1policy Analysisintroductionorganizational Policy Alignment And Adher ✓ Solved

1. Policy Analysis Introduction Organizational policy alignment and adherence to laws and regulations is critical for overall corporate compliance and to decrease organizational risks (patient falls, medication errors, cyber hacks and PHI data breaches, infection control, et cetera). In this assignment, you will select, evaluate, and update one health care provider’s policy related to a significant regulatory risk to the health care organization. Instructions Select one of two options: Option A If you work for a hospital or health care organization you may select a policy that is of interest to you then follow these assignment instructions: · Imagine you are a health care administrator at your current employer.

Analyze the policy you selected, taking into consideration any recent changes. Evaluate what information and where that information would need to be updated. Propose revisions that are based on current identified standards and/or new guidelines that you have researched in the text or identified in other high-quality sources (that is, journals, government websites, and the like). Analyze the significance of the selected policy updates as it relates to potential litigation. (Why did the policy need updating? What threats do these changes help avoid?) Summarize your perspective on the revisions as well as any additional changes that should be considered.

Present your work as an executive summary suitable for distribution to your organization’s board members. Option B If you do not work in the industry or do not have access to a health care policy, use the Hahnemann Falls Policy to complete this assignment. Then follow these assignment instructions: · As you can see, this policy was written in 2012. Now, imagine you are a health care administrator working at the health care organization where this policy originates from. Analyze the policy, taking into consideration the changes in HIPAA and PHI since 2012.

Evaluate what information and where that information would need to be updated for a current revision of this document. Locate the areas where you would update or add information to this 2012 version. Propose revisions that are based on current identified standards and/or new guidelines that you have researched in the text or identified in other high-quality sources (that is, journals, government websites, and the like). Analyze the significance of the selected policy updates as it relates to potential litigation. (Why did the policy need updating? What threats do these changes help avoid?) Summarize your perspective on the revisions as well as any additional changes that should be considered.

Present your work as an executive summary suitable for distribution to your organization’s board members. Your paper should be 3–5 pages long and should include a title page and references for a total of 5–7 pages. Strayer Writing Standards This course requires the use of Strayer Writing Standards. For assistance and information, please refer to the Strayer Writing Standards link in the left-hand menu of your course. Grading Criteria The grading criteria for this executive summary is as follows.

It must include the elements listed below, so be sure to address each point. You may also want to review the performance-level descriptions for each criterion in the scoring guide to see how your work will be assessed: 1. Analyze a problematic or dated health care policy, explaining its primary purpose and effectiveness. 1. Determine the issues the selected policy poses as it is written and any related ramifications.

1. Research the changes needed to update and align the policy with current standards and guidelines. 1. Propose revisions that are based on current identified standards and/or new guidelines. 1.

Analyze the significance of the selected policy updates as it relates to potential litigation. 1. Summarize personal perspective on the revisions as well as any additional changes that should be considered. 1. Meet clarity, writing mechanics, and formatting requirements.

1. By submitting this paper, you agree: (1) that you are submitting your paper to be used and stored as part of the SafeAssignâ„¢ services in accordance with the Blackboard Privacy Policy ; (2) that your institution may use your paper in accordance with your institution's policies; and (3) that your use of SafeAssign will be without recourse against Blackboard Inc. and its affiliates. Overview: Assume you are a Maryland resident and Medicaid recipient looking to enroll in a managed care plan, review the Maryland Managed Care Website(s) at: Assess and evaluate HealthChoice, Maryland’s statewide mandatory managed care program based on the following evaluation criteria. Please choose one (1) of the MCO's under HealthChoice to evaluate (e.g., Maryland Physician's Care).

Using the table format below, answer the questions (using a narrative format) in each section that appear in bold type. Please be sure to include a reference page. HGMT 420 Assignment #5 Student Name: Type your name here Assignment #5 Title HealthChoice/Maryland Managed Care Plan Benefits Offered and Services Covered You want a plan that offers a comprehensive benefits package including preventive care as well as treatment programs for chronic disease management. Also, you may need emergency care and/or care away from home. What questions would you ask to determine the benefits and covered services offered?

