1 / 21

CONTROL & RISK MANAGEMENT

CONTROL & RISK MANAGEMENT. STRATEGIC MANAGEMENT IN HEALTHCARE 14 April 2009. CONTROL MONITORING POINTS. INPUTS - PROSPECTIVE FEED FORWARD CONTROL PROCESSES - CONCURRENT SCREENING CONTROL OUTPUTS - RETROSPECTIVE FEEDBACK CONTROL. INPUT CONTROL. FOCUSES ON RESOURCES CONSUMED

dorac
Download Presentation

CONTROL & RISK MANAGEMENT

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. CONTROL & RISK MANAGEMENT STRATEGIC MANAGEMENT IN HEALTHCARE 14 April 2009

  2. CONTROL MONITORING POINTS • INPUTS - PROSPECTIVE • FEED FORWARD CONTROL • PROCESSES - CONCURRENT • SCREENING CONTROL • OUTPUTS - RETROSPECTIVE • FEEDBACK CONTROL

  3. INPUT CONTROL • FOCUSES ON RESOURCES CONSUMED • IN A SERVICE INDUSTRY THIS USUALLY MEANS PERSONNEL • PHYSICAL RESOURCES SHOULD NOT LIMIT PERSONNEL BUT USUALLY DO

  4. PROCESS CONTROL • OUTPUTS ARE DETERMINED BY: • AMOUNT & APPROPRIATENESS OF INPUTS • EFFICACY & EFFICIENCY OF PROCESS

  5. OUTPUT CONTROL • ALSO CALLED FEEDBACK CONTROL • QUALITATIVE & QUANTITATIVE • REQUIRES STANDARDS OR EXPECTATIONS

  6. CQI AND CONTROL • PROCESSES CAN BE IMPROVED • CONTROL IS DIRECTED AT PROCESSES • INPUT CONTROL IS NO SUBSTITUTE FOR PROCESS AND OUTPUT CONTROL

  7. CONTROL METHODS • BUDGETING • COST ALLOCATION • RATIO ANALYSIS - % OF EXPECTED • FINANCIAL STATEMENTS/ANALYSIS • OPERATIONAL ACTIVITY ANALYSIS • BENCHMARKING • STANDARD SETTING

  8. DESIGNING CONTROLS • INFORMATION BASED • PROSPECTIVE WHEN POSSIBLE • REALISTIC & UNDERSTANDABLE • ACURATE, TIMELY & RELIABLE • IMPORTANT &/OR COST-EFFECTIVE

  9. INFORMATION SYSTEMS • MANAGERIAL - HUMAN RESOURCES • CLINICAL – DOCTOR VISITS • MIXED - LABORATORY

  10. INFORMATION SYSTEMS • ALL THE USUAL PROBLEMS • HIGHLY IDIOSYNCRATIC INFORMATION • HIGHLY “TECHNICAL” INFORMATION • HIPPA

  11. ELECTRONIC MEDICAL RECORDS • GARBAGE IN – GARBAGE OUT • IF A SYSTEM IS NOT FUNCTIONAL, COMPUTERS WILL MAKE IT WORSE • INFORMATIONAL NOISE

  12. ADVANTAGES OF EMR • Access from multiple sites • Reduced offline storage costs • Improve quality & coherence of process • Automated clinical guidelines • Support research and quality improvement • Easier reporting of all types • Portability – disaster response

  13. DISADVANTAGES OF EMR • Scores of incompatible data sources • Duplicate information and effort • Obtaining information from physician • Physician as clerk/typist • Confidentiality • No reduction in support staff • Transfer to next provider

  14. RISK MANAGEMENT • PRIMARY, SECONDARY, AND TERTIARY PREVENTION • SPECIALTY OF LAWYERS • ABOUT STANDARDS • ABOUT LOSSES • MONEY • REPUTATION/BUSINESS • FREEDOM

  15. RISK MANAGEMENT • AVOID OR REDUCE LOSSES/MISTAKES • MITIGATE THE DAMAGE FROM LOSSES/MISTAKES • INSURE AGAINST LOSSES/MISTAKES • OBEY THE LAW

  16. STEPS IN RISK MANAGEMENT • IDENTIFY • EVALUATE • REDUCE/ELIMINATE • TRANSFER/INSURE

  17. WHEN A LOSS OCCURS • SECURE THE RECORDS • MITIGATE DAMAGES • DON’T ADD INSULT TO INJURY • BE SMART ABOUT BILLS • SUPPORT YOUR PEOPLE

  18. SELF-INSURANCE • YOU ARE YOUR OWN INSURANCE COMPANY • REINSURANCE OR UMBRELLA IS USUALLY NECESSARY • DEDUCTIBLE IS A FORM OF SELF-INSURANCE

  19. INCIDENT REPORTS • MAY BE USED FOR NUMBERS ONLY • SERIOUS PROBLEMS NEED A FAST TRACK • MUST HAVE A CORRECTIVE ACTION COMPONENT - DON’T JUST DOCUMENT YOUR STUPIDITY!

  20. NATIONAL PRACTITIONER DATA BANK • MUST REPORT SIGNIFICANT ACTIONS AGAINST A PRACTITIONER • MUST QUEARY IT BEFORE TAKING ON A NEW PRACTITIONER • AVOIDING REPORTING

  21. INDEMNIFY & HOLD HARMLESS • USUALLY A STUPID IDEA FOR BOTH PARTIES • DON’T EVER SIGN ONE YOURSELF • INSURANCE OR A BOND IS THE RIGHT WAY TO DO THIS

More Related