Kaiser Permanente Risk Management Executive Summary Essay

Organization DescriptionKaiser Permanente (KP) is the nations largest coordinated wellness cautiousness legal transfer system. KP serves nine recounts and over nine billion members, with an yearly operating r veritable(a)ue in 2013 of 53.1 billion. KP is a loss leader in type amendment efforts in the health consider industry through p guileicipation in studies performed by the National Committee on whole step Assurance (NCQA), The Joint counsel (TJC) accreditations, and the effectuation of a state of the art electronic health records system, which foc holds on con substantialityation and calibre of cargon standardization. The focus of this abridgment is on KP hospitals in the northern atomic number 20 region and provide include topics such as the innovation of lay on the line and pure tone forethought, hazard acknowledgement and instruction, current perils, fictional character proceedss, shapingal goals, and the relationship surrounded by guess and w oodland counselling. seekiness and Quality centering PurposeGeneralThe purpose of take a chance perplexity in health complaint is simply the butt of protecting the assets and minimizing pecuniary injuryes to the formation (Singh & Habeeb Ghatala, 2012). A across-the- instrument panel take chances prudence schema indoors a health c are governance leave behind include focus on continual type cleansement (CQI). The purpose of CQI in health direction, according to Sollecito and Johnson (2013), is to stick out a structured organisational outgrowth for involving personnel in externalisening and execution a continuous flow of utilitys to bear prime(prenominal) health interest that meets or exceeds wantations (p. 4). Through linking the processes of essay caution and prime(a) onward motion the success of both processes is more likely to be realized. Kaiser PermanenteThe key concepts for adventure and flavor centering at KP are commitment to quality, tolerant safety, privacy protection, and subterfuge bar board. KP jeopardize instruction and quality commission curriculums are central to their mission, values, and culture. Methods currently apply to support these concepts deep down KP are consumer surveys, the use of an integrated EHR with evidence based guidelines and clinical decision- reservation functionality, stringent patient privacy edicts and processes, continuous clinical and administrative staff educational activity platforms, and participation in studies focused on standardizing national quality measures (Kaiser Permanente, 2012). stake realization and counselingStepsWhile KP is a leader in health shell out hazard and quality management in that location are specific steps this consultant is recommending on a continual terra firma that leave alone improve attempt denomination and management at heart the organization. 1. Identify and learn loss and exposureWhile there are many methods utilized w ithin the health care industry in the identification and abridgment of loss and exposure, the recommended methods for KP are as meets a) Incident-reporting compendiumb) cleansement on the current performance management process for employees to bring focus on risk mitigation and quality emolument. c) Quantitative analysis of patient complaints and satisfaction surveys. d) revaluation of the organizations medieval professional liability and workers compensation reports. e) palingenesis of surveys completed by TJC and NCQA on some other hospitals in modulate to come in risk areas that KP should focus on. (McCaffrey & Hagg-Rickert, 2009)2. Research and propose pick risk proficiencysTo mitigate risks that are inevitable at KP, a combination of alternative risk techniques will help centralise situations that might negatively affect the organization. A pecuniary analysis and risk analysis should be performed in order to regulate the likelihood of utilizing the exposure ob viateance technique. This is non a likely option as the financial impact of eliminating serve whitethorn out weigh the risks snarled with move them. A loss decrement snuggle is more likely to be the technique chosen for this organization. The core prevention activities that moldiness be present in the loss simplification technique are as follows a.) Ongoing staff educationb.) veritable insurance insurance and procedure criticism and smorgasbordc.) Updates to the organizations current EHR system to ensure the selective information present in the clinical decision- make and evidence-based clinical guidelines technology is the well-nigh current selective information available. According to Chen, et al (2009), a increment body of literature confirms the value of electronic health records (EHRs) in better patient safety, ameliorate coordination of care, enhancing documentation, and facilitating clinical decision making and adhesiveness to evidence-based clinical guideline s (p. 323). 3. essay management technique selectionThis two-part process of risk management technique selection is gracious through forecasting and application of an current measurement process, which will allow KP to give way the risk management technique with realise to outcome and cost effectiveness. intromitd in the measurement process both risk discourse and risk-financing techniques should be measured (McCaffrey & Hagg-Rickert 2009). 4. devour the selected techniquesImplementation of the chosen risk management techniques may include decisions on restitution coverage and policy changes, overall segment workflow changes to ensure contour with state and federally mandated regulations and guidelines, and elimination of processes that impede or immobilise patient safety. 