areas that may seem not important is the regulation. One of the principal issues facing health care risk management is governmental regulation. Over the last few decades, there has been a growing public...
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...or the idea behind risk management one of their focus is to reduce the financial risk other areas that may seem not important is the regulation. One of the principal issues facing health care risk management is governmental regulation. Over the last few decades, there has been a growing public demand for accountability in health care delivery. The consequent tightening of governmental regulation has led to a greater allocation of an organization's resources to regulatory compliance. Some states, including New York, enacted stringent incident reporting requirements for hospitals, requiring additional staff to investigate and prepare such reports. Additionally, competition among hospitals has also fostered a greater concern over the community's perception of quality of care. Many hospitals have had to compete harder for patients as inpatient lengths of stay decrease and more procedures are performed on an outpatient basis. Risk management in the health care In the past risk management and quality improvement job was separate in the health care organization. Even though, the job function may have been different the goal was the same. Managing risks is the quality of services provided & the safety of patients, their careers & visitors. To manage risks to staff & subsequent risks to service quality. To manage risk of failing to meet national & local priority targets to manage risks to the efficiency of services. To manage risks to the reputation...
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... 1.1 a. What are some of the industries in the healthcare sector? Some of the industries in the healthcare sector are health insurance, pharmaceuticals and biotechnology, medical equipment and supplies and health services. Others include education institutions, government and private research agencies. b. What is meant by the term healthcare finance as used in this book? Healthcare finance is a term used in this book to describe accounting and financial management principles and practices used to ensure the financial well-being of health care organizations. c. What are the two broad areas of healthcare finance? The two broad areas of healthcare finance are accounting and financial management. Accounting is the recording of financial transactions concerning a business or organization, providing a summary of transactions. Financial management is the use of theory, principles, and concepts developed to help managers make better financial decisions. d. Why is it necessary to have a book on healthcare finance as opposed to a generic finance book? While each service industry has a certain definitive characteristic, the health service industry is different to most others. Non-profit corporations dominate the health service industry either by government or privately. Third parties such as insurance companies, employers and government programmes are the ones that make the majority of the payments to healthcare providers over individuals. The application of finance...
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...Introduction In Health care, quality and utilization management have been forced into the spotlight by an insatiable demand for technologically advancing services, a legal system that compels physician to order unnecessary services, and the costs that are soaring higher than ever. The inconsistent use, overuse, misuse or even under used healthcare services has created inefficiencies and value concerns that demand oversight to ensure the best care is received while utilizing resources in the most efficient manner. "The knowledgeable health reporter for the Boston Globe, Betsy Lehman, died from an overdose during chemotherapy. Willie King had the wrong leg amputated. Ben Kolb was eight years old when he died during "minor" surgery due to a drug mix-up."[i] The Institute of Medicine Committee on Quality of Health Care in America identified strategies for quality improvement through two historic reports: To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century[ii]. The IOM published the "To Err is Human" study which showed that these horrible examples (commonly referred to as "Never Events") were only the tip of the iceberg. The study found that adverse events occurred in 2.9 to 3.7 percent of every hospitalization and that over half of all adverse events had resulted from medical errors that could have been prevented. To apply these numbers across American's nearly 34 million hospital admissions in 1997...
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...Healthcare Law and IT Brittany Technology is constantly evolving and advancing. As the healthcare industry becomes more electronic the laws protecting patient health information also need to evolve to cover the ever changing technologic advances. The concerns of protecting patients’ private healthcare information have grown as the use of electronic medical records has become more prevalent throughout the industry. In the 1960s computers began being used for generalizing human behavior. A physician established the idea of the Electronic Medical Record (Srinivasan, 2013). Unfortunately, the usage of electronic medical records did not become more mainstream until two decades later. (Srinivasan, 2013). As the use of EMRs became more prevalent healthcare information technology has played a “pivotal role in improving healthcare quality, cost, effectiveness, and efficiency,” (Srinivasan, 2013). However, the use of healthcare information technology has brought up concerns about privacy and protection of patient health information. In 1996, the Health Information Privacy and Accountability Act also known as HIPAA was passed. This was the first federal law regulating the privacy of health information. HIPAA was “designed primarily to modernize the flow of health information” (Solove, 2013). While at this time medical records were still in paper form, it was clear that health records would become digital in the future. (Solove, 2013). In the early years of HIPAA...
