Risk management, quality improvement, and compliance programs have discrete applications within a healthcare organization, yet they have complementary goals. The motive for these programs is to improve all aspects of the patient experience. There are external regulations and requirements imposed on all organizations, and these regulations are controlled by the internal processes designed by each organization.
There is an expectation of care and trust between patients and their healthcare providers. An organization needs to be vigilant in all circumstances, particularly those involving patient safety.
A. Analyze the attached “Compliance Management Scenario” by doing the following:
1. Describe five health information management (HIM)-related mistakes made in the scenario.
2. Determine whether each of the five mistakes described in part A1 was a violation of organizational compliance, a legal concern, or both.
3. Describe one specific solution the compliance officer and Anika, the manager, should implement to prevent each of the five mistakes described in part A1 and justify how these solutions will prevent reoccurrences of each mistake.
B. Explain how the manager of a HIM department could teach compliance behaviors to the clinic’s staff members in order to mitigate legal risk within a healthcare organization.
1. Explain why it is important for staff to understand patient authorization as it relates to release of information, including how this ensures patient safety and trust.
2. Explain protocols for release of protected health information (PHI) and how these protocols protect patient privacy.
C. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
D. Demonstrate professional communication in the content and presentation of your submission.
The submission accurately describes each of the 5 HIM-related mistakes made in the scenario.
The submission accurately determines whether each of the 5 mistakes from part A1 were a violation of organizational compliance, a legal concern, or both.
The submission describes 1 specific solution for each of the 5 mistakes described in part A1 and logically justifies why each solution should be implemented by the compliance officer and manager to prevent reoccurrences of those mistakes.
The submission explains specific methods an HIM manager could use to teach compliance behaviors and each of the behaviors taught are effective in mitigating legal risk within a healthcare organization.
The submission logically explains why it is important for staff to understand patient authorization as it relates to release of information. The submission logically explains how this understanding ensures both patient safety and trust.
The submission accurately explains the protocols for release of PHI and logically explains how the protocols for the release of PHI protect patient safety.
The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style.
Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.
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