5. Monitor and improve upon the implemented risk management program In order to continue improving upon the newly implemented risk management program a comprehensive observe strategy should be employ ed. In fact, McCaffrey and Hagg-Rickert, (2009) stated, a multidisciplinary approach to evaluating the risk management program ensures that the impact of additional opportunities to improve the risk management function are amply explored (p. 21). a.) Prepare an annual risk management reportb.) Compare the new annual report against prior years risk management data (McCaffrey & Hagg-Rickert 2009)Current take a chances terzetto risks that KP should take superfluous(prenominal) care to avoid are rejection of newly implemented risk management and CQI procedures by employees, statute andregulatory changes, and health care associated transmittals (HAIs). 1. RejectionChange implementation is never an easy task and without special care taken the rate of rejection to change by clinical and administrative employees is high. In order to achieve successful CQI changes the following guidelines and recommendations are presented. a.) Minimize employee rejection through easily implemented and followed CQI procedures. b.) Engage employees in planning to adjoin acceptance.c.) Ensure lateral linkages within the organization across specialty departments to improve communication (Sollecito and Johnson, 2013). 2. Statute and regulatory changesWith the dynamic landscape in state and federal statutes and regulations surrounding the health care industry, special attention to this risk area moldinessiness be taken. In fact, Cohen (2009) stated that health care is one of the most to a great extent regulated of all sectors of commerce (p. 328). ruin to comply with state and federal statutes and regulations corporation bring slightly negative financial affects at KP, including but not particular(a) to fines, loss of accreditation and credentialing, and an increase in malpractice lawsuits, not to mention a decrease in quality of care. a.) take chances management and quality improvement policemans stay current and involved in statute and regulation changes. b.) order educati onal goals for risk management and quality management policemans with regard to state and federal regulations. c.) Implement a monthly employee newsletter within which the risk management officer and quality improvement officer delimitate regulation changes. Include processes that employees should expect to hold in implemented to allege conformation. Include a signature page with those editions that include changes to policy and ensure all employees sign and income tax return to the human resources department. d.) Ongoing homework for clinical and administrative employees with regards to statute and regulation. The risk management and quality improvement officers will be responsible to work with the organizations education department to implement new workshops as needed. e.) Include these responsibilities in the performance monitoring strategy for the risk management and quality improvement officers. 3. HAIsHealth care associated contagions are a serious risk in hospitals, as n oted by Sydnor and Perl (2011), in their controversy HAIs are the most common forking seen in hospitalized patients (para. 20). Im good prevention rotter lead to increase costs, lengthier hospital stays, and even patient death. Additionally, a Condition of affaire (CoP) (42 CFR 482.42) by CMS mandates hospital infection take for programs to adhere to specific requirements. Recommendations are as follows. a.) Implement a house-keeping checklist to ensure fitting sanitization of patient rooms. b.) Implement a sanitization checklist for clinical staff that will enforce hand washing in the first place and after patient contact. c.) Develop a committee to review and revise the KP infection prevention and throw program. Revisions should focus on compliance with TJC and the Center for Disease govern (CDC) regulations. Quality OutcomesInternal and external common chord internal and external factors that influence quality outcomes are organization management of social relationships between physicians and patients, patient compliance, and continuity of care. Without fitting management of interpersonal relationships between physicians and patients, the organization will face degradation in trust and openness. Patients should be involved in all interposition decisions, through proper education on their diagnosis and treatment options. This will bring about patient engagement in this decision making process. While KP shadowernot force their patients to comply with treatment guidelines, the external influence of patient compliance is crucial to quality outcomes. Programs focused on thorough training and education of patients and family members will improve the rate of compliance, thus improving the probability of positive quality outcomes for patients. want of patient compliance will hinder the treatment process and lower the train of quality outcomes standards at KP. Continuity of care is another internal influence that can affect quality outcomes. Regular follow up with patients will also increase patient compliance. Without improving continuity of care, the KP organization will see a reduction in positive quality outcomes and an increased in undesired outcomes (DeHarnais, 2013, chp 5). GoalsShort-Term1. blueprint new regulatory and statute training programs for all clinical and administrative employees. 2. Review and revise the KP infection prevention and control program 3. Revise the performance management system to include CQI measurements and risk management procedures as performance metrics.Long-Term1. cast up adherence to state and federal regulations and statutes end-to-end the KP organization. 2. Reduce HAIs by 10% passim KP hospitals in the northern atomic number 20 region. 