Strategic Risk Management in Health Care
Instructions: My arena is health care facility focused on new and existing employees and reducing and eliminating the spread of infection .
Solution.
Introduction
Health risk management is based on comprehensive analysis of the theoretical information available and formation of guidelines and processes to ensure successful outcomes. Most importantly, evaluation of risk management policies should form a basis for the risk management plan. A risk management plan that is a conceptual framework for the development of various initiatives should, therefore, be within given guidelines and procedures. Therefore, this paper will examine an employee based risk management plan as per the case questions.
Risk Management Plan that is Employee-Focused
A risk management plan entails an overarching and conceptual idea that plays the role of guiding the development of a given program. Specifically, the program entails risk management and employee-based safety initiatives and activities. Therefore, as an employee based health risk management plan, the implementation of formal and clearly stated risk management and community safety are paramount. The employee-based safety and risk management plan aims towards supporting the need for cohesive employee health and risk management (Lerner, et al., 2013). As such safety and risk management forms a collective responsibility. Through the employee-based safety and risk management plan, the main focus will be on ensuring teamwork and participatory approach among volunteers, the community, healthcare providers and the diverse agencies involved. Through the coordination of various organizations and departments, the rationale for the employee based safety and risk management program will entail:
- Evaluation of various health complaints and incidence severity
- Provision of education on trends in health risk management
- Trend evaluation and comparison of the misses and achievements in employee based health risk management especially on incidences of health infections
Steps and processes for a risk management program contrasted with administrative steps and processes for selected plan
Health risks are an aspect of concern for any organization. Different health organizations implement various action plans that focus on handling the negative outcomes that emanate from health risks such as deaths, financial loss due to litigation, and damage to health organization reputation and failure to conform to the regulatory requirements. Therefore, as a clear example, the Arizona General Hospital implements a strict health risk management program that is based on the following steps and processes:
- Identification of the risks
- Rating of the risks to comprehend their level of impact
- Focusing on the most effective risk controls
- Monitoring of risks and research on pertinent trends in regulations
On the other hand, the employee based health risk management plan is reliant on an effective understanding of the employee health needs. Therefore, Arena, et al. (2013) emphasizes that the key steps and processes are dependent on developing a mutually beneficial environment between the organization and the community. Hence, the key steps and processes in the employee health risk management are:
- Development of systems that ensure proper analysis of reports emanating from the community on health issues such as infections
- Data collection and analysis to evaluate the risks and adverse effects
- Forming a committee that comprises of various stakeholders such as community members, healthcare providers, and management to evaluate aspects such as infection incidences
- Development of key policies and performance approach that are compliant with industry requirements
Agencies that regulate administration of safe healthcare and roles in risk management oversight
Regulation is integral in the oversight of risk management. There are agencies across the USA that is charged with the role of ensuring regulation of the administration of health risk management. The main agencies as per Lerner, et al. (2013) include:
Office of Health Care Quality (OHCQ): is an agency that operates under the Department of Health and Mental Hygiene that monitors quality of healthcare in community residential programs
- Center for Medicare and Medicaid (CMS): plays an oversight role of the regulations that are inter-related to the healthcare system and compliance with the Health Insurance Portability and Accountability Act (HIPAA)
- Agency for Healthcare Research and Quality (AHRQ): undertakes research that focuses on addressing patient safety and medical disputes
- National Commission for Quality Assurance (NCQA): ensures quality is of utmost level in management of care plans
Compliance with American society health risk management standards
The American Society of Health Risk Management (ASHRM) is important in oversight of risk management programs in the health sector. Most importantly, the organization sets forth various standards that require conformity and are within the regulatory guidelines. Hence, an exemplary employee health risk management plan that is compliant to ASHRM on patient confidentiality should address current trends. It is important that all documents that form a part of the employee health risk management process be privileged to privacy that is within the compliance levels of ASHRM. Confidentiality guidelines or protections as per Maeng, et al. (2013) may be inclusive of peer review protections, healthcare provider client privilege, and attorney-client privilege. Hence, in the employee health risk management plan, conformity to the protections outlined in the Patient Safety and Quality Improvement Act of 2005 on information, data and reports should denote:
Establishing employee-based safety analysis system that is reliant on information analysis and confidentiality
Proposed Recommendations in Selected Risk Management Program
A successful employee based health risk management program depends on agreement and cohesion among the stakeholders via conformity to the regulations set forth. Therefore, it is mandatory that analysis of the significant industry trends prevails to necessitate successful outcomes. From the analysis of the employee based health risk management program, the main recommendation should focus on continuous improvement of the set processes. The employee based health risk management plan should encompass effective reporting approaches. Consequently, the reporting should be inclusive of claims analysis, credentialing activities, staff and community information relay and severity data analysis (Arena, et al., 2013).
Conclusion
Health risk management plan should
be a comprehensive approach towards addressing a given risk both in the
internal and external organizational environment. Therefore, the employee based
health risk management should be built on guidelines that are formed through
communication among the various stakeholders. Additionally, the formation of
the guidelines towards handling issues in employee health risk management
should conform to the regulatory standards available.
References
Arena, R., Guazzi, M., Briggs, P. D., Cahalin, L. P., Myers, J., Kaminsky, L. A., … & Lavie, C. J. (2013, June). Promoting health and wellness in the workplace: a unique opportunity to establish primary and extended secondary cardiovascular risk reduction programs. In Mayo Clinic Proceedings (Vol. 88, No. 6, pp. 605-617). Elsevier.
Lerner, D., Rodday, A. M., Cohen, J. T., & Rogers, W. H. (2013). A systematic review of the evidence concerning the economic impact of employee-focused health promotion and wellness programs. Journal of Occupational and Environmental Medicine, 55(2), 209-222.
Maeng, D. D., Pitcavage, J. M., Tomcavage, J., & Steinhubl, S. R. (2013). Can Health Insurance Improve Employee Health Outcome and Reduce Cost? An Evaluation of Geisinger’s Employee Health and Wellness Program. Journal of Occupational and Environmental Medicine, 55(11), 1271-1275.