Evaluate the HealthChoice plan and summarize your findings. Cost vs. Benefits Managed care plans vary widely in the cost of services offered. It may be tempting to base your selection primarily on the periodic, out-of-pocket costs to you. You can’t be sure that the least expensive plan will give you all the medical services you need.

Review cost vs. benefits for the HealthChoice plan carefully and summarize your findings. Services of the Primary Care Physician Choosing your primary care physician (PCP) may be the most important decision you make when enrolling in a managed care plan. The following questions are important when choosing your plan: Please answer each question. · Can you choose more than one PCP for your family? · Is there a large choice of primary care doctors and specialists? · How long is the average wait to get an appointment with the chosen PCP? · Can you see the same doctor consistently? · When and how can you change doctors if you are dissatisfied How does HealthChoice measure up? Prescription Drug Benefits When evaluating a health plan it is very important to know what kind of prescription drug benefits the plan offers.

Depending upon the plan, there are several systems that have been implemented in efforts to control costs. Some plans offer a “generic only†plan. What prescription drug benefits does HealthChoice offer? Are they beneficial to your current drug regimen? Provider Network and Geographic Service Area Be sure you inquire from the Provider Membership Directory which providers are included in the network and where they are located in your community.

If you live in one community and work in another; determine if routine care can be received in either location. Does HealthChoice have a strong network of Providers in a geographic area that is amenable to you? Must you go to different locations for different services? If you have a child away at school, does the network extend to that area? Commitment to Quality of Care and Service What measures of quality care and satisfaction of service are available?

It is worthwhile to find out if the plan has been accredited by the National Committee for Quality Assurance (NCQA). NCQA is the most common accrediting body for network plans. Review and report on what measures of quality care and satisfaction are available for HealthChoice. Customer Satisfaction How do enrolled members feel about the plan? There are various objective forms of measurement used to determine “quality services†given by managed care plans such as accreditation, HMO report cards and/or publications produced by the industry.

You would be wise to look at any that measure customer satisfaction. The National Committee for Quality Assurance (NCQA) mission is to provide information that enables purchasers and consumers of managed health care to compare plans based on quality. Their web site may be reached at Limitations, Maximums, or Exclusions Lifetime Cap refers to the maximum dollar amount of benefits available to a consumer in a managed care plan during his or her lifetime. This amount becomes important when confronted with a life-threatening disease or accident that requires prolonged care involving expensive therapeutic intervention and support. Does HealthChoice outline limitations, maximums, or exclusions?

Paper for above instructions

Introduction

This executive summary evaluates the Hahnemann Falls Policy, which governs patient safety regarding falls within healthcare settings. Originally created in 2012, this policy is now outdated, especially with several regulatory updates regarding Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI). As a healthcare administrator, updating this policy is essential for enhancing compliance, minimizing litigation risks, and ensuring the safety of patients, particularly vulnerable populations.

Policy Analysis

Purpose and Effectiveness

The Hahnemann Falls Policy is designed to provide guidelines to reduce the incidence of patient falls, a significant risk factor that can adversely affect patient outcomes. The policy emphasizes staff training, fall risk assessments, and post-fall evaluations (National Patient Safety Foundation, 2016). However, with the evolving regulatory landscape and emerging data on best practices, the effectiveness of this policy has been compromised. For example, the integration of technology in monitoring patient mobility and coping strategies could greatly enhance fall prevention but is not addressed in the current document (Matz et al., 2020).

Identified Issues

There are several issues regarding the Hahnemann Falls Policy. Firstly, its recommendations are stuck in time, as they do not align with the latest evidence-based practices. The rapid development of telehealth has introduced new modalities for continuous patient monitoring that can prevent falls. Moreover, the policy does not consider recent regulatory updates to HIPAA regarding patient privacy and data security, specifically concerning the electronic transmission of health data (U.S. Department of Health & Human Services, 2021). Failure to address these gaps places the organization at risk for both patient safety incidents and regulatory penalties.

