Need help
4
SummaryBrief (Risk Management)
Risk Management Summary
Joshua Garcia
Grand Canyon University: HLT-308V
January 30, 2020
Running head: ASSIGNMENT TITLE HERE
1
Summary Brief
Risk Management Process (Quality Improvement)
There are many governing bodies that exist to assist and ensure compliance. The main governing body for physical therapy in a outpatient setting is the Centers for Medicare and Medicaid Services (CMS). CMS has created the foundation and the basis for all therapy services to follow in every setting in order to be in compliance. All insurances such and Blue Cross Blue Shield, Humana, and Aetna are adopting and following CMS standards as well. Most organizations have created quality indicators (QI) to measure outcomes, quality care, cost, documentation in order to meet CMS standards. The Centers for Medicare and Medicaid services have developed a method to measure a organizations quality of care and improvements. “The CMS uses quality measures in its various quality initiatives, including quality improvement, pay for reporting, and public reporting for specific health care providers.” (Westby, Klemm, Li, Jones, 2016). The Merit-Based Incentive Payment System (MIPS) uses an incentive program to promote quality care, compliance with documentation etc. “MIPS is a streamlined, one-stop shop for CMS to measure quality and provide financial incentives for eligible clinicians to improve their level of care.” (Jannenga, 2018). MIPS measures quality, improvement activities, promoting interoperability, and cost. Quality measures include: preventative care, documentation, and quality care. With a good risk management plan all criteria’s will be met and up to CMS standards.
“Other important considerations include whether there are opportunities to change clinical practice and improve quality of care and patient outcomes within the clinical area and whether related interventions are within the control of providers whose performance is being measured.” (Westby et al., 2016).
Roles Within The Organization
Roles are different in every organization depending on the size and the amount of employees that are involved in the risk management. In a small business like my own the therapists’ play a big role in risk management. Physical Therapist and Physical Therapist Assistants set and uphold the standard. Technicians are to follow and can only assist the therapists’ with tasks. We follow a code of ethics that has been created and established by the American Physical Therapy Association (APTA). The code of ethics ensure that the risk management plan is being followed as well as the policies. Here is are the code of ethics: “Physical therapists shall respect the inherent dignity and rights of all individuals; Physical therapists shall be trustworthy and compassionate in addressing the rights and needs of patients/clients; Physical therapists shall be accountable for making sound professional judgments; Physical therapists shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public; : Physical therapists shall fulfill their legal and professional obligations; Physical therapists shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities, and professional behaviors; Physical therapists shall promote organizational behaviors and business practices that benefit patients/clients and society; Physical therapists shall participate in efforts to meet the health needs of people locally, nationally, or globally.” (Code of Ethics, 2019).
Physical Therapy Risk Management
Risk management strategies have a foundation to support ethical standards in care. As a therapist we have a commitment to provide quality care. We follow a code of ethics that creates a place of success with all patients. We also are charged to practice within the physical therapy scope of practice and professional competence. In the field of physical therapy we follow protocols, policies and procedures when providing care. Before the initiation of any treatment or evaluation we are to educate the patient regarding the recommended intervention, alternatives, goals, benefits, risks and costs. It is important to involve the patient and promote patient autonomy. After performing the evaluation the patient is informed of the findings. “The physical therapist shall use sound professional judgment in informing the patient or client of any substantial risks of the recommended examination and intervention and shall collaborate with the individual to establish the goals of treatment and the plan of care. Ultimately, the physical therapist shall respect the individual’s right to make decisions regarding the recommended plan of care, including consent, modification, or refusal.” (APTA Guide, 2019).
Legal and Ethical Responsibilities
Every health care professional is faced with legal and ethical responsibilities. Even more so when following and upholding the risk management strategy that is in place. In physical therapy there currently a lot of gray areas when providing care and interventions. This is where the risk management strategy is important in order to keep all health care professionals in check when practicing. The most important part in physical therapy is to provide care and interventions within the scope of practice. Following the scope of practice ensures the safety of all patients in every aspect of treatments such as: therapeutic exercise, manual therapy, balance training, modalities and physical agents. “The physical therapist practices according to the Code of Ethics of the American Physical Therapy Association.” (Association Business, 2005). As well as patient privacy and proper documentation for each patient to maintain compliance with CMS.” The physical therapist communicates, coordinates and documents all aspects of patient/client management, including the results of the initial examination and evaluation, diagnosis, prognosis, plan of care, interventions, response to interventions, changes in patient/client status relative to the interventions, re-examination, and discharge/discontinuation of intervention, and other patient/client management activities.” (Association Business, 2005) It is also important to treat what has been ordered by the doctor and avoid expansion of treatment of other body parts unless a proper order is given with evaluation. As long as organizations are compliant the risk for malpractice and legal issues can be controlled.
