Homework answers / question archive / Chapter 2 1

Chapter 2 1

Health Science

Share With

• Chapter 2

  1. Explain Peer Review Privilege Statutes

  2. Describe Quality Monitoring Initiatives

  3. What is the Theory of Corporate Negligence?

  4. What is Early Warnings for Litigation?

  5. Describe a Post-Event Management & Media Relations

  Chapter 4

  1. Describe the Risk Management Department from Figure 4-

  2. List some of the Analysis of Strengths, Weaknesses, Opportunities, and Threats 2. Define and briefly explain Risk Assessment, Risk Finance, and Risk Control abilities

  3. From Exhibit 4-2 list the major changes evident in the External Environmental Assessment

  4. Describe briefly the five Goals that support the critical success factors for healthcare organizations

  5. Describe briefly the five Strategic Initiatives and tactics

  Chapter 6

  1. Name the four-tiered the IOM report’s recommended

  2. Name the five duties in the Patient Safety and Quality Improvement Act of 2005?

  3. Define the ultimate goal of this act. Why do you think this act it is important?

  4. What does the National Quality Forum pursuit?

  5. Name the professional societies that are setting standards in order to improve patient safety (third tier)

  6. Name the purpose of the report created by AHRQ in order to evaluate Hospitals

FLORIDA NATIONAL UNIVERSITY ----------*---------- SYLLABUS COURSE NUMBER: HSA-4502 COURSE TITLE: Risk Management COURSE CREDITS: 3 (6 Hours Lectures) PREREQUISITES: None INSTRUCTOR: Amarelys Mundaray, BS., MPH INSTRUCTOR EMAIL: amundaray@fnu.edu 1- TEXT AND MATERIALS: Title: Principles of Risk Management and Patient Safety Author: Youngberg, Barbara J ISBN: 978-0-7637-7405-9 Publisher: Jones & Bartlett Learning- 2011 2- COURSE DESCRIPTION: This course was designed to provide the students with the knowledge and skills necessary to develop and maintain risk management programs in health care settings. Also, the students will receive the knowledge on how public and private organizations identify, assess, and reduce risk to patients, visitors, and staff. Likewise, the student will familiarize with three principle domains that are part of risk management: Job Responsibility: Claim management, risk financial and proactive risk. 3- COURSE OBJECTIVES: The students will: 1)- Students will demonstrate a basic understanding of risk management and patient safety 2)- Students will demonstrate understanding enterprise risk management and the impact on healthcare organizations 3)- Students will be familiar with claims management issues and the aftermath of error. 4)- Students will demonstrate understanding of how to apply principles of risk management and patient safety to change the environment 4- COURSE REQUIREMENTS: ATTENDANCE: Students are expected to attend classes every day. EXAMS: One mandatory final exam will be required to pass the course. Other evaluations will be taken during the course. For Online Classes Students are expected to log on at least twice a week and successfully complete all Assignments and tests. 5- LIBRARY ASSIGNMENTS: There should be at least one library assignment. 6- FIELDTRIPS OR GUEST SPEAKER: A fieldtrip to a Hospital or similar facility might be done. A guest speaker could be another choice. 7- COURSE OUTLINE: 1- FIRST WEEK: 1. Week One: Chapters 2, 4 & 6 *Integrating Risk Management, Quality Management, and Patient Safety into the organization. *Risk Management strategic Planning for Changed Healthcare Delivery System. *Patient Safety: The Past Decade. 2- SECOND WEEK: Week Two: Chapters 9, 11 & 14 *The role of Governance in Hospital Risk Management and Patient Safety. *Enterprise Risk Management: The impact on HealthCare Organizations. *Managing the Risk of Workers’ Compensation. 3- THIRD WEEK: . Week Three: Chapter 15 & 16: *Guideline for In-House Claims management. *Principles of strategic Discovery. 4- FOURTH WEEK: Week Four: Chapter 20. *Criminalization of HealthCare Negligence. • Midterm: Material from Week 1, 2, 3 and 4 5- FIFTH WEEK: . Week Five: Chapters 21, 22 & 24: *Preparing and Limiting Potential Liability for Medical care Provided During Disaster Event. *Creating Systemic Mindfulness *Improving Risk Management Performance and Promoting Patient Safety. 6- SIXTH WEEK: . Week Six: Chapters 25, 29 & 30: *The benefits of using Simulation in Risk Management and Patient Safety *The Impact of Fatigue on Error and Patient Safety. *Managing the Failures of Communication in Healthcare Settings. 7- SEVENTH WEEK: Week Seven: Chapters 31 & 32 *Improving Handoff Procedures in Health Care To Reduce Risk and Promote Safety. The Risk and Benefits of using E-Mail to facilitate Communication. 8- EIGHTH WEEK: FINAL REVIEW. FINAL TEST: Material from Week 5, 6, and 7 8- CLASS POLICY: FNU Medical Dress Code is not mandatory. FNU ID is required. The textbook will be required to work in class. The student must stay in the classroom during the scheduled hours. 