MHA-FP5014Hlth Care Quality Risk- Regulatory bodies oversee the subsector of the health care industry

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as a part of your assessment.
The Regulatory Environment:
• Which regulatory bodies oversee the subsector of the health care industry in which you currently work or would like to work?
• How would you figure out which organizations oversee the subsector?
• How would you determine which laws apply to your setting and what type of data you need to collect and examine?
• What are the standards of care?
• How would you locate these standards?
• How would you know if your organization exceeded those standards and might be in a position to apply for accreditation?
Establishing a Culture of Patient Safety:
• What is an example of a best practice for establishing a systems-based culture of patient safety?
• How will you know if your organization was identified as an example of success when best practices are used?
Benchmarking:
• What types of processes exist for collecting and analyzing data to identify trends in the performance of your health care setting?
• Who are some of the health care industry's best performers in terms of risk management?
• What types of benchmarking data are important to consider?
• What roles within your own organization need to be involved in a proactive risk-management program?
• What are some critical success factors for the establishment of a systems-based risk-management program?
• What types of considerations or cautions are important to keep in mind when interpreting internal and external benchmarking data?
Resources
Required Resources
The following resource is required to complete this assessment.
• Executive Summary Table [DOCX].
Suggested Resources
The resources provided here are optional and support the assessment. They provide helpful information about the topics. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The MHA-FP5014 – Health Care Quality, Risk, and Regulatory Compliance Library Guide can help direct your research. The Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you.
• Terminology Drag and Drop | Transcript.
Accountable Care Organizations
This article discusses how a health care facility transitioned into an Accountable Care Organization successfully.
• O'Connor, J. (2016). An ACO success story. McKnight's Long-Term Care News, 37(1), 27.
This article discusses how ACOs have achieved cost savings while improving care for their patients.
• Perez, K. (2014). ACOs and the quest to reduce costs. Healthcare Financial Management, 68(9), 118–122.
Quality Improvement Strategies
This article examines the revised nursing home quality measures endorsed by the National Quality Forum which could best represent the improving quality of care in nursing homes.
• Barr, P. (2011). Setting higher standards: Nursing home quality measures offer guide. Modern Healthcare, 41(18), 17–19.
This article examines the various domains associated with quality improvement in healthcare organizations.
• Brandrud, A. S., Nyen, B., Hjortdahl, P., Sandvik, L., Haldorsen, G. S. H., Bergli, M., . . . Bretthauer, M. (2017). Domains associated with successful quality improvement in healthcare - a nationwide case study. BMC Health Services Research, 17.
This article explains the key role that leadership plays in supporting and aligning staff for patient care using the Malcom Baldrige criteria as a path to quality excellence.
• Miller, R. P. (2007). Baldrige as a path to excellence. Modern Healthcare, 37, 23–24.
This article explores how hospital managers perceive lean in the context of quality improvement.
• Savage, C., Parke, L., von Knorring, M., & Mazzocato, P. (2016). Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement. BMC Health Services Research, 16.
This article discusses methods for auditing cost and quality tailored to a hospital’s specific population.
• Silber, J. H., Rosenbaum, P. R., Ross, R. N., Ludwig, J. M., Wang, W., Niknam, B. A., . . . Fleisher, L. A. (2014). A hospital–specific template for benchmarking its cost and quality. Health Services Research, 49(5), 1475–1497.
This article focuses on the factors affecting the adoption of innovative assurance technologies in nursing care.
• Storey, J. (2013). Factors affecting the adoption of quality assurance technologies in healthcare. Journal of Health Organization and Management, 27(4), 498–519.
Regulatory and Compliance
This article discusses a new regulation establishing and new safety-reporting for drugs under the investigational new drug applications.
• Behrman Sherman, R., Woodcock, J., Norden, J., Grandinetti, C., & Temple, R. J. (2011). New FDA regulation to improve safety reporting in clinical trials. The New England Journal of Medicine, 365(1), 3–5.
