Compliance and Risk Management Essay Example

For a compliance and risk management plan to be efficient it must have a proposal, and explanation of duties of the board of directors and the board of committee’s and have a code of conduct (Ryan, 1997, VOL.51). Madison Hospital is a small rural hospital in North America, the population demographics are elderly White, Black, Chinese, Hispanic or Latino culture, 35% women and 65% male, and the poverty level is 35%; with 5% white, 11% Black, 12% Hispanic or Latino, and 7% Chinese. When conducting an evaluation for your organization policies and procedures, the demographics of the area will need to be considered. The policies and producers are rules that have been put in place to ensure the safety of the employees and patients. 

Compliance and Risk Management Plan

A compliance and risk management plan must be suitable to the demographic environment of the organization, making sure that the policies, procedures, regulations, and laws of the state and government are complied with for each member of the staff, employees, and providers. As a manager, license, certifications, and accreditations are verified and approved by the state. 

In the compliance and risk plan I will be addressing safety, rules, laws, and regulation to Madison's Hospital. First, safety inside the hospital. Patient monitoring is the most important thing here, making sure that patients are in the right place at the right time, the right patient is receiving the right care, treatment plan, and procedure. What this means is that each system here at Madison Hospital is obligated to ensure patient safety. For the front office administrators, make sure to verify insurance, patient’s information, and that confidentiality of patient’s records. For the nursing staff, they ensure the 7 rights: the right patient, the right drug, the dose, the right time, the right route, right reason, and the right documentation. For the providers, remember the rights of the patient; the right to be treated with respect, the right to obtain their medical record, the right to privacy, the right to informed consent, and their right to make decisions about end-of-life care. Employees, staff, and providers should enforce that patients are in the “patient designate area”, ensure that documentations are secure, and ensure your own safety when handling disrespectful patients.

The rules for Organization are to be followed to guidelines of state and federal laws, if a member of the staff, employees, or provider does not to follow the regulations of the state, federal, or organization policies and procedures disciplinary actions will be taken: reported to you Accredited Licensor, the Board of this Hospital, and to the Medical Board. Each system will have a different set of rules and responsibilities that keep him or her in compliance to the Organization’s Vision, Value, and Mission. These rules will be instructed to you doing orientation, with documentation in a designed location, and the staff, employees, and providers will continue to receive work related training through in-house programs, online programs, and selected classes.

The Laws to Comply With

The laws and regulations are different for each system or each employee, staff, and provider. Each system will have their own employment regulations and each system in the hospital will have their own additional laws. Everyone one should uphold the regulation and laws of the Organization:

For Patients’:

• HIPAA Privacy Rule

• HITECH Act

• Patient Safety

• Patient Confidentiality

• Fraud and abuse of patients’ record and payment

Workplace Rules:

• Employees responsibilities 

• No toleration for Harassment 

• Bullying 

Our Organization will provide employees, staff members, and providers with materials to help prevent these unethical obstacles from occurring by conducting overall audits every month, introducing a check and balance system for all systems, providing employees an anonymous hotline for “whistle blowing”, and conducting SWOT analysis to ensure employees, staff, and providers are valuable forward movement.

The Second part of the Compliance and Risk Management Plan is informing the employees, staff, and providers of the risk factors of hospitals and the solutions. The risks in the Organization are chemical risks, medications risks, patient risk, employee risk, and documentation risk. These are some of the important, more obvious risks, we will talk about some solutions. 

When an employee, staff member, or provider is handling chemicals; whether it is for transport, distribution, or handling the containers; please follow all instructions that are placed on the workstation for that chemical or the instructions that are written on the chemical’s label. Members that are not approved to handle certain chemicals should not do so. 

For medication, nurses should again consider the 7 rights. Medication should not be left out, in front of a patient or in or outside of its container. Medication should be documented and accounted for, there is a sheet inside the medication lab that staff should document all medication going in and out, providers need to document the medication amount, the patient it was used for, and the dose. If there is a chance that you find that someone you know or do not know but have seen him or her mistakenly miss a patient’s dose, report that person to your department supervisor, HR, and call the anonymous hotline that is provided to all employees, staff members, and providers. 

Patient risk is harm, fraud and abuse, and disrespect towards patients and their family members. Patients are not allowed in employee, staff members, and providers workspaces. Patients are not allowed medical records unless the patient has followed the laws and regulation procedures that are in place by Organization, State, and Federal government. For front desk administers; patient records are confidential, patient records are sealed, treated with respect, and insurance is processed and collected correctly. For nurses, patients will be treated with respect, patient documentation verified with patient, patient mentoring, and procedures corrected done correctly and verified with the patient's treatment plan. For providers, patient insurance claims are treatment plan authorized, patients are treated with respect, and providers are encouraging open discussions with patients.