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Regulatory Requirements, Leadership, and Risk Management

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Regulatory Requirements, Leadership, and Risk Management

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The Deficit Reduction Act of 2005 and the institution of the  Inpatient Prospective Payment System of 2007 were sentinel events for  health care leaders with respect to quality management and regulatory  compliance. The creation of Present on Admission (POA) and “never  events” accountability required health care leaders to change processes  and to assess and manage potential risks. Additionally, these events  required leaders to effectively intervene for assurance of quality care  or risk denial of payment for services (Youngberg, 2011, pp. 70–71, 78).  The era of accountable care organizations was driven by policy change.

Review the Hospital Acquired Condition (HAC) list from Appendix 7-B on page 79 in your Principles of Risk Management and Patient Safety text.

Imagine that you are the risk manager of an accountable care  organization. Select one never event from the list on page 79 and  describe how you would institute proactive monitoring for POAs. For this  discussion:

  • Describe how you would intervene when an HAC occurred.
  • Identify departments or functional areas that would be involved in reporting to regulatory entities.
  • Describe problem resolution.
  • Describe how you would use the data from the lesson learned for organizational improvement.

An outline format is acceptable for this discussion as long as you  include in-text citations. Distinguished posts will describe, in 1–3  sentences, the role of a risk manager and briefly define an accountable  care organization, using a government or other credible industry source.  Additionally, distinguished posts will include a short 3–5 sentence  summary on how to create a culture to enhance voluntary, non-punitive  reporting of “never events.” Include a minimum of one peer-reviewed or  best practice resource.

Initial posts should be based upon peer-reviewed, evidence-based  literature. In your post, include at least one APA-formatted in-text  citation and accompanying, congruent APA-formatted reference. Your  source can be a course textbook, assigned reading, or other scholarly  source.

Reference

Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones and Bartlett.

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