Additional Resources for Further Exploration
You may use the following optional resources to further explore topics related to competencies.
Process and Performance Improvement
This is the home page of the American Productivity and Quality Center that provides best practices and benchmarking tools for designing effective methods for process and performance improvement.
• APQC. (n.d.). APQC's glossary of benchmarking terms. Retrieved from https://www.apqc.org/knowledge-base/documents/apqcs-glossary-benchmarking-terms
Quality Improvement
This is a blog page on how to improve care for patients with Medicare.
• Berwick, D. (2011). Improving care for people with Medicare [Blog post]. Retrieved from http://www.whitehouse.gov/blog/2011/03/31/improving-care-people-medicare
This is the home page of Medicare that summarizes measures of quality shown on Hospital Compare.
• Medicare.gov. (n.d.). Hospital compare. Retrieved from https://www.medicare.gov/hospitalcompare/search.html
This article discusses the Affordable Care Act funding for health providers to improve patient care.
• Infection Control Today. (2011). Up to Up to $500 million in Affordable Care Act funding will help health providers improve care.00 million in Affordable Care Act funding will help health providers improve care. Retrieved from http://www.infectioncontroltoday.com/news/2011/06/up-to-500-million-in-affordable-care-act-funding-will-help-health-providers-improve-care.aspx
Patient Safety
This article discusses various principles for creating a culture of safety in hospitals.
• Teal, K. (2017). What infection preventionists can do to ensure a culture of safety. Retrieved from http://www.infectioncontroltoday.com/general-hais/what-infection-preventionists-can-do-ensure-culture-safety
This is the home page of the National Quality Forum. It focusses on reducing preventable admission and readmissions, reducing adverse health care associated conditions, and reducing harm or unnecessary care.
• National Quality Forum. (n.d.). Retrieved from http://www.qualityforum.org/Home.aspx
This is the home page of the Joint Commission on patient safety goals and standards.
• The Joint Commission. (n.d.). Retrieved from http://www.jointcommission.org
Regulatory and Compliance
This is the home page of the Healthcare Compliance Association for compliance professionals in the healthcare provider field.
• Healthcare Compliance Association. (n.d.). The Healthcare Compliance Association. Retrieved from https://www.hcca-info.org/
This is the home page of the OIG U.S. Department of Health and Human Services. It discusses legal issues regarding ACOs participation in Medicare.
• U.S. Department of Health & Human Services. (n.d.). Accountable care organizations. Retrieved from http://oig.hhs.gov/compliance/accountable-care-organizations/index.asp
This is the home page of the U.S. Department of Health and Human Services laws and regulations.
• U.S. Department of Health & Human Services. (n.d.). Laws & regulations. Retrieved from http://www.hhs.gov/regulations/index.html
Risk-Management Text Books
• Kavaler, F., & Alexander, R. S. (2014). Risk management in health care institutions: Limiting liability and enhancing care (3rd ed). Burlington, MA: Jones and Bartlett. Available from the bookstore.
• Chapter 4, "Communications to Reduce Risk," read the section, "Grading and Ranking Health Care," pages 111–114.
• Chapter 5, "Financing Risk," pages 123–125.
• Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones and Bartlett. Available from the bookstore.
• Chapter 1, "Risk Management and Patient Safety: The Synergy and the Tension," pages 3–12.
• Chapter 2, "Integrating Risk Management, Quality Management and Patient Safety into the Organization," pages 13–22.
• Chapter 3, "Benchmarking in Risk Management," pages 23–30.
• Chapter 6, "Patient Safety: The Last Decade," pages 63–68.
• Chapter 16, "Principles for Strategic Discovery," pages 203–214.
• Chapter 17, "Full Disclosure as a Risk Management Imperative," pages 215–224.
• Chapter 24, "Improving Risk Manager Performance and Promoting Patient Safety with High-Reliability Principles," pages 343–350.
• Chapter 29, "The Impact of Fatigue on Error and Patient Safety," pages 423–430.