3. Improve CQI measurement and risk management policy adherence throughout the northern California region by 20% among clinical employees. Risk and Quality vigilanceRecommendationsRisk management policies1. Quarterly peer reviewThe Health do Qualit y benefit Act (HCQIA) of 1986 encourages hospitals, state licensing boards, and professional societies to identify and discipline physicians, dentists, and other health care providers who, after adequate, nondiscriminatory peer review, were found to guard engaged in inattentive or unprofessional conduct (Cohen, 2013 p. 333). Through current screening of new and current clinicians, KP will take responsibility for offering their patients that highest quality of care and reducing the risk of employing negligent clinical employees. 2. Zero tolerance adherence policy for all employees with regard to infection control procedures Part of the CMS CoP (42 CFR 482.42) regulation is the designation of an infection control officer and development of relevant policies that address the identification and control of infections and communicable diseases. Without full compliance with all CoPs, KP could face the loss of their Medicare provider agreement. 3. Vulnerability analysis chart and fate brake plan policy.According to Rawson and Hammond (2009) by evaluating vulnerabilities and taking appropriate preventive action, loss can be minimized in an emergency(p. 506). Health care facilities should include prevention measures in their emergency plans that include the risk of terrorist attacks. While terrorist attack risk cannot be completely mitigated, it is the responsibility of the health care facility to be prepared for such an emergency. Obtain additional information on including risk of terrorist attacks from the National Institute for occupational Safety and Health (NIOSH). Quality management policies1. Adherence to evidence-based clinical guidelinesWhile it has been shown that clinicians withdraw customarily enjoyed a great plentitude of autonomy in their practices (Argawal, 2010, para 3), it is self-asserting that clinicians follow evidence-based clinical guidelines. If exceptions should be make the details of, the patient diagnosis and variations should be pres ented for peer review prior to altering treatment plans. 2. Minimum score of 88% on customer satisfaction surveysClinicians must(prenominal) maintain an average score of no less than 88% on customer satisfaction surveys quarterly. In nowadayss health care market, measurements of quality include consumer satisfaction. In fact, Bernard and Savitz (2009) state that in todays rivalrous health care environment, consumers want and expect better health care services and hospital systems are concerned about maintaining their overall image (p. 185). Relationship between risk and quality managementIn the past, risk management officers and quality improvement managers worked autonomously from one another, in fact they most often reported to different superiors. However, today healthcare organizations are realizing that in order to reach quality of care goals and maintain effective risk management programs these disciplines must work together closely. An example of how risk management effo rts and quality improvement efforts concomitant one another is seen in the reduction of medical errors. The risk management plan must consider ways to humble medical errors, while the quality improvement plan will offer solid steps toward minimizing medical errors (Sollecito and Johnson, 2013). ConclusionThis digest focused on topics such as the purpose of risk and quality management, risk identification and management, current risks, quality outcomes, organizational goals, and the relationship between risk and quality management. While KP is the nations largest integrated health care delivery systems and leader in CQI standardization, there is always room for improvements. This consultant understands the importance of improvement at KP, thus humbly presents this summary and recommendations to the board of directors.ReferencesAgarwal, R. (2010, May). A Guideline for Quality Accreditation in Hospitals. Quality Digest, (), 1-4. Retrieved from http//www.qualitydigest.com/inside/twit ter-ed/guideline-quality-accreditation-hospitals.html Chen, C., Garrido, T., Chock, D., Okawa, G., & Liang, L. (2009). The Kaiser Permanente electronic health record Transforming and streamlining modalities of care. Health Affairs, 28(2), 323-33. Retrieved from http//search.proquest.com/docview/204522974?accountid=458 Cohen, M. (2009). Statutes, Standards, and Regulations (chp 10) in McCaffrey, J. J., & Hagg-Rickert, S. (2009) Risk guidance Handbook (5th ed.). San Francisco, CA Jossey-Bass. DesHarnais, S. I. (2013). The outcome model of quality (chp 5) in Sollecito, W. A. and Johnson, J. K. (2013). McLaughlin and Kaluznys Continuous Quality Improvement In Health Care (4th ed.). Jones and Bartlett Publishers. Emily R. M. Sydnor, Trish M. Perl (2011, January). Clin Microbiol, 24(1) 141173. Retrieved from http//www.ncbi.nlm.nih.gov/pmc/ members/PMC3021207/ Kaiser Permanente. (2014). Kaiser Permanente, Retrieved from http//share.kaiserpermanente.org/article/history-of-kaiser-permanente / McCaffrey, J. J., & Hagg-Rickert, S. (2009, Chp 1) Developing of a Risk Management Program in Risk Management Handbook (5th ed.). San Francisco, CA Jossey-Bass. Rawson, M. L. and Hammond, H. Y,. (2009) Emergency Management in McCaffrey, J. J., & Hagg-Rickert, S. (2009, Chp 7) Developing of a Risk Management Program in Risk Management Handbook (5th ed.). San Francisco, CA Jossey-Bass. Singh, B., & Habeeb Ghatala, M. (2012, August). Risk Management in Hospitals. International ledger of Innovation, Management andTechnology, 3(4). Sollecito, W. A. and Johnson, J. K. (2013). McLaughlin and Kaluznys Continuous Quality Improvement In Health Care (4th ed.). Jones and Bartlett Publishers.