BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure

Part 1: Risk Management Policy and Procedure

Purpose Statement:

The risk management program (BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure) is a complete strategy that addresses organizational risks, risk solutions, and established rules and procedures. The risk management program contributes significantly to the organization’s quality of care by increasing patient safety. Risk managers work closely with the quality and safety departments to create and maintain a structured and safe workplace for patients and employees (McGowan et al., 2023). This program is essential for creating a safety culture, maintaining regulatory compliance, and reducing possible risks to patient outcomes and organizational efficiency.

Related Assessment:
BHA FPX 4004 Assessment 1 Address a Patient Safety Issue

Key Risk Management Terms

1. Risk Prevention: 

Risk prevention refers to proactive efforts done to prevent the occurrence of potential risks. This includes identifying possible risks, analyzing their likelihood and effect, and putting solutions in place to avoid these risks (Thomas, 2022). The objective is to establish a safe environment by removing or reducing potential sources of risk before they cause harm. For example, to avoid transmitting infections within the hospital, implement a required hand-washing protocol for all healthcare workers. 

2. Risk Reduction

Risk reduction is the process of taking steps to reduce the possibility or effect of risks that are not completely preventable. Implementing controls, modifying procedures, and training employees can all help to limit the consequences of possible risks (Lutkevich, 2021). Risk reduction is concerned with limiting the implications of risks to assure less severe results if they occur. For example, bedside alarms on hospital beds can help minimize the likelihood of patient falls. Even though falls cannot be totally avoided, these alarms notify personnel when a patient who is at high risk of falling attempts to get out of bed, providing immediate help.

3. Regulatory Compliance

Regulatory compliance involves following laws, rules, guidelines, and specifications that apply to the organization’s operations. In healthcare, this involves adhering to regulating organizations’ criteria for patient safety, quality of care, and ethical behaviors (Young & Smith, 2022). Compliance enables firms to avoid legal fines, improve their brand, and assure high levels of care. For example, ensuring that all healthcare practitioners inside the business are qualified and follow the Health Insurance Portability and Accountability Act (HIPAA) rules to preserve patient privacy and health information.

4. Patient Safety

Patient safety is the prevention of injury to patients during the course of healthcare delivery. It entails developing methods and procedures that reduce the likelihood of mistakes, injuries, accidents, and infections (World Health Organization, 2023). Patient safety is a critical component of healthcare quality, ensuring that medical care does not cause undue harm to patients. For example, using barcoding systems for medicine administration to verify that the correct medicine is given to the correct patient at the correct time and dose. 

5. Adverse Event

An adverse event is any unanticipated damage to a patient caused by medical care or therapy, rather than the patient’s underlying disease. This might involve medical blunders, problems, or injuries sustained during medical operations or treatments. Adverse events underscore the importance of comprehensive risk management and quality improvement programs (Rodziewicz, 2023). For example, a patient can experience a severe allergic response after getting a drug to which they are allergic, despite having their allergy listed in their medical records. 

6. Near Miss

A near miss is an event or situation that could have caused harm to a patient but did not, either by accident or due to prompt action. Near misses are important for learning and development in healthcare because they reveal possible flaws in procedures and systems without causing the negative repercussions of real adverse occurrences. Identifying and analyzing near misses can assist in preventing future accidents (Sheikhtaheri, 2021). For example, a nurse almost gave a patient the wrong prescription but realized it when she double-checked the patient’s wristband and medication order. 

Risk Categories and Risk Identification Techniques

1. Financial Risk

Financial risk in healthcare refers to the possibility of financial losses caused by a variety of reasons such as reimbursement rate changes, patient volume fluctuations, billing mistakes, fraud, and malpractice claim expenses (Pisu & Martin, 2022). Financial audits are a risk-identification technique.

Technique Explanation: Regular financial audits are performed to ensure that all financial transactions are appropriately recorded and that there are no irregularities. These audits aid in identifying possible financial risks such as billing problems, fraudulent activities, and inefficient financial management. By evaluating financial accounts, cash flow, and billing procedures, the firm may identify and manage financial concerns early. For example, an audit exposes a pattern of coding mistakes in insurance claims, resulting in denied claims and revenue losses.

