Fictitious Health Care Organization
Fictitious Health Care Organization
In the role of a health care manager, for the final project you will develop and write a comprehensive marketing and communication plan for your fictitious health care organization. The final project will be divided into four parts:
- Health Care Organization Profile
- Communication Plan
- Marketing Plan
- Community Collaboration Plan
Part 1, “Health Care Organization Profile,” should include the following components:
- Name and type of health care organization (stand-alone, multifacility, multicampus, community-based, etc.).
- Mission, vision, and goals
- Bed number
- Type of services provided
- Quality indicators
- Financial performance indicators
- Human resource challenges
- Diversity issues
- Community population statistics
Healthcare businesses are always faced with challenging decisions regarding how to allocate their time, energy, and resources in order to avoid unnecessary risk exposure. Healthcare internal audit departments must align their risk assessments and resulting internal audit plans to the areas most critical to achieving organizations’ strategic goals and business objectives, as well as maintaining compliance with critical regulatory and other requirements, in order to manage this environment of increasing risks and limited resources. This risk-based strategy concentrates on the most significant risk areas and advises that low-risk regions receive less, if any, attention. The higher the return on risk for a company’s internal audit investment, the better the alignment between the internal audit plan and the most critical organization risks.
Even as the business has become more complicated and the number of serious risks has expanded over the last decade, healthcare organizations’ internal audit resources were already insufficient as we entered 2020. When the United States was attacked by the COVID-19 epidemic in early2020, the delicate balance between a rising number of hazards and internal audit resources grew even more difficult. Despite the fact that the healthcare industry has been preparing for natural disasters, terrorist attacks, and other events that could result in a large influx of patients, the COVID-19 pandemic has quickly shifted the industry and resulted in new and significant risks that were not previously considered.
A healthcare organization’s failure to prepare for new hazards might cost it money and its reputation at a time when it can least afford to lose both. The greatest method to achieving a return on risk is to thoroughly understand the organization’s operations and strategic direction, as well as to identify current and emerging hazards. Crowe has identified the main risks confronting healthcare organizations in 2020 to assist with this. The list was compiled with the help of executives and board members from some of the country’s top health systems, as well as data gathered from risk assessments completed at more than 250 hospital customers in 2019. The Crowe article “5COVID-19 Emerging Hazards for Healthcare Organizations” lists important risk categories that have emerged as a result of the COVID-19 pandemic, in addition to risks highlighted as part of the 2019 assessment process.
Because of the fast increasing use of technology and the establishment of complicated alliances and vendor relationships throughout the healthcare business, what is a high risk at one company may not be a top risk or even relevant at another; thus, the risks have not been prioritized.
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Healthcare executives, audit committees, and boards continue to be concerned about cybersecurity as technology-enabled care and communication with patients becomes more common. Identifying information assets and related cyberrisks, implementing protective controls, detecting and responding to security threats, and recovering from incidents are all topics covered in well-established cybersecurity recommendations. Healthcare institutions have recognized the importance of cybersecurity as a result of regulations and ongoing breach reports, and many have taken measures to conduct risk assessments and install comprehensive preventive controls.
While healthcare organizations are getting better at recognizing and protecting physical, intellectual, and informational assets, there is still a lack of preparation when it comes to detecting and responding to cyberthreats. Detecting cyberthreats necessitates a large investment in personnel and equipment to support networked system monitoring, which poses a challenge to IT and security budgets that are already pushed tight. To make matters more complicated, the healthcare industry is unique in that it must consider both security events such as ransomware and distributed denial of service (DDoS) as well as HIPAA regulations, which require healthcare entities to plan for breaches of patient privacy and unauthorized access to sensitive patient information. The detective capabilities and incident response plans become more sophisticated as a result of this combination. Walk-throughs of response plans, tabletop exercises, and disaster recovery testing all necessitate cooperation and time from multiple groups outside of IT. Even the best attempts to monitor all systems and have suitable response plans in place are hampered by the healthcare industry’s high integration rate of mobile devices, cloud services, and network-connected biomedical devices. It’s all too easy to disregard the costs of developing, maintaining, and constantly improving security detection and response capabilities. Security mishaps are unavoidable, and leadership recognizes the importance of focusing on creating strong detective and corrective processes and controls to complement the preventive controls already in place.
Many commercial payers are reimbursing based on quality, following the lead of government payers, as more payment models change from volume to value. Organizations have been forced to publicly publish quality measurements by federal and state regulators, and quality has been linked to reimbursement through incentives, payment reductions, and penalties. Patients’ outcomes, cost of care, reputation, and financial performance are all at risk if healthcare organizations do not have processes in place to provide and improve quality care. Pay-for-performance penalties can have a negative impact on patient outcomes, cost of care, reputation, and financial performance.
The COVID-19 pandemic has highlighted the importance of having strong processes and contingency plans in place to ensure quality performance during disasters. For example, during an emergency, healthcare organizations must consider how they will staff quality functions and other administrative responsibilities, as well as how they will ensure the consistent application of important nurse-driven protocols (such as Foley removal) and how they will address scope-of-practice issues as staff is reassigned to other responsibilities.
alignment of physicians
Physician alignment risks have risen in recent years as doctors leave private practice in droves. As healthcare companies contract with an increasing number of physicians, it is vital that they ensure that expectations and contract stipulations are suitable and adhered to without breaking federal fraud and abuse laws (for example, Stark Law and anti-kickback laws). Patient scheduling and registration, patient billing, cash processing, prescription and drug management, coding, human resource management, and information systems administration are all operational and compliance concerns that health systems are progressively integrating. Due to the geographic dispersion of physician practices, there are still challenges. For example, many are located far away from the hospital campuses with which they are affiliated, and thus may not be included in the day-to-day scope of work for all oversight functions such as compliance, IT security, and patient safety.
The most serious integration risks, on the other hand, are strategic and long-term: physician alignment and engagement. Healthcare reform and new payment models necessitate better efficiencies and coordination, which cannot be contracted into existence. Physician leadership is critical for improving patient care quality, controlling health-care costs, and competing in the realm of patient happiness and consumerism. Clinical champions must be developed and empowered to confront increasing clinical concerns, such as pandemic preparedness and the national opioid epidemic. Because of growing workloads, loss of authority, and ever-changing administrative needs, clinician burnout is a persistent threat to such leadership.
Patient safety is paramount.
Patient safety failures could result in avoidable injuries, diseases, and death, as well as significant litigation costs, increased liability, and a negative influence on the reputation of facilities and health systems. Emergency preparedness, medical equipment cleaning, disinfection, and sterilization, transmission of key test results, and awareness of behavioral health requirements are all clinical processes with inherent patient safety hazards. As healthcare becomes more reliant on technology and automation, inefficient implementation of these solutions may exacerbate many patient safety concerns. As complicated algorithms warn healthcare personnel to the probable diagnosis of sepsis or infection with varied degrees of accuracy, alarm management, for example, becomes a higher concern. Effective collaboration and communication among doctors, healthcare workers, and patients, as well as strong alignment of clinical processes and technology with evidence-based practices, must be balanced against limited resources and daily priorities of patient care.
Pharmacy is one of the few areas in healthcare where patient safety, cost management, compliance, and community health risk are all intertwined. Preventing and identifying drug addiction and restricted substance diversion is a big job for pharmacists and clinicians.
Fictitious Health Care Organization