Issue link: https://emsworld.epubxp.com/i/336320
24 Integrated Healthcare Delivery July 2014 www.ihdelivery.com Project Management Institute, the International Organization for Standardization (ISO), the National Institute of Standards and Technology (NIST) and various actuarial societies, just to name a few. A solid risk-management plan seeks to mitigate differ- ent kinds of risk across the organization, not just one par- ticular type. Risks commonly addressed in risk-management plans include things like accidents in the workplace; fires, floods, earthquakes and other natural disasters; legal risks like fraud, theft and lawsuits; business, hiring and human-resource practices risks; revenue and reimbursement risks; credit risks; and the risks associated with the security and storage of data and records. Many business risk- management plans focus on simply keeping the organization sustainable through the reduc- tion of financial risks. However, solid plans should also focus on protecting employees, cus- tomers and the general public from adverse or catastrophic events, such as, in the case of healthcare organizations, errors in medications, diagnosis or treatment. In addition, consideration must be given to preserving the physical facili- ties, data, records and physical assets a business owns or uses. For example, a comprehensive risk-management plan will take into account not only decreases in revenue streams, which may affect the organization's credit and financial health, but also data breaches, care errors and technology failures. Risk-Management Strategies There are an infinite variety of strategies that can be employed to mitigate or eliminate risk within an organization, but the process for identifying and managing risks is fairly standard. It consists of five basic steps: 1. Risk Identification —In this step, risk events and their relation- ships are defined, followed by an assessment of the prob- ability of each. As an ongoing example, let's use congestive heart failure. A risk might be that patient discharge track- ing following hospital admis- sion for chronic CHF is not consistent, and follow-up is left to the patient. 2. Risk Impact Assessment — Identify the vulnerability of key assets (such as informa- tion or financial health) based on the threat or risk. Map the consequences of each risk, which may include cost, scheduling issues, techni- cal performance impacts, and capability or functional impacts. In the CHF example, lack of patient tracking after hospital discharge is a critical risk, because if the patient is readmitted for treatment or complications from chronic CHF within 30 days, reim- bursement will be denied. 3. Risk Prioritization Analysis — Once you've determined the expected consequences of specific threats, you can cat- egorize and prioritize them based on their importance to the organization. Risk events identified as medium to high criticality might be addressed with risk-mitigation planning and implementation of risk- reduction measures, while low-acuity risks might simply be monitored and tracked (i.e., assign someone to keep an eye on trends in a par- ticular area and report back regularly). The risk threat level for CHF readmissions is high under the Affordable Care Act because of their negative impact on financial reim- bursement. To address this risk, develop a policy and implement technology to identify patients at high risk for readmission due to chronic CHF. Work with community partners to develop strategy and care plans for patients of the healthcare organiza- tion with chronic CHF. 4. Risk Mitigation Planning, Implementation and Progress Monitoring —Once you've implemented risk-reduction measures, reassess existing risk events and mitigation strategies and identify new risks—all on an ongoing basis. With CHF, you'd iden- tify and engage community partners (home health, EMS, etc.) and select technology ÒThe greatest risk to any organization is to turn a blind eye, stick its head in the sand and proceed under the assumption that ÔIt canÕt happen to us.ÕÓ IHD_23-25_LegalScene0714.indd 24 6/13/14 11:25 AM