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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.

Response Guidelines

Respond to the posts of other learners according to the Faculty  Expectations Response Guidelines. If possible, respond to one learner  who has a perspective, background, or goals that are similar to yours,  and to one learner whose perspective, background, or goals are  different. Peer responses should be substantive and need to include one  peer-reviewed source that aligns with the discussion thread. You may  feel free to add an additional source that is new or provides a  completely different perspective. “I agree” and “Thanks for sharing your  insights” are examples of responses that do not contribute content for  enhanced learning and are unacceptable. The goal is quality, substantive  feedback that demonstrates higher order critical thinking and  evaluation of peers’ initial posts.

Resources

  • Discussion Participation Scoring Guide.
  • APA Style and Format.
  • Capella Library.
  • How Do I Find Peer-Reviewed Articles?.
  • Interpretations of Integration in Early Accountable Care Organizations.
  • Sustainable Competitive Advantage for Accountable Care Organizations.

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Research and Resources

Being part of a close community of people who share your interests  can be a great advantage to your professional and intellectual  development.

This course requires you to discover and utilize peer-reviewed and  professional resources for discussions and assignments. For this  discussion’s initial post, please share the complete citation of an  article or resource you have discovered. It could be an interesting  source but one not yet used in the course. Provide a brief summary of  the content and what search terms or tactics you used to find this  resource. How useful was the resource? Will it be something you will  continue to refer to throughout the course or in your professional work?  If the resource was not what you needed for your research, would you  recommend it for someone else’s topic?

Response Guidelines

Respond to the posts of other learners according to the Faculty  Expectations Response Guidelines. If possible, respond to one learner  who has a perspective, background, or goals that are similar to yours,  and to one learner whose perspective, background, or goals are  different. In your responses, ask questions or share search terms. This  is a chance for you to discuss the scholarly research process and the  successes you have or obstacles you may encounter.

Resources

  • Discussion Participation Scoring Guide.
  • APA Style and Format.
  • Capella Library.
  • How Do I Find Peer-Reviewed Articles?.

 

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