Risk and Quality Management

Risk and Quality Management Assessment Summary Kelly Hennessey HCS/451 02/18/2012 Lauri Rose Risk and Quality Management Assessment Summary Evergreen Woods health and rehabilitation center is located in Spring Hill Florida. The center has been serving Hernando County for over 25 years. Services that the center offers are: Post-acute services, Rehabilitative services, skilled nursing, Short and long term care through physical, occupational and speech therapists. The mission of Evergreen Woods health and rehabilitation center is to provide comprehensive services to meet the care of the residents and patients.
They strive to meet customer satisfaction daily and follow core values to obtain excellence in care. Risk management serves to protect patients and staff members by reducing medical errors, remaining up to date with state and federal regulations. As well risk management protects staff and patients by eliminating hazards within the organization. Quality management serves the purpose to ensure that patients are receiving the best care available. In the organization Evergreen Woods risk and quality management plays the same role as it does in any other health care organization.
Being that this center is an in-patient facility serving many different patients with many different health issues there are many different risks involved in the daily operation of the organization. Key concepts of risk and quality management within Evergreen Woods rehab while are undefined to the public it is noticeable to any person that is involved in the organization whether it be a patient, family member or a staff member. The organization takes steps daily to ensure the safety and wellbeing of every person that walks in their doors.

The doctors and nurses take extra steps to make sure that the residents and their family is comfortable with the choice they made in selecting them. The keep patients and families up to date on all issues that are transpiring with the patient whether it is health related or financial. The staff stays up to date on all regulations both state and federal to ensure the best quality of care is being received. The organization maintains a clean and hazard free environment. Steps that the organization can take to identify and manage their risks are Proper documentation, risk assessments and proper training of staff members.
In order to manage the risk of medical errors the organization should make sure that all staff members are documenting the patient’s charts in the proper legal manner. As well the management should be making sure that there are properly documenting all information pertaining to the employees such attendance and job performance. Using risk assessments can keep the organization from ruling into issues concerning safety and financial risks. Performing assessments will allow management to see where forms of risk fall and what kind of risks is a possibility for the organization.
After performing risk assessments the organization can then develop plans to minimize risk and maintain a safe efficiently running organization. Typical risks in a long term care facility such as Evergreen woods would be patient fall risk, injury to staff and patients due to improper transferring and financial risk due to insurance issues for both the organization and the patient. Since many patients in long term care facilities are ones that have mobility issues there is always a risk of falling which can further injure the patient.
It is important for staff to make sure that the patient is labeled a fall risk and that necessary precautions are made to ensure the patients safety. Using items such as safety belts in wheelchairs and during therapy sessions can eliminate this risk. Another risk would be injury to staff and patients due to improper lifting, while this does not seem like something that is too difficult to do it is. Lifting a person with limited or no mobility can be very difficult for both the staff and the patient. There is a proper way to lift a patient and any and all staff members should be properly trained before being allowed to perform this task.
The last risk would be financial issues due to insurance issues. “Of 10 million Americans nearly 7 million of them being over 65 rely on some level of assisted care” (Weston 2012). This number does not include the number of people that are under the age of 65. Many people that rely on long term care live on disability or social security. These people are living on extremely limited income put them and their families in mental distress trying to figure out how to pay for the needed care. “Medicare provides only 100 days of care following hospitalization” (Weston 2012).
After the 100 days it then becomes the responsibility of the patient to either pay out of their pocket or use a supplemental insurance. For many this is an issue as they do not have any other insurance nor do they have the finances to afford this care on their own. With patients under Medicaid insurance there is still an issue “Medicaid provides long term care, but only after a patient has deplete his/her finances” (Weston 2012). So how does this affect the organization itself, now with lack of insurance you run the risk of not being paid for services already rendered.
The other risk involved is that if a patient is unable to pay for the care themselves then they have to resort to other means of care, now the organization has empty beds. Empty beds mean that there is not a high need for staff members resulting in layoffs. All of these risks can in fact the quality negatively. The lack of funds causes the staff to not always give the best care to each patient. Injury to staff can cause the staff to become nervous when it comes to lifting patients as well it can make the patients not want to be lift in fear of being hurt cause them to lay for longer periods of time then they should.
Any and all accidently injuries to a patient can in fact be seen as neglect by family members and could cause serious legal issues for all staff of the organization. While there are many internal and external risk in this organization the biggest risks internally would be lack of staff involvement, lack of funding and poor risk management. The care received by patients relies strongly on the doctors and nurses employed by the organization. If the staff is afraid or care not to voice their opinions and concerns this can cause a lack of quality care.
When the staff does not feel that their needs matter they tend to not try their best this often leads to medical errors. Lack of funding to the organization cause the organization to cut corners, this in return hinders the care that the organization can give to patients. Funding is a big part of how an organization runs daily. If funding is low then the organization cannot hire top nurses and doctors nor can they provide state of the art equipment. Poor risk management is probably one of the most important.
Without excellent risk management the organization puts not only the organizations name but the staff and patients in danger of physical and medical harm. As well poor risk management can bring legal problems to the organization. External risks that influence quality would be impact of regulations, Changes in insurance, Society changes. As the regulations change through the years it will begin to make the way that long term care facilities run. They will need to stay on top of the regulations as well as stay on top of the staff to make sure that they understand the impact that errors can cause. Nursing homes incur costs when they are required to make changes to comply with the regulations” (Walshe n. a). Interference from the insurance company on what will and will not be covered will also cause problems with the care that is received by patients. As society changes the need for long term care will change, the needs now will not necessarily be the needs in 10 years. As changes occur within research we will see a big change in treatment this will in return call for more training as well as equipment changes. The organization Evergreen woods works daily to achieve goals within the organization.
Their short term goals are excellent daily care of patients. This goal not only touches the health aspect of the patient but also the emotional health of a patient. While staying on top of each and every patient’s health issues they make time to check on each patient on a personal level. The organization strives to make sure that the families of the patients are happy with the care that the patient is receiving. For patients that are there rehab from an injury their short term goal is to get the patient well enough to go home and continue without patient treatment.
Long term goals for the organization is to continue to be a leader in rehab services, to continue to serve the community with quality trusted care. In order to ensure quality care the three policies that the organization should put into effect would be monthly risk assessments, monthly staff training and patient surveys. All of these policies would help ensure that the organization is doing everything that they possible can do to provide excellent quality care. Risk management and quality management have a strong relationship with each other.
Without risk management there would be no quality care, and without excellent quality there would be risks everywhere in an organization. In order for an organization to run properly and provide all the patients with the care they deserve they have to have strong risk and quality management. References: http://content. healthaffairs. org/content/20/6/128. full A guideline for quality accreditation in hospitals. Quality Digest. Agarwal, R. (2010, May 19). www. http://evergreenwoodshealthandrehab. com/