9- VIRTUAL CLASS POLICIES: a) Students are responsible for all the material covered during the course. b) Students must log-on at least twice a week. c) Students must have their textbooks from the first day of class. d) Discussion Board participation is required from all students. e) All assignments must be turned in by the due date (usually Sundays). Late homework assignments will be deducted 10% of the grade for each date late up to 3 days. After the 3rd day past due; the homework assignment will not be accepted and student will be given a 0. f) If students experience any issues that will affect their performance, they must contact the professor prior to assignment due date. g) The professor will respond to any questions or concerns within 24 hours via email. h) Students should familiarize themselves with the Blackboard environment and participate in the Blackboard orientations provided in any of the FNU campuses. i) Students must check their FNU email on a regular basis. At times, course communication will be done via email 10- LEARNING OUTCOMES: Upon completion of this course the student will be able to: 1). Describe and assess three principle domains that are part of risk management: job Responsibility: Claim management, risk financial and proactive risk. 2). Analyze how public and private organizations identify, assess, and reduce risk to patients, visitors, and staff 3). Develop and maintain risk management programs in health care settings. 11- GRADING CRITERIA: The results of the weekly evaluation, midterm test, coursework (research), and final exam are the basis for the evaluation. Graded Assessments Maximum Points 1. Homework Assignments 70 points (10 points each HW) 2. Midterm Exam 15 points 3. Final Exam 15 points Total Points = 100 Points Description of Graded Assessment: a) Homework Assignments: there will be weekly homework assignments based on the covered materials and assigned readings. The assignments will be online and each will account for 10 points with a total of 70 points. b) Midterm Exam: A midterm examination will be administered to evaluate the knowledge acquired from the Chapters evaluated. The evaluation will be online and it is worth 15 points of your grade. Failure to complete the exam by its due date will result on a grade of zero (0) for the examination. c) Final Exam: A final examination will be administered to evaluate the knowledge acquired from the chapters evaluated. The evaluation will be online and it’s worth 15 points of your grade. Failure to complete the exam by its due date will result on a grade of zero (0) for the examination. d) Incomplete: will only be allowed when the student and the instructor establish a written agreement as per school policy and the reason meets the criteria for authorizing an incomplete. e) Last Day to Submit: all assignments, Midterm, and Final Exam must be submitted by 11 pm on the Due date. No exceptions! f) Student Misconduct: FNU is a community dedicated to generating and imparting knowledge through excellent teaching, research, and community service. All students should respect the rights of others to have an equitable opportunity to learn and honestly to demonstrate the quality of their learning. Therefore, all students are expected to adhere to a standard of academic conduct, which demonstrates respect for themselves, their fellow students, and the educational mission of the college. If a student is found responsible for academic misconduct, they will be subject to the Academic Misconduct Procedure and sanctions, as outlined in the Student Handbook. 12- GRADING SYSTEM: 0-59 F 60-69 D 70-74 C 75-79 C+ 80-84 B 85-89 B+ 90-100 A REVISED AMARELYS MUNDARAY 04/2021 Risk Management Strategic Planning for a Changed Health Care Delivery System Chapter 4 FIGURE 4–1 Strategic Planning Model Terms Important to understand the following terms: -Critical success factor -Goals -Objectives -Strategic initiatives Identification of Core Strengths and Values • Analysis of Departmental Strengths and Weaknesses – Risk manager should carefully and honestly evaluate the current strengths and weaknesses of the department and the individuals working to support the risk management program in the organization – Determine if and where other safety-oriented functions are occurring & how RM can work collaboratively to maximize the effectiveness of all patient safety efforts FIGURE 4–2 Risk Management Department—Analysis of Strengths, Weaknesses, Opportunities, and Threats Identification of Core Strengths and Values Risk Assessment- comprises abilities: 1. To assess particular environments and situations that pose a threat of risk to patients, health care providers, or the organization 2. To understand the root-cause-analysis process in order to identify the true systemic components contributing to risk 3. To use data to estimate the economic value to the risks assessed, and to minimize existing risks Identification of Core Strengths and Values Risk Finance – comprises abilities: • To evaluate a variety of commercial insurance products to determine which is most appropriate for the risks assessed • To analyze the capability of the organization to assume some of the financial risk and transfer the rest in a manner that allows for the most sound financial portfolio for the organization Identification of Core Strengths and Values Risk Control- comprises abilities: • To design unique and creative approaches to minimizing the risks that are identified • To relate to multiple persons through education to ensure that all who contribute to the organization understand key risk management and patient safety concepts • To understand the legal process and to assist in achieving the most favorable resolution of a claim or incident Key Success Factors for Risk Management Goal 1- Develop comprehensive methodology for identifying & managing the multiple systemic factors that cause or contribute to risks associated with managing patient care across the continuum Goal 2- Be positioned to accept appropriate levels of financial risk and become less reliant on the turbulent financial and insurance markets Goal 3- Achieve a leadership position within the health care delivery system through development of creative and comprehensive risk management programs and services that focus on system support and provider accountability Key Success Factors for Risk Management Goal 4- Foster systemic mindfulness by creating a non-punitive accountable culture where information about errors is shared to enhance learning and drive change Goal 5- Promote a process that supports and monitors rational, ethical, and safe practices, as well as the appropriate use of technology Risk Management Strategic Initiatives and Tactics • First Strategic Initiative- develop and implement a set of services that will support the organization’s ability to manage the risks of patients across the continuum • Second Strategic Initiative- assist the organization in its ability to collect, analyze, and report information that will enable it to identify, analyze, quantify, and control risk, and to advance a culture of safety Risk Management Strategic Initiatives and Tactics • Third Strategic Initiative- assist the organization in identifying the appropriate markets and products that can be used to transfer the risks associated with the health care organization’s business to a third-party partner • Fourth Strategic Initiative- expand programs and services that help to identify new areas of risk created by all aspects of the health-care-system’s operation Risk Management Strategic Initiatives and Tactics • Fifth Strategic Initiative- develop and implement a set of services that assist members of the healthcare organization to manage clinical and financial risk Integrating Risk Management, Quality Management, and Patient Safety into the Organization Chapter 2 Peer Review Privilege Statutes • Designed to improve health care systems & define best-practice recommendations for clinical providers • Promote and protect candid review of care – Documents shielded from discovery in many jurisdictions if created or used by applicable committee under statute – Can also be used by medical staff to conduct morbidity and mortality reviews – Must fit within statute to be privileged Risk managers (RM) has a key role in ensuring compliance Peer Review Privilege Statutes • Risk managers can use the peer- review privilege to shield from discovery the results of the quality and safety reviews conducted as part of their investigations into adverse patientcare events. • Risk managers maintain vigilance throughout the organization to guarantee that processes be conducted within the framework defined by their jurisdiction’s peer- review statutes • Risk Managers can ensure a steady flow of information between departments to improve patient care while protecting their institutions from exposure to liability by ensuring applicability of their state’s peer-review- privilege statutes. Medical Staff and Quality Monitoring Initiatives • The Joint Commission requires active participation from medical staff • Performance improvement standards require: – Ongoing professional-practice quality evaluations – Active participation in measurement, assessment and improvement of a variety of quality-care metrics – Data collection requires close coordination between medical staff and risk and quality departments. General Competencies • Patient Care: must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health • Medical/ clinical knowledge • Practiced-based learning and improvement • Interpersonal and communication skills: must demonstrate skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. General Competencies • Professionalism: residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents must demonstrate: Compassion, integrity, and respect for others;•responsiveness to patient needs that supersedes self- interest;•respect for patient privacy and autonomy;• accountability to patients, society, and the profession; and• sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. • Systems-based practice: Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Theory of Corporate Negligence • 1. Duty- Hospital must exercise reasonably care to ensure physicians are qualified to perform privileges requested • 2. Breach- failing to adopt state licensing or applicable accreditation standards • 3. Causation- but for the hospital’s failure to exercise reasonable care, the injury would not have happened Defending the Hospital • In corporate negligence suit, RM must assess whether jurisdiction’s peer-review statutes allow an organization to waive privilege & produce documents normally shielded from discovery in malpractice cases • RM may consider working with the medical-staff to develop credentialing documents that are transparent, accessible, & separate from for-cause peer-review analysis • To avoid liability, RM must ensure that the