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

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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?

Regulatory Requirements, Leadership, and Risk Management