Regulatory Requirements, Leadership, and Risk Management
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.