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...publicly-traded companies must establish internal controls and procedures for financial reporting and must document, test and maintain those controls and procedures to ensure their effectiveness. Non-for-profit healthcare organizations do not hold themselves to the same standards as the for-profit organizations. Although whether SOX guidelines apply to businesses in the healthcare industry depends on whether the business is a for-profit or non-for-profit organization, some voluntarily adopt SOX in an effort to strengthen internal management controls and increase the quality of healthcare financial reporting (Lohrey, n.d., ¶1). Non-for-profit organizations could certainly benefit from the SOX Section 404 to help reduce the possibilities of corporate fraud by increasing the stringency of procedures and requirements for financial reporting. Many health care executives and board members have concluded that SOX created a new benchmark for best practices, as well as provided extra protection from liability by evidencing direct board attention and oversight of organization compliance (Kusserow, 2013, ¶1). Without audit committees, non-for-profit organizations are at higher risk of financial disaster. Following the SOX compliances can be very beneficial for the non-for-profit healthcare businesses because it will increase the business’s public reputation by increasing the community trust and confidence in the organization. Having better internal controls will help eliminate the possibility...
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...Risk and Quality Management Assessment Summary Beverly L. Rivera HCS/451 April 1, 2015 Kevin Stevens Risk and Quality Management Assessment Summary The healthcare industry is growing rapidly with significant changes directing new trends and advance technology for the future. Within recent years, the shift from manual medical records to electronic medical records allows individuals to be an active participant in direct control of their health care. As these changes continue to increase, the risk and quality departments within health care organizations has an enormous duty to enhance the quality of care for its internal and external customers. Gwinnett Medical Center is one of many healthcare organizations that embraces change along with enhancing the quality of care their patients receive. The executive summary assessment will describe details of Gwinnett Medical Center, the risk, and quality management department policies, and how the risk and quality management determines the quality outcome for the goals the hospitals. Gwinnett Medical Center Gwinnett Medical Center (GMC), also known as Gwinnett Hospital System, Inc. (GHS), was established in the early 70s and is a not-for-profit health care network. The hospital is a 553-bed facility, which includes 464-inpatient and 89-skilled licensed nursing and long-term facility. Gwinnett Medical Center has two acute-care hospitals, and facilities in different cities and the metro Atlanta area. The facility in Lawrenceville...
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...Date: April 27, 2012 Subject: Feasibility of Building a Health Retreat Center, 2012 This report is the result of an initiative triggered by the worrisome health-related statistics (2011) related to the declining physical and mental well-being of Bulgarian citizens. This is a private initiative that takes into account people’s natural inclination to improve their situation by resorting to effective and affordable means. The creation of a health retreat center seems to be a plausible option to solving the aforementioned problems. This is why I believe the executing of such a project in Varna, Bulgaria’s most prominent seaside resort, is a solution to people’s problems. The content of the report covers: (1) an analysis of nowadays overall health condition of Bulgarian citizens; (2) a suggestion as to how to successfully eliminate the existing problem and the specific “steps-by-step” ways to realize the project It is my hope that you will join me in this cause and be a part of this exclusive project that will surely bring about change in the lives of people. I will very much appreciate any help you could offer as a man of vision and experience. I can be reached at +359 997310153 or via email at h.hristov@yahoo.com. Thank you for your time, I am looking forward to hearing from you. FEASIBILITY OF BUILDING A HEALTH RETREAT CENTER Formal Report 2012 [pic] Prepared...
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...DISRUPTIVE PHYSICIAN By Irene Greenstein Risk Management in Healthcare Loyola School of Law Master in Jurisprudence in Health Law Dr. Blauhard's story… The Chief of Vascular surgery, Dr. Blauhard,, strode confidently down the central corridor of the operating theaters. Passing the open heart surgery rooms and the new hybrid theater he knew that his patient would be going to sleep in room 12, his room. The patient was lucky to have him as her surgeon. He had been vice-chairman of vascular surgery at a major university and had published extensively in his chosen field. He was viewed as a star. But he was not respected or revered or even liked by the staff at his new hospital. In fact, his behavior at the new hospital had been outrageous. He yelled. He criticized. He threw instruments. He humiliated nurses and technicians and even environmental services workers. He was insufferable to work with and for. So as he pushed through the doors into operating room 12 a sudden quiet fell and bodies tensed. The patient, scheduled for a popliteal aneurysm repair was fast asleep and intubated, sleeping deeply inhaling the agents that allowed the surgeons to invade and repair. The aneurysm pulsed quietly in the right leg, awaiting repair. The right leg was clearly marked across the front of the knee. But prior to prepping, the patient was rolled from the supine position into the prone position, effectively shifting the right leg to the left side of...
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