Identifying and Reducing Risks in Healthcare Organizations

Write 6-8 pages analyzing a specific issue that occurred in a health care organization. Apply risk management best practices to it for the purpose of early risk identification and risk reduction or elimination in the future.
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Introduction
Health care organizations have always searched for ways to identify and reduce risks. An organization’s ability to identify and analyze its risk exposure is a determining factor in the effectiveness of its risk management program (Hoarle, 2015). Early identification and analysis are essential.
Current health care risk management practices developed in the mid-1970s as a result of a surge in malpractice suits. These suits caused rapid increases in claims costs for the industry, which later resulted in increased insurance premiums. Today, health care delivery systems and organizations realize the value of risk management and have developed formalized programs (Hoarle, 2015). In addition, organizations have established mechanisms to review potential incidents of risk and safety concerns (Pelletier & Beaudin, 2018). While risk management programs are responsible for daily management and risk operations, all health care stakeholders are responsible for participating in activities that will reduce unnecessary risks and improve safety and quality (Hoarle, 2015).
References
Hoarle, K. (2015). Risk management poised to grow as healthcare evolves. Biomedical Instrumentation & Technology, 49(6), 433–435.
Pelletier, L. R., & Beaudin, C. L. (2018). HQ solutions: Resource for the healthcare quality professional (4th ed.). Wolters Kluwer.
Preparation
To successfully complete this assessment, use the Risk Management Policy & Procedure Template [DOC] to address the following:
• For part 2 of this assessment, you will conduct an in-depth analysis of the organizational risk you selected from the Vila Health: Patient Safety simulation.
• Review the Risk Management Policy & Procedure Template [DOC], which you will use to complete your assessment. This document is formatted and has space for completing all components of the assessment.
Instructions
Part 1: Risk Management Policy and Procedure (3–4 pages)
As the new risk manager in your health care organization, your director has assigned you the responsibility of drafting the organization’s risk management policy and procedure. This assessment stemmed from your director’s perception that employees lacked knowledge and awareness of risk management’s contribution to furthering the organization’s safety and quality improvement efforts. Likewise, your director also saw evidence that departments within the organization were inconsistently applying risk management principles to their daily work practices.
The guidance you have received from your director about writing this policy and procedure is that it needs to include all of the following headings. It also needs to answer all of the questions underneath each heading:
• Purpose Statement:
o How can a risk management program help this organization advance its strategic safety and quality goals?
• Key Risk Management Terms:
o What is the definition for each of these risk management terms?
 Risk prevention.
 Risk reduction.
 Regulatory compliance.
 Patient safety.
 Adverse event.
 Near miss.
• Risk Categories and Risk Identification Techniques:
o Discuss 3 of the 5 following health care risk categories, as well as their corresponding risk identification technique:
 Financial.
 Human capital.
 Clinical.
 Strategic.
 Legal/ethical.
o What risk management strategies will the organization use to identify potential organizational risks? Be sure your narrative identifies and describes such risk identification techniques as concurrent, retrospective, incident-reporting, and previous trends.
 Note: These are only a few of the risk identification techniques to address in your policy and procedure. Be sure to include other examples you are aware of from your professional experience or from your readings.
o What are some specific examples of risks and their appropriate corresponding risk identification techniques? For example, coding errors are a type of financial risk. Retrospective auditing is the risk identification technique used to identify this risk type.
• Risk Manager’s Role in Program Implementation and Compliance:
o What is the risk manager’s role in risk management program implementation and compliance?
o How can a risk manager impact the effective management of the organization’s risk management program?
o What is one example from the literature that shows how the risk manager role can positively impact a health care organization’s management of its risk management program?
Part 2: Application of Risk Management Principles to a Specific Incident (3–4 pages)
To further help employees and the organization at large see risk management’s contribution to helping the organization achieve its safety and quality goals, your director has asked you to analyze and apply risk management principles to a recent incident that occurred in the organization. Your director has asked you to include all of the following headings in your analysis and to address all of the questions underneath each heading.
