Risk management principles and practices

Risk Management in Nursing and Healthcare Organizations

Briefly explain the impact of two to three special standards and regulations that apply to healthcare organizations.

Since the full implementation of the Privacy Rule of the Health Insurance Portability (HIPAA) Act of 1996 as of 2006, all healthcare organizations are expressly required to safeguard and maintain the confidentiality of protected health information (PHI) from unauthorized disclosure (Kutkat, 2004; Reid, 2009). For example, HIPAA standards strictly prohibit healthcare organizations from unauthorized PHI disclosure; they require that healthcare organizations establish and enforce specific privacy policies capable of ensuring the reasonable safety, security, and privacy of all PHI; they require the designation of a specific person to fulfill the role of Privacy Official; and they require that healthcare organizations provide comprehensive workforce training to every individual with conceivable access to PHI in the proper maintenance and privacy protection of that information (Kutkat, 2004; Reid, 2009).

Under HIPAA rules, healthcare organizations must also establish an action plan for the implementation of all measures necessary to comply with HIPAA requirements and that plan must also include provisions to enforce specific penalties and sanctions against their employees for violations of HIPAA rules (Kutkat, 2004; Reid, 2009). Failure to comply with HIPAA rules can result in fines imposed by the federal government up to $25,000 for some types of repeated violations and up to $250,000 and imprisonment for as long as 10 years for willful misuse of PHI (Kutkat, 2004; Reid, 2009) .

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Healthcare organizations must also comply with the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) which establishes standards and accreditation criteria (Reid, 2009). According to the JCAHO Environment of Care Standard, healthcare organizations must establish a written safety plan to ensure the safety, health, and welfare of all patients, personnel, and visitors to the healthcare organization, as well as to the community. Those standards pertain to all conceivable risks and hazards that may arise in connection with the operations of the organization and in connection with external environmental risks to its facilities (Reid, 2009).

Based on your research, identify the risks for a hospital that receives Medicare funding and fails to accept a patient who enters through its emergency department needing emergency care.

Pursuant to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) (Public Law No. 99-272) section entitled Emergency Medical Treatment and Active Labor Act (EMTALA), hospitals receiving Medicare (and other federal funds) that fail to accept a patient in its emergency department are liable for civil penalties as well as civil liability in legal actions filed by the patient who was refused medical services (Reid, 2009).

Briefly discuss a risk management strategy that would protect the health of the patient.