Risk Management in a Health Care Facility

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There are several things in an organization which should be made to have a proper and efficient organization which will have smooth running. Risk management is one of the factors which should be considered in an organization, and therefore it includes the identification, assessment, and prioritization of risks. This involves the economic and coordinated application of aspects to monitor, control and minimizes the impact and probability of unfortunate occurrences (Lončarski, 2016). In the health sector, there are several major risks which should be considered the quality of care, cost reports, claims development and submission, and emergency medical treatment. These categories have an integral role in the understanding of the management of risks by the directorate.

The quality of care is one of the major issues which need critical consideration by any organization regarding evaluation, investigation, and prioritization. Therefore, health care facilitates should develop a plan to implement the performance improvement and quality assessment programs which will include identification of the safety of patients and reduce medical errors in hospitals (Lončarski, 2016).

One of the issues which need to be addressed includes deficient care, medical necessity, and the reporting of quality data in an accurate manner. The technique of identification of quality of care is the study and understanding of the previous trends of the facility to understand to how it has been functioning.

The other major category is the cost of reports of the health care facility. There are reviewed to determine the completeness, reasonableness, and accuracy of the data which has been recorded (Lončarski, 2016).

The restro-respective technique of risk identification should be used to check cases of, for example; unallowed costs reports being included in the financial reports of the facility. In this case, it can be issues of falsification and misrepresentation of financial reports can handle before they happen (Barker, Kamar, Graco, Lawlor & Hill, 2010).

One of the major issues which feature in the risk area in health care is in the claims development and submission. These include other requests for payment from the financiers of the health care programs (Singh, 2012). The technique for this is the use of concurrent adjustment technique which can use to determine the subject of false claims based on outdated documents, incorrect claims of medical trials and the manner of abuse of payments for partial hospitalization. This is because if these vulnerabilities in the facility if they are not addressed, they can result in penalties, fines and the aspect of Corporate Integrity Agreements.

Emergency medical treatment is another aspect of risk management which is critical in a health care facility. The technique tool of identification for this kind of risk is incident reporting on the part of the issues which regard to emergency medical treatment (Singh, 2012). This includes the matter in which it includes the aspect of on-call of specialist and the inability to provide adequate stabilization and screening. This includes the failure of the health facility to provide appropriate matters of transfer of patients in the facility. In this case, for example, the facility should have the mechanisms for the on-call aspect of response by the physician, medical screening and the response from medical issues outside the hospital and the non-clinical parts of the health facility.

Risk management initiatives are essential for the well-being of the health care facility. Risk prevention for this matter is the ability of the health care facility which includes management practices and techniques are used to preventing risks which are unforeseeable and unnecessary (Singh, 2012). This is in the manner that there should be a review of the loss of prevention measures before making any plans which may affect the healthcare facility. There is a sense in which the prevention measure can be used to check on the flaws of any activity or a plan. It is therefore prudent of the facility to have preventive measures in which employees all practices to improve the quality of health care management and provision. For example, there should be proper documentation of the activities of the patients to have a proper and organized way of handling future problems.

Risk reduction, in this case, matters in the sense that the hospital can have a have practices and strategies which help prevent that freque cy and severity of losses in the hospital. This includes the aspect of loss of control when it occurs or if it has the high probability of happening and if it happens how it can be handled in the future ("Risks, Benefits, And Uncertainty in Health Care," 2007). For example, the hospital can have a strategic and immense investment in fire protection and handling equipment and facilities which would see the proper and efficient handling of fire outbreak within the hospital to prevent massive loss. Also, the hospital can be used to make the necessary plans to have the mechanism to prevent and rehabilitate cases of the frequency and severity of the chronic lifestyle diseases such as diabetes and HIV-Aids.

One of the essential and most critical in the health care facility is the regulatory compliance. This is in the aspect where the hospital complies with the guidelines, laws, regulations and other specifications which are relevant to the health care facility. This is because violation of these regulations can lead to punishments, punitive measures, and fines regarding the violation which has been done. There is a sense in which legal punishment leading to the closure of the health care can be the most daunting to the health care provisions. In this case, for example, the hospital should have proper ethical medical conducts such as the privacy of the information of the patients. This is because the law regulates against the disclosure of the information of a patient without his or her consent.

