MHA_FP5014_Foster__Judy_Assesment_2_2.docx
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Prince Georges County
Hospital
Memo
To:
Risk Management Team
From:
Judy Foster
MHA5014-FPX – Assessment 2
cc:
Date:
February 7, 2020
Re:
Financial Risk Management
Identified Risk Performance Indicators and Measures
Prince Georges County Hospital has developed to be center of medical education, operating as a
teaching facility for seven specialties. This internal memo will be talking about the safety of the
patient using risk financing to curb financial impact in the facility. Coming up with new policies
and putting in use good safety measures will help minimize surgical site infections. Surgical site
infections are a big issue for the hospital and there are a number of factors contributing to those
infections which need to be discussed. Addressing this issues effectively will enhance patient’s
safety and lower the financial strain. The estimated yearly incidence of SSIs in the U.S varies
from 160,000 to 300,000 while yearly estimated cost vary from $3.5 billion to $10 billion
(Cluett, 2020). The facility duration of stay rises by 9.7 days when patients have surgical site
infection and this is according to studies quoted in the guidelines (Medical, 2017). State huge
hostile events was 3.7% with 27.6% of them being as a result of negligence. 70.5% of adverse
events caused minor health complication with full recovery, 2.6% led to total permanent
RISK FINANCING MEMO
2
disability while 13.6% led to death (Medical, 2017). Unfavorable post-operative events
gained
popularity in 1980s as indicators of quality and they are recently the most used hospital
indicators of quality worldwide (Medical, 2017). Other outcomes often proposed in surgical care
as measures of quality are; postoperative long-term survival, patient satisfaction, postoperative
mortality, postoperative functional status and health –related quality of life, postoperative length
of stay ,costs and access and other postoperative morbidity.
There has been strong evidence that depicts continuous quality improvement in surgical
care. The evidence was founded on the process-based quality indicators and on the measurement
and monitoring of the outcome-based. Providing monthly feedback to managers and providers is
necessary in curbing patient mortality, post-operative complications and costs. Efficient
prevention of surgical infection needs redesigning to lower risk factors and to maximize
evidence–based care processes (Cluett, 2020). Necessary processes for prevention of surgical site
infections are center measures in the Surgical Care Improvement Project and has been important
components in IHI surgical safety efforts. Having monthly meetings to debate on data and
solution will also aid. In order to sustain proper measurement which will lower service costs
ACO guidelines has to be followed, reporting incidents and giving reports from leap frog safety
will also help as well as doing research on different hospitals and how they improved. This
recommendations will assist price Georges County Hospital improve their score from a D to
possibly B.
Strategies Used to Identify Risk Financing Issues
RISK FINANCING MEMO
3
Coming up with a risk management plan is basically having structure and being able to
incorporate time and resources effectively. (Webb, n.d). The first step is pointing out your risks
(Webb n.d). Ensuring proper training of staff. Putting into place monthly debates and
benchmarking will assist the facility measure their improvements by comparing financial loss in
the current and previous years. Benchmarking will help the company in looking for challenges
within the organizations. Monthly discussions will he held to check on the data and generate an
action plan to improve the results. Dashboard are used to keep track on the data and coming up
with them at Prince Georges County hospital will be the initial step in observing risk
management to surgical site infections. The dashboard will act as a source in giving continuous
quality and preventative safety improvements that carry data that cast graphics to present figures
and facts.
Recommendations for Risk Financing Options
Whereas costs of an SSI defer largely depending on the site of surgery and the degree of
infection, the assessed average cost of an SSI can be above $25,000 and can even raise to
$90,000 if it concerns a prosthetic implant. Generally, SSIs cost the US healthcare system an
assessed $3.5 to $10 billion yearly. The US Centers for Medicare and Medicaid Services (CMS)
are no longer compensating hospitals for HAIs like SSI since 2008. The facility needs to put in
use at least one risk control and one risk financing technique. For an organization to improve on
risk financing, it should; establish and analyze exposures, analyze other risk financing
techniques, choose the suitable risk financing technique, implement and monitor the selected
technique.
.
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RISK FINANCING MEMO
4
Legal and Ethical Financial Risk Obligations
Accountable Care Organizations (ACOs) are a main mechanism of the Patient Protection
and Affordable Care Act (PPACA) (Graber, Bhandary, & Rizzo, 2016). ACOs will impact
incentives for providers for them to make a well- considered treatment decisions. The providers
task to perform in the patients best interest is the adherence of beneficence. Poor services will
make the patients lose trust in the physicians. The mission of ACO is to give improved care for
Medicare patients, this aids both providers and patients to save money, while putting control
waste in the Medicare system (Graber, Bhandary, & Rizzo, 2016).
RISK FINANCING MEMO
5
References
Cluett, Jonathan. “Surgical Infections Can Be Easily Prevented.”
(2020).
Verywell Health
,
Verywell Health, Retrieved from
www.verywellhealth.com/how-to-prevent-surgical-
infections-2549276
.
Graber, Abraham D, et al. (2016). “Ethical Practice under Accountable Care.”
HEC Forum: an
Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
, U.S. National Library
of Medicine, www.ncbi.nlm.nih.gov/pmc/articles/PMC5501323/.
Medical, Science X. (2017).
“Surgical Site Infections Are the Most Common and Costly of
Hospital Infections.”
Medical Xpress - Medical Research Advances and Health News
,
Medical Xpress, medicalxpress.com/news/2017-01-surgical-site-infections-common-
costly.html.
Webb, R. (n.d). “8 Ways to Identify Risks in Your Organization.”
8 Ways to Identify Risks in
Your Organization
,
www.clearrisk.com/risk-management-blog/6-ways-to-identify-risk
.