Risk Management Program
The ever changing regulations and numerous by laws enacted by relevant bodies continue to make risk management program a number one priority program in the modern dynamic enterprise environment. Health care facilities have not been left out in managing various risk programs. They operate under various bodies with different demands and standards which they must follow to avoid legal consequences.
In the 21st Century, risk management has dominated board list of priorities. This is because of numerous threats to an organization continuity and efficiency. It is important to note that the growing concern over risk management programs have been fueled by the fact that the modern risks are virtually foreseeable and easily manageable when diagnosed early. Organizations that do not have a strategic risk management program exposes themselves to unnecessary legal battles and liquidity problems as a result of numerous fines and court cases. Madigram Army Medical Centre Risk Management Program and Analysis
Just like any other health care facility, MAMC is subjected to various regulatory bodies such as Centre for Medicare and Medicaid services (CMS), National Institute of health, the department of Justice (DoJ), office of the inspector general (OIG) among others. The center must conform to all the requirements to avoid being struck of federal health care program. It also owes patients quality and approved medical services to improve their quality of life with utmost professionalism.
According to Smith and Seligman (2015), the first step towards risk management is risk assessment. This is then followed by risk remediation, risk auditing and finally risk response and reporting. The facility has clearly listed various risks that are likely to cripple its operations and the management is always on the look out to ensure these risks are contained through periodic reviews. The facility management always brief the board about some of these risks to keep them informed of various regulation changes such as congress by laws, other health agencies reviews and communications concerning public changes as well as federal government health care reforms.
The facility is implementing health insurance portability and accountability act (HIPAA) of 1996. This is in line with protection of an individual health records and ensuring the information is secured. The hospital is implementing electronic health record system to ensure total compliance and also to instill confidence among the people they serve about their ethical practices.
Furthermore, the hospital is implementing emergency medical treatment and active labor act (EMTALA). This is one of the rigorous regulations facing health care facilities. The office of inspector general is always required to submit biannual report about past records regarding some of the measures taken against health care institutions violating the law. MAMC complies with this regulation through offering adequate stabilization and screening services as well as provision of on-call specialist care for all emergency situation made to the institution.
Additionally, the hospital partners with approved medical equipment manufacturers and suppliers to conform to the quality of care requirement. It also offers competitive employment opportunities through a rigorous selection and recruitment of qualifies and certified health professionals to ensure service quality always remain a plus.
However, there are a number of risk management programs that are missing or have been kept under the carpet by the facility which may spell doom for its future participation in the federal health programs. There is poor cost reporting in the organization. The hospital does not use the set standards in reporting its various cost. In some instances, unallowable costs found their way in the final cost report. This automatically falsify the report real figures and can is subject to either administrative, civil or criminal punishment. This may dent the image of the hospital in its annual financial reporting. It may lose credibility and may compromise its credit worthiness among lenders if it cannot keep to the cost reporting standards.
Another area of great concern regards to managing risks associated with overpayment and audits. There are no programs in place to cover these two important risk factors which any organization can face in the cause of providing services and assessing its managerial and operations efficiency. Every health care institution should implement these two programs to safeguard contractual agreements and avoid financial losses as well as legal challenges with their suppliers and other service providers. (Young and Tippins, 2011).
Also, there is low risk awareness among junior employees. It is only the board of management and senior health care practitioners that are aware of various risks likely to face the organization in its quest to improve the quality of life in the region. This is likely to derail risk response and reporting among junior staff (singh, 2011). The organization may then find itself at the center of conflict arising from negligent act of its junior employees which could have been avoided if the whole institution healthcare fraternity are from time to time briefed about changes in laws together with revision of various medical code of ethics which they must comply with while administering services to their patients.
MAMC Moving Forward
There is an imperative need to for the center to improve on some of its risk management program. Effective risk management program is the only avenue that the hospital will use to surge its presence in the competitive industry and be known for best health care service provision and an award institution in the coming years. These improvements must be communicated from the top to the bottom to enhance efficiency and success across the various level of representation in the hospital.
Next, the organization should enhance risk management program transparency across its various departments. Evidently, the hospital seem to have disregarded the input of junior staff in risk management. They are supposed to be informed about emerging issues and trends affecting the health care sector. This will give them an opportunity to rethink of their working ethics and areas of improvement to conform to the current regulations and practices in provision of quality care.
Lastly, the facility needs to implement a risk management system (RMS) to help keep track and remedy some of the most urgent regulations that require immediate implementation. An effective RMS will always capture various policy changes and regulations in the health care industry and update them in real time on the company data base. The hospital environment is always characterized by busy schedules and emergency response 24/7 and it will be difficult to keep up with the current flow of information concerning the industry at all time without RMS supported by an efficient and reliable information management system (IMS).
Reference
Moeller, R. R. (2013). Executive's guide to IT governance: Improving systems processes with service managment, Cobit and ITIL. Hoboken (N.J.): John Wiley.
Singh, T. (2011). Risk Managment. New Delhi: Maxford Books
Smith, M. Y., & Seligman, P. J. (2015). New Opportunities for Integrating Drug Safety Risk Management Programs Into the Health Care System. Jama, 314(17), 1793.
Young, P. C., & Tippins, S. C. (2011). Managing business risk: An organization-wide approach to risk management. New York: AMACOM.
