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In this assignment, you will create a SWOT analysis and a comprehensive executive summary table of tools and best practices for quality improvement, risk management, and learning guidelines. Include an executive summary table that describes the status of an organization’s compliance with regulatory requirements.
The healthcare industry is continually evolving with the advancements of technology, science, and regulation. The consistent evolution of the industry has created an unprecedented environment for healthcare leaders to be operating within. The evolution of change has therefore transitioned the industry into a value-based delivery model.
Regulatory compliance in healthcare is in place to ensure patient safety and that healthcare facilities are operating under a legal and ethical umbrella to which standardized best practices are being utilized.
As an entity within the healthcare industry, the goal for all organizations is to aim for regulatory compliance, but to be consistently assessing and reevaluating your operations with an aim toward achieving the mentality and behaviors of a high-reliability organization (HRO). A key example of the endeavor to transition healthcare toward becoming HROs is the development of affordable care organizations (ACO).
Preparation
For this assignment, select your organization, Path 1, or one of the organizations from the list in Path 2, on which to base your work.
Path 1
You are highly encouraged to select your current employer on which to base your work, and if you choose this path, make sure the Learner and Employer Acknowledgement and Release Form [PDF]Links to an external site. from your workplace is completed.
See the Workplace Integrated LearningLinks to an external site. resource for more information about selecting the healthcare organization you will use for the assessments in this course.
Be sure the organization has readily available data for the four categories from Kaplan and Norton’s 1996 model. Those categories are:
Financial performance measures.
Internal business processes.
Learning and growth.
Customer satisfaction.
Path 2
Select one of the following cases from one of the organizations listed below as the basis for each of your assignments. Note: The assignments in this course build upon each other, so you are required to use the same case and organization throughout.
UPMC Children’s Hospital of Pittsburgh: Hospital-Acquired Conditions. Imagine you are the director of risk management.
CVS Pharmacy: US Labor Department’s OSHA Proposes $89,000 in Fines to CVS Pharmacy for Exit, Storage and Other Hazards at Orange, Conn., Store. Imagine you are the new safety officer for CVS Health.
Anthem Blue Cross Blue Shield: Anthem Pays $16 million in Record HIPAA Settlement for Data Breach. Imagine you are the risk officer for Anthem Blue Cross Blue Shield.
Note: These are the same cases from the Regulatory Environment CasesLinks to an external site. reading list.
Instructions
Assume that you have taken on a new role as the chief operating officer of a healthcare organization and are charged with leading system-wide risk management efforts to identify risks and minimize hospital acquired conditions (HACs). Your organization’s financial viability depends on receiving proper reimbursement for services delivered. As the chief operating officer, you must create an executive summary table that describes your organization’s compliance with the regulatory requirement, to promptly identify conditions that are POAs and proactively assess and manage risk.
Select a risk management issue within a specific healthcare setting or organization. You will use this issue as a starting point for your work on this assessment. Use the Executive Summary Table Download Executive Summary Table (Attached BELOW) to complete this step.
Current organization and background. Present your organization and background.
Present the organization’s philosophy or culture statement: Include mission, vision, and values
Prepare a SWOT analysis for your organization. Assess the internal versus external environment relative to the risks associated with your chosen risk management issue.
Regulatory requirements: Compile a list of the applicable regulatory requirements and an explanation of what they mean to your organization. How do you anticipate these regulations to change in the future? Is your organization prepared?
Risk management implications: Identify the associated risk management implications. For example, HACs result in no reimbursement and poor quality ratings. Where is your selected organization experiencing risk by not meeting a regulation or not providing services as efficiently as they could?
DMAIC lens: Assess your risk management concern. What is causing this problem to occur?
Recommendations: What recommendations do you have for this scenario? What challenges will you face when implementing this change?
Measuring and monitoring:
Identify metrics for measuring or monitoring the risk management issue and your recommendations.
Propose how you will make use of the outcome data for organizational improvement.
Ethics considerations: Describe legal and ethical implications related to the handling of this risk management issue.
In your executive summary table and SWOT analysis, be sure you:
Conduct a proactive assessment based on the existing regulations and requirements.
Describe strategies to influence, impact, and monitor the needed changes for quality improvement.
Develop a value proposition for change management that incorporates quality and risk management concepts.
Prepare a SWOT analysis for your organization assessing the internal versus external environment relative to the risks associated with your chosen risk management issue.
Integrate legal and ethical principles and also organizational mission, vision, and values into the decision-making process.
Utilize established sources of information. Some sources that may be useful to you include the federal register, statutes, discipline-specific peer-reviewed journals, and government agency references.
APA Format: Use appropriate APA format for a clear, concise presentation of information. Communicate information and ideas accurately, utilizing peer-reviewed sources, including proper APA reference citations.
Additional Requirements
Written communication: Written communication should be free from errors that detract from the overall message.
Length: 3–4 pages for the table.
Number of resources: A minimum of three resources.
APA Format: Use appropriate APA format for a clear, concise presentation of information. Refer to the APA ModuleLinks to an external site. to help with APA style guidelines. Communicate information and ideas accurately, utilizing peer-reviewed sources, including proper APA reference citations.
Font and font size: Times New Roman, 12 point.
Friendly Reminder that the Template PROVIDED should be used to complete this assignment. The Executive Summary is a little more condensed to align with the Criteria.
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