Risk Scenario

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Quality Improvement in Healthcare

Course Project

HIM420

By:

Karon O’Brien

Table of Contents

IntroductionPage 3

Risk Scenario Related to Patient Care and SafetyPage 5

Risk Scenario Related to the Physical PlantPage 9

Risk Scenario Related to StaffingPage 13

Best Practices in 4 HospitalsPage 15

Tenet Healthcare Page 16

Cleveland Clinic Stroke Improvement PlanPage 17

ConclusionPage 18

ReferencesPage 19

Introduction

The issue of risk scenario carries immense importance for most of the hospitals that are part of the healthcare setting. However, there is not only one scenario that can affect the hospitals but there are several scenarios that can create an impact on the functions of the hospital. There are three scenarios that would be highlighted in the current topic. These three scenarios have a tendency to put a hospital at risk for financial stability. The first scenario that can produce a negative impact on the hospital risk is related to patient care and safety. The second scenario is related to the physical plant. The third and last scenario is related to staffing. The role of HIM practitioner in this regard would be very important. They would serve as a clinical quality assessment resource and as a team member to perform their tasks related to healthcare work. Therefore, all the issues related to three scenarios will be discussed in detail.

The impetus for quality improvement has been driven in recent years by three main factors:

1. The amount of money that the US spends on healthcare per capita and as a percent of GDP is far higher than any other country in the world. We spend 15% of GDP, with the next-highest countries, Germany and France, at 10% of GDP. This high level of spending has not brought higher life spans or quality of life years. Those who pay the bills are therefore asking if they are getting quality for the money that we are spending on our health care.

2. The healthcare institution is under competitive pressure in a way that was less obvious in previous decades. Alternative healthcare delivery means have been encroaching on the market share of “traditional” hospitals and clinics. HMO’s have brought a capitated model with an emphasis on preventative care. Specialist hospitals have focused on high-profit procedures, such as heart catheterization and orthopedics, leaving traditional hospitals less-profitable procedures. These alternative institutions compete not on price, but quality of the outcomes and the patient experience. Traditional healthcare institutions must therefore adapt in order to compete.

3. States and the federal government are now implementing quality measurements into healthcare procedures. Some states, such as New York and Massachusetts, have published results. The trends in hospitals and by specialty are clear: quality is not only measured on an absolute basis, but compared across specialties and institutions. Those hospitals and clinics which fail to continuously improve their quality—measured in patient outcomes—will fall behind in their census and the ability to attract top healthcare staff.

The above trends make quality improvement particularly necessary in today’s environment. Healthcare institutions have tried to incorporate quality improvement schemes from industry, but the success has been mixed at best. The most common attempt has been with procedures-based medicine, in which best practices are inculcated amongst staff, and specific procedures are to be followed. These measures have led to resistance from staff, as comparability between patients has been challenged.

Risk Scenario Related to Patient Care and Safety

The exposure of the staffing reduction in healthcare facilities, preventable medical errors requires more than attention to the quality of health...
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