• Risk Description: Provide an overview of the risk including a description of the risk, implications to patients, and risk management strategies.
o Which potential risk to your organization from the Vila Health: Patient Safety simulation are you analyzing? These include a patient identification error, a medication error, and a HIPAA/privacy violation.
Selected safety issue is medication error, conversation from the simulation provided is as follows
Kyra Dilley: This is Kyra Dilley.
Arthur Chester: Hi, Kyra, this is Arthur Chester. I’m calling to let you know about a medication error on the eighth floor.
Kyra Dilley: Oh, no. Was it B. Moore or B.R. Moore?
Arthur Chester: How did you know? It was B. Moore, birthdate 8/11/05. My investigation isn’t complete but there were two patients with similar names and birthdates in rooms in close proximity.
Kyra Dilley: Okay. Have you interviewed the nurses involved yet? There should have been different nurses for each patient.

• Risk Implications: Propose evidence-based risk management strategies and techniques to identify and eliminate or reduce a particular risk.
o What are the risks to the patients, employees, and organization if this particular risk is not addressed? In other words, what could happen if the organization chooses to do nothing?
• Risk Reduction/Elimination: Propose evidence-based risk management best practices or strategies to identify and eliminate or reduce a particular risk.
o What evidence-based risk management best practices or strategies could the organization employ to eliminate or reduce the risk in the future? For example, if you plan to identify the risk by analyzing incident report data, would you conduct a drill down to determine what is causing the risk? What other best practices might you employ? Consult your suggested resources for guidance on best practices for eliminating and reducing risk.
o What steps would you take to implement your plan to eliminate or reduce your selected risk?
• Importance of a Risk Management Program: Explain the importance of a risk management program to health care organizations.
o Why is a risk management program important to an organization?
o What are some important elements of a risk management program?
o What is the organizational impact of not having a risk management program?
Please review the Risk Management Policy and Procedure Scoring Guide to ensure you understand the grading requirements for this assessment.
Additional Requirements
Your assessment should also meet the following requirements:
• Template: Use the Risk Management Policy & Procedure Template [DOC] to complete this assessment.
• Length: 6–8 double-spaced pages, excluding title and reference pages.
• Font and font size: Times New Roman, 12 point.
• APA format: Your submission— including the body, citations, and title and references pages— needs to conform to current APA format and style guidelines. Make sure that it is clear, persuasive, organized, and well-written, without grammatical, punctuation, or spelling errors. Also, you must cite your sources according to current APA guidelines.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
• Competency 1: Analyze the quality and performance improvement activities within the health care organization.
o Provide an overview of the risk including a description of the risk, implications to patients, employees, and organization if risk is not addressed, and risk management strategies.
o Propose evidence-based risk management strategies and techniques to identify and eliminate or reduce a particular risk.
• Competency 2: Explain the risk management function in the health care organization.
o Define key risk management terms.
o Describe the major risk categories in a health care organization, along with their corresponding risk identification techniques.
o Analyze the risk manager’s role in effective management of the organization’s risk management program.
o Explain the importance of a risk management program to health care organizations.
• Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with the expectations for health care professionals.
o Use correct grammar, punctuation, and mechanics as expected of an undergraduate learner.
o Writing adheres to APA formatting rules and APA writing style with few or minor errors.
Resources
Use the resources linked below to help complete this assessment.
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Risk Identification
• Use your Patient Safety Handbook to read the following:
o Chapter 9, “The Investigation and Analysis of Clinical Incidents,” pages 111–122.
• Simsekler, M. C. E. (2019). The link between healthcare risk identification and patient safety culture. International Journal of Health Care Quality Assurance, 32(3), 574–587.
• Hoarle, K. (2015). Risk management poised to grow as healthcare evolves. Biomedical Instrumentation & Technology, 49(6), 433–435.