current credentialing process meets applicable requirements Early Warnings for Litigation • A close, collaborative relationship between the risk and quality departments, as well as others (patient relations/advocacy, billing, the HIPAA office &medical records) provides opportunities for quick problem identification and allows for early interventions with patients and family members • The two early warnings signs of possible liability are: Patient Complains and Medical Records Patient Complaints • A proactive and responsive patient relations office can often intervene early during a patient’s hospital stay to counter negative patient, friend, or family impressions of care • An organization’s billing office is another outlet for patients to voice their concerns related to patient care Medical Records • Charts are routinely requested for case-review analysis and abstraction • Role in identifying adverse events and quality-ofcare concerns increased exponentially with the implementation of the CMS “Never Events” – October 2008 – Focuses on many health-care-acquired conditions (HAC) Post-Event Management & Media Relations • Quick response to Plaintiff’s use of media outlet can be key to mitigate reputational damage • If RM or clinical provider has reason to believe an adverse patient-care event may become a media event, the media relations team should review the details and consider drafting an appropriate response HSA 4502-Risk Management HW Assignment# 1 Chapter 2 1. 2. 3. 4. 5. Explain Peer Review Privilege Statutes Describe Quality Monitoring Initiatives What is the Theory of Corporate Negligence? What is Early Warnings for Litigation? Describe a Post-Event Management & Media Relations Chapter 4 1. 2. 3. 4. 5. Describe the Risk Management Department from Figure 4-2. List some of the Analysis of Strengths, Weaknesses, Opportunities, and Threats Define and briefly explain Risk Assessment, Risk Finance, and Risk Control abilities From Exhibit 4-2 list the major changes evident in the External Environmental Assessment Describe briefly the five Goals that support the critical success factors for healthcare organizations Describe briefly the five Strategic Initiatives and tactics Chapter 6 1. 2. 3. 4. 5. Name the four-tiered the IOM report’s recommended Name the five duties in the Patient Safety and Quality Improvement Act of 2005? Define the ultimate goal of this act. Why do you think this act it is important? What does the National Quality Forum pursuit? Name the professional societies that are setting standards in order to improve patient safety (third tier) 6. Name the purpose of the report created by AHRQ in order to evaluate Hospitals Patient Safety: The Past Decade Chapter 6 Institute of Medicine: Four Tier Approach 1) Leadership and Knowledge 2) Identifying and Learning from Errors 3) Setting performance standards and expectations for safety 4) Implementing safety systems in health care organizations Leadership & Knowledge – Tier 2 Patient Safety and Quality Improvement Act of 2005 (PSQIA) Duties: • Provide for the certification and recertification of Patient Safety Organizations • Collect and disseminate information related to patient safety • Establish a patient safety database • Facilitate development of consensus among health care providers, patients, & interested parties concerning patient safety and recommendations to improve patient safety • Provide technical assistance to states that have medical -error reporting systems, assist states in developing standardized methods for data collection, and collect data from state reporting systems for inclusion in the patient safety database Leadership & Knowledge- Tier 2 National Quality Forum • Established in 1999 • Goal: improve the quality of American health care by setting national standards • Members include hospitals, physicians, businesses and policymakers & national, health, government, and consumer organizations committed to specific, measurable actions and goals for performance measurement and public reporting regarding patient safety Setting Performance Standards and Expectations for Patient Safety- Tier 3 • Professional groups already working to improve patient safety: – American Medical Association (AMA) – National Patient Safety Foundation (NPSF) – American Nurses Association (ANA) • IOM Recommendations: – Professional societies that make a clear commitment to improving patient safety. – Food and Drug Administration (FDA) increase attention to the safe use of drugs and devices Creating Safety Systems Inside Health Care Organizations- Tier 4 • The Joint Commission- established the National Patient Safety Goal program in 2002 with the first set of goals taking effect in January 2003 • Developed the national patient safety goals (NPSGs) – 13 goals with multiple elements of performance AHRQ • Developed a tool to assist hospitals in evaluating how well they establish a culture of patient safety within their institution – Hospital staff provides opinions about patient safety, medical-error and adverse-event reporting – Purpose: • (1) allow hospitals to compare themselves with each other • (2) facilitate internal learning in patient safety improvements • (3) assist hospitals in identifying strengths and areas for improvement • (4) show trends in patient safety over time