Journey To Excellence
The journey to excellence in any organization long process that comes with many trials and tribulations. It is important o research and receive wisdom from experts so that a good risk management plan can be created. I believe it is imperative to also have the proper staff that will work together as a team to deliver high quality care and practice following all policies, procedures, and protocols. Every successful organization has to have a great leader. An organization will be successful and will achieve excellence with a leader who will hold employees accountable and will demonstrate excellence. A greater leader will replicate themselves in others and create other leaders so that the organization continues to run with excellence in all sectors. Quality improvement in my organization start from the top and runs down to all employees. Working with in our scope of practice, proper documentation, competency with continued education and compliance with the risk management plan produces positive and optimal results overall. The use of quality improvement tools and complying with CMS ensures that therapists’ will be practice at a high level providing optimal care to patients. It also ensures the safety of patients. The journey to excellence requires a whole team.
References
Association business. Standards of practice for physical therapy and the criteria. (2005). Physical Therapy, 85(1), 84–88. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=106611054&site=eds-live&scope=site
APTA Guide for Professional Conduct. (2019). American Physical Therapy Association.Retrieved from
https://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforProfessionalConduct
Code of Ethics for the Physical Therapist. (2019). American Physical Therapy Association. Retrieved from
https://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/HOD/Ethics/CodeofEthics
Jannenga, H. (2018). Physical Therapists’ Guide to MIPS. Retrieved from
https://www.webpt.com/physical-therapists-guide-to-mips/
Occupational Health Physical Therapy: Legal and Risk Management Issues Guidelines. 2011. Retrievedfrom
https://www.orthopt.org/uploads/content_files/OHSIG_Guidelines/OHSIG_guidelines_2/OCCUPATIONAL_HEALTH_in_PT_LEGAL_RISK_MGT
Marie D. Westby, Alexandria Klemm, Linda C. Li, C. Allyson Jones, Emerging Role of Quality Indicators in Physical Therapist Practice and Health Service Delivery, Physical Therapy, Volume 96, Issue 1, 1 January 2016, Pages 90–100,
https://doi.org/10.2522/ptj.20150106
4
Approach to Risk Management in Physical Therapy
Approach to Risk Management in Physical Therapy
Joshua M. Garcia
Grand Canyon University: HLT-308V
January
1
6, 2020
Running head: ASSIGNMENT TITLE HERE
1
Risk Management in Physical Therapy
Risk Management (Business Approach)
There are many different approaches to risk management. Many plans have been created for organizations of all kinds to follow in order to maintain compliance, increase quality care and safety. Risks are present in many organizations; however, some are prone to more compliance issues such as hospitals. I will be discussing risk management in physical therapy. I chose this as my topic of discussion because I am currently a practicing physical therapist assistant in a outpatient setting as well as an owner. I think it is important to perform research in this field as it will increase my knowledge and make more aware of the compliance issues at hand. I will be able to create and enhance the current risk management plan that is in place.
The risk management applies to the overall practice of physical therapy and the common issues that arise. Risk management role is to improve quality care, safety and identify risks that affect the business such as scope of practice, documentation, patient relationship, and interventions, and malpractice. It is important to understand and know the business of physical therapy in an outpatient setting as it is different to a hospital, nursing home, home health, and an inpatient rehab setting. The risk management
Standard Risk Management
There is a standard to risk management that many organizations refer to create a foundation and incorporate their own ideas. It is imperative that specificity be used in each sector of healthcare. What is the standard of risk management? “Risk management which is forecasting and evaluation of risks together with the identification of procedures to avoid or minimize their impact which includes identification, analysis, assessment, control, and avoidance, minimization, or eliminate on of unacceptable risks through strategies like risk assumption, risk avoidance, risk retention, risk transfer, or any other strategy (or combination of strategies) in proper management of future events” (Chugh, 2015). The is the foundation on which a risk management plan derives from. Standard risk management follows risk management with specificity to physical therapy (health care) is: “A situation involving exposure to danger where a probability or threat of damage, injury, liability, loss, or any other negative occurrence that is caused by external or internal vulnerabilities exist and that may be avoided through preemptive action.” (Chugh, 2015). Physical therapy plan to risk management is “According to the Guide to Physical Therapist Practice, the elements of patient/client management include examination, evaluation, diagnosis, prognosis, and intervention.” (Anonymous, 2011). This the common strategy for the sector of physical therapy. “Work within the physical therapist scope of practice and professional competence. When appropriate, maintain separate files for personal injury claims and each worker’s compensation claim. When documenting individual patient/client behaviors, document only those things observed. Avoid disparaging remarks which could lead to claims of defamation (e.g. “malingerer”) or clinical labels which you might not be qualified to make (e.g. “patient/client is depressed’). Document only the intervention and avoid comments related to “secondary gain” or its origin. Avoid expansion of services at the individual patient’s/client’s request unless approved by appropriate referral sources and an additional examination/evaluation is performed.” (Anonymous, 2011). The accrediting body of CMS is important in maintaining compliance especially with documentation, safety, accreditation of a therapist, medical records and practicing of a therapist.