2. Human Capital Risk

Human capital risk refers to risks linked with the workforce, such as staffing, employee turnover, training, competency, and workplace safety. These risks can influence the quality of treatment delivered, staff morale, and overall organizational success (Zhenjing et al., 2022). Employee surveys and performance reviews are effective risk identification techniques.

Technique Explanation: Regular employee surveys and performance evaluations aid in detecting human capital concerns. Surveys can give information on employee happiness, engagement, and areas of concern, whereas performance reviews analyze individual capabilities, identify training requirements, and evaluate overall workforce performance. For example, a poll of nursing staff found significant levels of work dissatisfaction and burnout.

3. Clinical Risk

Clinical risk is the possibility of unfavorable outcomes and harm for patients as a consequence of clinical treatments and practices. This covers potential medical mistakes, infections, treatment problems, and general patient safety (Rodziewicz, 2023). Risk Identification Technique: Incident Reporting Systems

Technique Explanation: By implementing a strong incident reporting system, healthcare practitioners can record any clinical occurrences, near misses, or adverse events. Analyzing these reports aids in detecting patterns, root causes, and potential areas for improvement in clinical procedures and patient care systems. For example, the event reporting system identifies a sequence of medication mistakes in a particular unit. A root cause analysis finds that similar-looking drug packaging is confusing.

Risk Management Strategies

1. Employee Education

Annual training modules on risk management strategies are implemented for all employees (Risk management, 2022). For example, mandatory online training sessions are conducted annually to educate staff on the latest protocols, incident reporting procedures, and patient safety practices. This ensures that all employees are aware and can effectively contribute to the organization’s risk management efforts.

2. Documentation

Ensuring complete and precise recording of all risk events (BY TEAM SAFESITE , 2020). For example, thorough incident reports are required for any bad occurrences, near misses, or recognized dangers. These reports should provide a detailed description of the occurrence, relevant circumstances, and measures taken. Accurate documentation helps to analyze patterns and devise preventive actions.

3. Departmental Preparedness

 Promoting departmental unity via best practices (Bullock et al., 2019). For example, have monthly departmental meetings to discuss and evaluate optimal risk management methods. This encourages teamwork and ensures that all team members have a consistent approach to identifying and reducing risks.

4. Patient Concerns

Patient concerns are investigated and resolved in a timely and effective manner (Pichert et al., 2019). For example, establishing a dedicated patient feedback system allows patients to submit problems or complaints. The risk management team evaluates these issues, takes remedial action, and follows up with patients to ensure a satisfying resolution.

5. Participation in Surveys

Participating in state, federal, and regulatory surveys. For example, actively participating in surveys done by state health departments, federal authorities, or accreditation bodies. Participation allows the company to benchmark its performance, find areas for development, and remain compliant with regulatory standards (Regulation, 2020).

Examples of Risks and Corresponding Risk Identification Techniques

1.Coding Errors (Financial Risk)

  • Risk Identification Technique: Retrospective Auditing
  • Example: Reviewing medical records and billing codes after services to identify discrepancies and errors.

2.Medication Errors (Clinical Risk)

  • Risk Identification Technique: Incident Reporting Systems
  • Example: Documenting and analyzing medication errors reported by staff to prevent future occurrences.

3.Patient Falls (Safety Risk)

  • Risk Identification Technique: Concurrent Monitoring
  • Example: Using alarms to monitor at-risk patients in real-time to prevent falls.

4.Regulatory Non-Compliance (Legal/Ethical Risk)

  • Risk Identification Technique: External Benchmarking
  • Example: Participating in accreditation surveys to ensure compliance with standards.

5.Healthcare-Associated Infections (Clinical Risk)

  • Risk Identification Technique: Root Cause Analysis (RCA)
  • Example: Investigating infection cases to identify causes and improve prevention measures.