It is prudent for many hospitals to have strategic measures for the safety of the patients in the manner that there is prevention in the spread and contraction of infections rates in within the hospital. Also, the hospital should have elaborate means in which it can guarantee the safety of patients in the prevention of cases of mistakes which are detrimental to the safety of the patients (Singh, 2012). For example, there should be the management of the possible spread of contagious diseases especially the airborne ones such as tuberculosis, or the multiple infections of people with malaria and other diseases. This is in the sense that the hospital should ensure that the safety patients in the hospital are top notch to avoid cases of new infections or to worsening of the patients therein.

The pillar of risk management lies squarely in the hands of an effective and efficient risk manager. This is because he or she has an integral role in the management of the aspect of risk management strategies. He or she is important because they provide the methodology which is used to analyze and identify the aspect of risk management of the hospital, the staff and the patients (Mitchell, 2014). He or she is integral because there is no institution which can function without the aspect of assessing risk and efficiently working on them. Therefore, the risk manager is critical in providing the mechanisms for the analysis, assessment, preparation, and implementation of risk management initiatives which are essential for the success of the health care facility.

A risk manager is key in the claims development and submission in the medical facility. In essence, the manager in tandem with the governing council can be critical in the maintaining control over the claims process to ensure that the claims are settled concisely, fairly and in the best interests of the health care facility (Mitchell, 2014). Maintaining this kind of approach will ensure that there is proper handling of claims to the sponsors, government and other entities where accountability and other ethical standards of work are needed.

There is a potential health risk in the health facility which poses a critical concern to the functionality and success of the organization. The major one risks in the hospital are the exposure to the bloodborne and airborne pathogens ("Risks, Benefits, And Uncertainty in Health Care," 2007). The hospitals handle people who are suffering from diseases due to pathogens in their blood and accidental contact with the blood of a sick person can lead to new infections.

Also, there is the probability of contracting air borne diseases due to exposure to people who are suffering from them. In this case, there should be mechanisms to ensure that such infections and spread do not happen in the hospital. Frequent decontamination measures should be put in place where objects and equipment which handle blood and blood samples are kept safely and sterilized immediately after use. Also, there should be good air circulation and ventilation systems which would ensure proper air circulation and subjugation of the spread of pathogens by air ("Risks, Benefits, And Uncertainty in Health Care," 2007). All patients should be protective gear while in the hospital when handling patients and equipment.

If the risk is not addressed, the hospital risks chances that the hospital will be a place for the contacting and spread of diseases instead of it being ground zero for diseases. In this case, patients who access for the facility for medical purposes will have contract more diseases and complicate the provisions of cure ("Risks, Benefits, And Uncertainty in Health Care," 2007).

Also, if the staff becomes vulnerable to these diseases, the hospital will face serious shortages in the workforce or the reduction of the efficiency of conducting its business (Barker, Kamar, Graco, Lawlor & Hill, 2010). Inefficiency would mean there would be a serious loss of finances due to the facilitation of medical services to ailing staff.

To conclude, risk management is essential to the success of any organization and a hospital cannot function well if risks are not well assessed and evaluated. Risk managers in a hospital should ensure that risks which are posed therein are handled by putting the necessary mechanisms to identify them and apply the practices to control or prevent them. Therefore, risk management should ensure lower probabilities of the occurrence of risks or the high loss in case the risks happen in the long run.

References

Barker, A., Kamar, J., Graco, M., Lawlor, V., & Hill, K. (2010). Adding value to the STRATIFY falls risk assessment in acute hospitals. Journal of Advanced Nursing, 67(2), 450-457. http://dx.doi.org/10.1111/j.1365-2648.2010.05503.x
Lončarski, I. (2016). Risk Management (2016). Risk Management, 18(1), 1-3. http://dx.doi.org/10.1057/rm.2016.2
Mitchell, J. (2014). Spreading the word about the unique and valuable role of healthcare risk managers. Journal Of Healthcare Risk Management, 34(1), 1-2. http://dx.doi.org/10.1002/jhrm.21143
Risks, Benefits, And Uncertainty In Health Care. (2007). Health Affairs, 26(3), 624-624. http://dx.doi.org/10.1377/hlthaff.26.3.624
Singh, B. (2012). Risk Management in Hospitals. International Journal Of Innovation, Management, And Technology, 3(4). http://dx.doi.org/10.7763/ijimt. 2012.v3.266