Proposed Revisions

Alignment with Recent Standards

The following updates are proposed to bring the Hahnemann Falls Policy in line with modern standards:
1. Technology Integration: Implementing technologies such as Smart Beds and wearable devices that monitor patient movements could be integrated into the policy (Bhowmick et al., 2021). Guidelines should include protocols for equipment use and data interpretation.
2. Training Updates: Healthcare staff should undergo regular training sessions that emphasize the importance of new technologies and staffing analytics (Bard et al., 2022). A change management plan should also be included to ease the transition.
3. Enhanced Risk Assessments: Create a multi-faceted risk assessment protocol that includes a review of a patient’s mobility status, medication effects, and environmental conditions using a standardized assessment tool, such as the Morse Fall Scale (Morse et al., 1989).
4. Policy Lending to Telehealth: Telehealth consultations regarding fall risks and patient education should be included, emphasizing the role of patient engagement in fall prevention.
5. Documentation and Compliance: A focus on documentation is crucial to ensure compliance with HIPAA regulations relating to PHI. The policy must outline secure methods for documenting fall risks and incidents involving electronic health records, to protect patient information (U.S. Department of Health & Human Services, 2021).

Significance of Updates

Failing to update the Hahnemann Falls Policy increases exposure to various legal and regulatory risks. Outdated policies could result in increased patient falls, directly impacting patient care quality and leading to liability claims against the healthcare organization. Enhanced policies could help mitigate potential litigation risks by documenting proactive safety measures, demonstrating accountability (Abbott & Hurst, 2022). Providers can also reinforce compliance with federal regulations regarding patient safety and confidentiality.

Personal Perspective and Additional Changes

From a clinical standpoint, these updates are imperative. The integration of technological solutions not only enhances patient safety but also increases staff efficiency. Additionally, documenting procedures for addressing falls consistently will instantiate a culture of safety within the organization. Furthermore, this policy could benefit from periodic review and updates, to ensure it remains relevant as healthcare technology continues to evolve. Committees could be formed to oversee the adaptation of this policy in response to emerging research and regulatory requirements (Leiter et al., 2021).

Conclusion

The Hahnemann Falls Policy is essential for patient care, yet it requires significant revisions to address modern practices and regulatory changes. By integrating technology, enhancing training protocols, and ensuring compliance with HIPAA standards, the organization can strengthen patient safety initiatives. In addition, maintaining a culture of regular policy review will ensure the Hahnemann Falls Policy maximizes its effectiveness and minimizes any associated risks.

References

1. Abbott, M., & Hurst, T. (2022). Legal implications of fall prevention in healthcare. Journal of Health Law, 45(2), 134-150.
2. Bard, M., Kelly, M., & Taylor, J. (2022). The integration of healthcare technologies in fall prevention strategies. Health Informatics Journal, 28(1), 22-30.
3. Bhowmick, S., Smyth, R., & Ho, S. (2021). Smart technologies and their role in preventing fall risks in hospitals. International Journal of Medical Informatics, 150, 104469.
4. Leiter, M., Day, A., & Read, S. (2021). A proactive approach to policy revision in healthcare. Journal of Healthcare Risk Management, 41(3), 322-329.
5. Matz, M., MacKenzie, C., & Edgar, R. (2020). Enhancing patient safety through digital interventions. Patient Safety in Surgery, 14(1), 23-30.
6. Morse, J. M., Mackin, R. S., & Penrod, J. (1989). Development of a scale to identify fall risks in hospitalized patients. The Nursing Clinics of North America, 24(4), 975-986.
7. National Patient Safety Foundation. (2016). Free from Falls: A Toolkit for Fall Prevention. Retrieved from https://www.npsf.org/
8. U.S. Department of Health & Human Services. (2021). Health Insurance Portability and Accountability Act (HIPAA). Retrieved from https://www.hhs.gov/hipaa/index.html
9. Van De Velde, D., & Yano, E. (2021). Best practices in fall prevention strategies in healthcare settings. Journal of Clinical Nursing, 30(1-2), 246-252.
10. Wilson, A., & Thompson, C. (2020). The legal responsibilities of healthcare organizations regarding patient falls. The American Journal of Nursing, 120(4), 28-33.
This rewritten plan serves as a detailed framework for the necessary updates to the Hahnemann Falls Policy to reflect current regulations, best practices, and integrated care technologies.