Risk Manager’s Role in Program Implementation and Compliance

In healthcare organizations, a risk manager plays an important role in establishing and enforcing compliance with a risk management program. Risk managers have an important role in detecting, analyzing, and reducing risks in order to improve patient safety, operational efficiency, and organizational resilience (Ferdosi et al., 2020). They serve as catalysts for successful risk management by organizing cross-departmental plans, cultivating a safety culture, and ensuring regulatory compliance.

Risk managers that actively participate in risk management program implementation guarantee that policies and procedures are properly communicated and implemented throughout the company (Blundo et al., 2021). They organize training sessions, perform audits, and monitor adherence to established processes in order to reduce risks and improve outcomes. This proactive strategy not only reduces possible risks, but it also strengthens the organization’s reputation and operational integrity.

An example from the literature shows how a risk manager’s position benefits healthcare businesses. Kiman  (2023) discovered that risk managers who actively collaborated with clinical teams and administration to apply  risk management techniques decreased adverse occurrences and improved patient outcomes. Their engagement in performing root cause analyses and adopting preventative measures aided in the identification of systemic issues and the development of a culture of continuous improvement.

Part Two: Application of Risk Management Principles

Risk Description: Patient Identification Errors

Patient identification errors are serious risks in healthcare settings since they can lead to improper treatments, drug errors, or operations conducted on the wrong patient. These mistakes jeopardize patient safety and care quality, presenting ethical, legal, and operational issues to healthcare institutions (Biro et al., 2022). Without effective identification methods, patients may face delays in getting appropriate care or even injury from therapies designed for others. This condition has a direct influence on patients, as well as healthcare providers’ morale and the organization’s reputation.

Risk Reduction/Elimination:

Healthcare organizations can utilize solutions to better manage and eliminate patient identification errors. These include developing established processes for patient identification, such as requiring two identifiers (e.g., name and date of birth) before beginning any therapy or surgery. Regular hospital-wide audits are required to discover and fix anomalies in patient identification procedures (Abugabah et al., 2020). These audits aid in identifying systemic problems and assuring compliance with defined processes.

Patient identification errors can be reduced significantly by education and training. Healthcare workers should get continual training on correct identification processes and the significance of accuracy in patient records (Bell et al., 2020). Using technological solutions such as barcode scanning or biometric identification systems can improve the accuracy and reliability of patient identification operations.

Importance of a Risk Management Program:

Healthcare organizations must implement a thorough risk management approach to ensure patient safety and excellent service delivery. It includes proactive strategies for identifying, assessing, mitigating, and monitoring risks in all areas of healthcare operations (Organization, 2021). Prioritizing patient safety via effective risk management may help firms comply with regulatory standards, improve patient outcomes, and preserve trust and confidence among patients and stakeholders.

Conclusion – BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure

Patient identification errors in healthcare settings offer major risks including the possibility of performing incorrect treatments or operations on the wrong patient, endangering patient safety and care quality. Effective risk management techniques, such as standardized patient identification processes, frequent audits, staff education, and technology solutions like barcode scanning, can assist in reducing these risks. Implementing a strong risk management program improves patient safety while also ensuring regulatory compliance, operational efficiency, and corporate reputation. Healthcare organizations that manage risks proactively may maintain high standards of care, enhance results, and promote confidence among patients and stakeholders.

References

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Abugabah, A., Nizamuddin, N., & Abuqabbeh, A. (2020). A review of challenges and barriers implementing RFID technology in the Healthcare sector. Procedia Computer Science, 170(1), 1003–1010. https://doi.org/10.1016/j.procs.2020.03.094

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Bell, S. K., Delbanco, T., Elmore, J. G., Fitzgerald, P. S., Fossa, A., Harcourt, K., Leveille, S. G., Payne, T. H., Stametz, R. A., Walker, J., & DesRoches, C. M. (2020). Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes. JAMA Network Open, 3(6), e205867. https://doi.org/10.1001/jamanetworkopen.2020.5867

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Biro, J., Rucks, M., Neyens, D. M., Coppola, S., Abernathy, J. H., & Catchpole, K. R. (2022). Medication errors, critical incidents, adverse drug events, and more: a review examining patient safety-related terminology in anaesthesia. British Journal of Anaesthesia, 128(3), 535–545. https://doi.org/10.1016/j.bja.2021.11.038

