Hospital’s Risk Management Program Analysis

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Risk Management Plan: New Employees

The risk management plan for new employees or physicians (in this case) is designed to offer information and training sessions needed to ensure that all new employees are familiarized with the healthcare facility services, processes, culture, and systems (Southern Maine Health Care, 2016).

The plan defines various issues, including patient safety, treatment standards, ethical practices, compliance, emergencies, and competencies among others.

It is currently observed that many hospitals strive to stay competitive in the highly dynamic healthcare industry with heavy regulations and risks. Consequently, hospitals have opted to acquire physician practices and/or employ individual physicians. However, as many more physicians become employees of healthcare facilities, some hospitals have failed to conduct thorough risk assessment based on the new possible medical malpractice liabilities.

New physician employees present new risks. Conventionally, hospitals have employed specialists working within their facility environments, which provided effective risk control and management. Today, however, in addition to hospital-based physicians, healthcare facilities have hired many physicians who generally deliver services in their offices situated outside hospitals. This implies that such physicians are not within the control of hospitals.

Of course, various specialties expose hospitals in different ways (Craciun, Mankad, & Lynch, 2015). New physicians expose the hospital to new types of risks and liabilities (Jones, 2015). Likewise, risks can also increase based on new services introduced and new physicians hired to offer them. Thus, there are risks associated with hiring new physicians. The new employee risk management plan is extremely important for hospitals.

The recommended administrative steps and processes contrasted with risk management plan

Before the hospital hires new physicians, it is imperative to assess medical malpractice risks.

First, the hospital should conduct risk identification by evaluating historical data on malpractice claims for new physicians hired. Data can be mined to determine the extent of the exposure (Jones, 2015). Once critical issues have been identified, the risk management department can decide to mitigate risks by alterations in protocols or behaviors or dismiss such physicians from the facility.

Although the hospital has risk management physician orientation plan, it does not directly account for risks associated with newly hired physicians. Instead, it focuses on enhancing a culture of care and reducing mortality and morbidity.

Second, risk management also requires credential process assessment. That is, the hospital should evaluate its own risk management plan and credentialing procedures to ensure that it can positively identify physicians with history of malpractices and claims, or physicians with disciplinary issues and lack hospital privileges. The hospital usually caters for costs related to malpractices by their employed physicians.

Given that hiring independent physicians with their offices outside the hospital facility is a growing phenomenon, hospitals have generally focused on gaining competitive edge, but failed to update their risk management plan for new employees to reflect these developments in the healthcare industry.

Third, it is imperative to determine if new physicians are practicing within their scopes. Practicing beyond the scope of expertise is associated with increased risks and malpractice claims. In addition, personnel that support newly employed physicians may also increase malpractice liability claims for the facility.

The current risk management plan for new employees outside the hospital does not account for such risks.

Lastly, hospital administrators should develop certain orientation programs for newly hired physicians to ensure that they comprehend and are compliant with quality of care provisions, processes, patient safety, provider safety, and risk management procedures. It is imperative for newly hired physicians to acknowledge protocols for risk management.

The current risk management plan has clearly captured this recommendation. Nevertheless, it is imperative to review medical malpractice claims with physicians and if possible introduce incentives for best performing physicians.

Major agencies and organizations that regulate the administration of safe health care

While several agencies and organizations are involved in healthcare safety and privacy issues, as well as risk management, the following have been chosen. First, National Association Medical Staff Services (NAMSS) is the distinguished agency that develops credentialing, privileging, professional practice assessment, physician enrolment, enhancement of quality, risk management, and/or regulatory compliance for most physicians. That is, NAMSS is directly engaged in risk management through its practices and services.

Second, American Society for Healthcare Risk Management (ASHRM) represents healthcare professionals, insurers, law, and other similar practices. It is generally focused on enhancing better methods of improving risk management practices and professional leadership by advancing education, advocacy, research and publications, networking, and association with hospitals and government entities.

Finally, the Joint Commission is responsible for accrediting and certifying healthcare facilities and their services. It services are trusted as the hallmark of quality standards, which focus on specific quality standards. The organization concentrates on risk management improvement and risk reduction, which are facilitated by modern best practices and strategies to assist healthcare facilities to enhance safety, care quality, and privacy. In addition, the Joint Commission practices may reduce liability insurance claims by improving risk management practices, accreditation, and cutting liability cost associated with insurance coverage.

Evaluation of the exemplar risk management plan and its compliance with the American Society of Healthcare Risk Management (ASHRM) standards on privacy, health care worker safety, and patient safety

According to ASHRM Healthcare Risk Management, professionals have the responsibility to respect the dignity of their patients by ensuring non-discriminatory practices, advocate safety for their patients, promote best practices by advancing risk management research, avoid behaviors that could result in harm to others and uphold image that protects the profession (Rosenstein, 2015).

The risk management plan for the hospital focuses on reducing mortality and morbidity. In addition, it aims to improve patient care, safety, and integrity. Risks are identified, analyzed, and reduced appropriately to ensure that possible adverse effects on patients are mitigated. To this end, the exemplar risk management plan meets standards provided by the ASHRM Healthcare Risk Management.

The risk management plan for physician orientation emphasizes the importance of putting the patient at the center of every aspect of care delivery. In addition, the culture of safety and risk management is extremely important for the hospital.

Proposed recommendations or changes to the risk management program example to enhance, improve, or to secure compliance standards

These proposed recommendations are not currently documented in the exemplar risk management program for the hospital. Hence, they should be additional changes to current risk management efforts.

First, the hospital should account for medical malpractice risks that new physicians may bring. It will account for risk identification and possible financial burden for mitigation. The hospital should conduct this process methodically and early. Risk managers will have to assess new risks the hospital is mostly likely to encounter as it hires new physicians and determine possible mitigation strategies (Jones, 2015). It is imperative to assess possible cost impact and effective use of captive insurance firm in risk management.

The hospital should also align its interests to those of the hired physicians by using the insurance captive. In fact, the captive can be the most appropriate tool to control potential malpractice risks associated with newly hired physicians located outside the hospital.

Overall, as the hospital hire new physicians to enhance the quality of healthcare, care delivery, patient safety, and dignity, it must also account for risk management associated with new physicians and service delivery.

References

Craciun, H., Mankad, K., & Lynch, J. (2015). Risk Management in Radiology Departments. World Journal of Radiology, 7(6), 134–138. Web.

Jones, V. (2015). Hospital and Physician Professional Liability Trends and Industry Topics. Journal of Healthcare Risk Management, 35(1), 7–19. Web.

Rosenstein, A. H. (2015). Physician Disruptive Behaviors: Five Year Progress Report. World Journal of Clinical Cases, 3(11), 930–934. Web.

Southern Maine Health Care. (2016). Patient Safety & Risk Management Overview for Physicians, PAs and NPs. Web.

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