• Riskonnect. (n.d.). What is risk management in healthcare – and why is it important? https://riskonnect.com/healthcare/what-is-risk-management-in-healthcare/
• Singh, B., & Ghatala, M. H. (2012). Risk management in hospitals. International Journal of Innovation, Management and Technology, 3(4), 417–421. http://www.ijimt.org/show-38-493-1.html
• Howell, A., Burns, E. M., Bouras, G., Donaldson, L. J., Athanasiou, T., & Darzi, A. (2015). Can patient safety incident reports be used to compare hospital safety? Results from a quantitative analysis of the English National Reporting and Learning System data. Plos One, 10(12).
• American Society for Heathcare Risk Management. (n.d.). Healthcare risk management: The path forward [PDF]. http://www.ashrm.org/pubs/files/white_papers/Executive-Summary_Risks-Rewards-Healthcare-Reform_FINAL2.pdf
• American Society for Healthcare Risk Management. (2014). Serious safety events: A focus on harm classification: Deviation in care as link Getting to Zero [PDF]. http://www.ashrm.org/pubs/files/white_papers/SSE-2_getting_to_zero-9-30-14.pdf
Risk Manager
• Use your Patient Safety Handbook to read the following:
o Chapter 17, “The Role of the Risk Manager in Creating Patient Safety,” pages 217–224.
• Risk manager responsibilities in hospital setting. (2021). https://work.chron.com/risk-manager-responsibilities-hospital-setting-17331.html
• Shostek, K. (2014). Risk manager’s perspective. AORN Journal, 100(4), 422–423.
• Sanders, P. (2016). Seven strategies for partnering with risk managers. Nursing Management, 47(10), 18–19.
Root Cause Analysis
• Ewen, B. M., & Bucher, G. (2013). Root cause analysis: Responding to a sentinel event [PDF]. Home Healthcare Nurse, 31(8), 435–443.
• Staff. (2013). 6 ways to improve your root cause analysis. Healthcare Risk Management, 35(7).
• Institute for Safe Medication Practices. (2010). Building patient safety skills: Common pitfalls when conducting a root cause analysis. https://www.ismp.org/resources/building-patient-safety-skills-common-pitfalls-when-conducting-root-cause-analysis
Sentinel Events
• Bean, M. (2022). 10 most common sentinel events of 2021: Joint Commission. https://www.beckershospitalreview.com/patient-safety-outcomes/10-most-common-sentinel-events-of-2021-joint-commission.html.
• Patient Safety Network. (2019). Adverse events, near misses and errors.https://psnet.ahrq.gov/primer/adverse-events-near-misses-and-errors.
• Darbyshire, P., Ralph, N., & Caudle, H. (2015). Nursing’s mandate to redefine the sentinel event. Journal of Clinical Nursing, 24(11/12), 1445–1446.
• Watson, D. S. (2009). Sentinel events. AORN Journal, 90(6), 926–929.
• Institute for Safe Medication Practices. (2010). Building patient safety skills: Common pitfalls when conducting a root cause analysis. https://www.ismp.org/resources/building-patient-safety-skills-common-pitfalls-when-conducting-root-cause-analysis.
Risk Mitigation
• Use the Patient Safety Handbook to read the following:
o Chapter 26, “Patient Handoffs—Perils and Opportunities,” pages 323–332.
o Chapter 28, “Identifying and Addressing Physicians at High Risk for Medical Malpractice Claims,” pages 347–368.
o Chapter 29, “Medical Malpractice Litigation: Conventional Wisdom Versus Reality,” pages 369–380.
• Use The Healthcare Quality Book to read the following:
o Chapter 9, “The Patient Experience,” pages 233–236.
o Chapter 10, “Safety Science and High Reliability Organizing,” pages 262–266.
Incident Reports
Review this resource to understand how incident reports can reduce medical errors in an important tool in risk reduction.
• Howell, A., Burns, E. M., Bouras, G., Donaldson, L. J., Athanasiou, T., & Darzi, A. (2015). Can patient safety incident reports be used to compare hospital safety? Results from a quantitative analysis of the English National Reporting and Learning System data. Plos One, 10(12).