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Blundo, D. S., Sánchez, R. G., Salgado, S. M., & Muiña, F. E. G. (2021). Flexibility and Resilience in Corporate Decision making: a New sustainability-based Risk Management System in Uncertain Times. Global Journal of Flexible Systems Management, 22(2). https://link.springer.com/article/10.1007/s40171-021-00277-7

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Bullock, J. A., Haddow, G. D., & Coppola, D. P. (2019). Mitigation, Prevention, and Preparedness. Introduction to Homeland Security, PMC7158272, 435–494. https://doi.org/10.1016/B978-0-12-415802-3.00010-5

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: BY TEAM SAFESITE . (2020, February 27). Incident Report Samples to Help You Describe Accidents. Safesite. https://safesitehq.com/incident-report-samples/?

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Ferdosi, M., Rezayatmand, R., & Taleghani, Y. M. (2020). Risk Management in Executive Levels of Healthcare Organizations: Insights from a Scoping Review (2018). Risk Management and Healthcare Policy, Volume 13(1), 215–243. ncbi. https://doi.org/10.2147/rmhp.s231712

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Kimani, P. (2023). Risk Management Strategies for Healthcare Organizations: A Comparative Analysis of Patient Safety Measures in Kenya. International Journal of Modern Risk Management, 1(2), 1–9. https://doi.org/10.47604/ijmrm.2142

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Lutkevich, B. (2021, October). What is Risk Mitigation? Definition, Strategies and Planning. SearchDisasterRecovery. https://www.techtarget.com/searchdisasterrecovery/definition/risk-mitigation

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: McGowan, J., Wojahn, A., & Nicolini, J. R. (2023). Risk management event evaluation and responsibilities. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559326/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Organization, W. H. (2021). Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care. In Google Books. World Health Organization. https://books.google.com.pk/books?hl=en&lr=&id=csZqEAAAQBAJ&oi=fnd&pg=PR7&dq=Healthcare+organizations+must+implement+a+thorough+risk+management+approach+to+ensure+patient+safety+and+excellent+service+delivery.+I&ots=xKR381jjss&sig=PVo0o-LL06PMSoVbCx5KTBeyrcc&redir_esc=y#v=onepage&q&f=false

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Pichert, J. W., Hickson, G., & Moore, I. (2019, August). Using Patient Complaints to Promote Patient Safety. Nih.gov; Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK43703/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Pisu, M., & Martin, M. Y. (2022). Financial toxicity: a common problem affecting patient care and health. Nature Reviews Disease Primers, 8(1). https://doi.org/10.1038/s41572-022-00341-1

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Regulation, I. of M. (US) C. on N. H. (2020). Monitoring Nursing Home Performance. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK217555/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Risk management. (2022, July 26). Implementing risk management training and awareness (part 1) RISK-ACADEMY Blog. Risk Academy . https://riskacademy.blog/implementing-risk-management-training-and-awareness-part-1/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Rodziewicz, T. L. (2023). Medical error reduction and prevention. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Sheikhtaheri, A. (2021). Near Misses and Their Importance for Improving Patient Safety. Iranian Journal of Public Health, 43(6), 853–854. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4475608/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: Thomas, C. (2022). Five Steps of Digital Risk Management Process | 360factors. 360factors.com. https://www.360factors.com/blog/five-steps-of-risk-management-process/

BHA FPX 4004 Assessment 2 Risk Management Policy and Procedure: World Health Organization. (2023, September 11). Patient safety. World Health Organization; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/patient-safety

Young, M., & Smith, M. A. (2022, December 13). Standards And Evaluation Of Healthcare Quality, Safety, and Person Centered Care. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK576432/

Zhenjing, G., Chupradit, S., Ku, K. Y., Nassani, A. A., & Haffar, M. (2022). Impact of employees’ workplace environment on employees’ performance: A multi-mediation model. Frontiers in Public Health, 10(890400). Ncbi. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9136218/

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