Agencies
Many agencies exist to govern the practice of physical therapy. There are also many standards and guidelines at the state level that are important to follow in order to avoid compliance issues. The Guide to physical therapist practice is one of the protocols that is followed in order to be in compliance. “Physical therapists performing patient/client interventions should ensure that their methods are accepted, safe, justifiable, and comply with the standards of care (see Guide to Physical Therapist Practice).” (Anonymous, 2011). The organization that regulates the administration of physical therapy is the American Physical Therapy Association. APTA is a national organization that has set up general guidelines in order to be successful regarding risk management. “In an effort to properly train and use support personnel in physical therapy, the American Physical Therapy Association (APTA) has differentiated training and function of PTs, PTAs, and therapy aides (Bashi and Domholdt 1993) and promulgated guidelines on delegation of responsibilities.” (Resnik & Hart, 2006). Every state has specific rules and practice regulations as well. The Texas Physical Therapy Association governs specific standard, polices and procedures that can and cannot be performed in the state is Texas. “Despite efforts to promote reasonable uniformity in physical therapy regulatory standards and practices (Federation of State Boards of Physical Therapy 2002), there are wide variations in the governance of practice.” (Resnik & Hart, 2006). All of these governing bodies follow and create guidelines based of CMS. CMS is the gold standard in every aspect of business and patient care. “State regulation of PT and PTA behaviors has the potential to influence quality of care and utilization of health care personnel.” (Resnik & Hart, 2006).
Evaluation
Every health care organizations fear is non compliance with governing bodies. There is a lot of work being done in the background in every business. Organizations have lost their accreditation due to non-compliance. My risk management plan is in compliance with all governing bodies. Most importantly with CMS. There are not many changes that occur in an outpatient setting. The most common changes that occur are documentation and charging. Privacy and patient safety are secured and are in compliance with the current risk management plan. In the sixteen year of the business in practice it has been compliant to all governing bodies.
Recommendations
There are many things that an organization can increase quality care, safety and privacy of patients. One proposal to increase overall quality is to in house continuing education and in-service’s so that all employee of the organization are learning the same policy, procedure and approach. With this proposal all employees will be working together in unison to achieve quality of care, privacy and safety. Healthcare professional can learn how to approach and provide care in the specific sector to avoid negligence and malpractice lawsuits. Health care professionals will also be up to date on interventions to avoid injury such as the use of physical agents and proper intervention with therapeutic exercise to avoid injury. With this we can achieve best practice skills and outcomes. “The implementation of best practices can help improve patient outcomes” (Pozgar, 2014).
References
Chugh, N. (2015). Risk Identification, Assessment and Management in Healthcare Sector. ASCI Journal of Management, 44(2), 36–44. Retrieved from
https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=119119051&site=eds-live&scope=site
.
Occupational Health Physical Therapy: Legal and Risk Management Issues Guidelines. 2011. Retrievedfrom
https://www.orthopt.org/uploads/content_files/OHSIG_Guidelines/OHSIG_guidelines_2/OCCUPATIONAL_HEALTH_in_PT_LEGAL_RISK_MGT
Pozgar, G. (2014). Culture of Safety. Legal and Ethical Essentials of Healthcare Administration (pp. 331-341). Burlington, MA: Jones & Bartlett Learning.
Resnik, L., Feng, Z., & Hart, D. L. (2006). State Regulation and the Delivery of Physical Therapy Services. Health Services Research, 41(4P1), 1296–1316. https://doi-org.lopes.idm.oclc.org/10.1111/j.1475-6773.2006.00536.x
Order an Essay Now & Get These Features For Free:
Turnitin Report
Formatting
Title Page
Citation
Outline
