Week 5 – The Medical Administrative Assistant as Office Manager

Introduction

Healthcare managers identify and evaluate risks as a means to reduce injury to

patients, staff members, and visitors within an organization. Risk managers work proactively
and reactively to either prevent incident or to minimize the damages following an event.

Topics:

Risk Management

 What is Risk Management

 Risk Management in Healthcare Facilities

 The Risk Manager

What is Risk Management

Risk management is essentially a means to forecast and evaluate risks which could be
associated with finance, staff and resources and infrastructure involved and together with the identification of
procedures to avoid or minimize their impact. Thus an organization essentially needs individuals who can
assess and develop strategies to avoid or minimize the risk involved and efficiently handle the situation.

Risk Management in Healthcare Industry

In a healthcare sector apart from financial risk the priority always remains the patient safety and care.
Thus the stakes are high
er as it’s a matter of life involved and hence vigilance is the key. Essentially a healthcare industry
needs to be both proactive i.e. acting before an event occurs and reactive i.e. mitigating after a
situation has occurred.

 Individuals involved in assessing the risk have multiple roles associated with medical
administration involving finance, insurance, safety issues, medical errors, legal factors and
psychological welfare of the patients and staff members.

 Thus individual needs to be proactive, intuitive and essentially ready to react so as to keep the
risk as low as possible as well as updated with all policies and changes made in the
healthcare sector to prevent any undue legal challenges which can be potentially damaging to
the institute (or healthcare provider). To be negligent can increase liability risks and result in
major financial loss.

 Any healthcare industry must have standard operating procedures for each department and
sector which need to be evaluated by risk assessment team in terms of implementation,
regular monitoring and essentially updating as per the on sites changes observed. Guidelines
are provided by various organizations such as FDA, American Society for Healthcare Risk
Management to develop quality controls, guidelines, checklist, interventions to assess any
potential issues which can then be modified as per the institute as one size fits all policy is not
valid in any healthcare setting as it varies as per patients, the healthcare sector involved,
geographical concerns and even technological advancements.
Essentially patient safety initiatives should be a priority in a healthcare sector as largely legal concerns
associated with the medical industry is negligence which can be omitted by having experienced and qualified
staff with complete knowledge and understanding of the risk involved in the healthcare sector they work. Thus
verifying their checklist before releasing a patient can ultimately prove beneficial for the patients both in terms
of satisfaction and safety and beneficial to the institute in terms of the quality of service offered.

What is Risk Management in Healthcare?

Healthcare risk management helps protect healthcare organizations from many risks that
are specific to the healthcare industry. For example, they prevent problems with patient records, administrative
systems, and more.

These risks can cause issues with your finances, your business administration, losses, liability, and more.
However, risk management gives you a process to follow to prevent these risks and to deal with them when
they occur.
The role of risk management is not new to the business world, but is relatively new to the
field of health care. Risk management is an integrated function that utilizes a number of disciplines to reduce
the potential for organizational losses. Most health care risk management activities are proactive or preemptive
techniques designed to mitigate or prevent losses. Because the health care industry is driven by quality
measurements and the need for legal compliance, risk management demonstrates its worth through reducing
cost savings. For example, a healthcare risk manager would focus on objective, measurable goals that would
reduce malpractice claims or employee turnover rates. Therefore, they must have excellent math, analytical
and administrative skills.

Importance of Risk Management in Healthcare

There are many reasons why risk management is important in the healthcare industry. Here are a few of the
top benefits of a healthcare risk management solution and what problems it helps prevent.

1. Improve Patient Safety

The most important aspect of risk management in healthcare is that it will protect patient records. HIPAA, also
known as the Health Insurance Portability and Accountability Act, requires that all health data is kept private.
This information must be protected!

If HIPAA laws are violated, it can cause many issues for a healthcare organization. Some types of risk
management in healthcare prevent data breaches, focus on privacy policies, and make sure patient
information is kept safe from others.

2. Data Security
As was mentioned before, it is vital to have data security to keep patient information protected. However, a
common problem in today’s world is cyberattacks and other things that lead to data leaks.

If you have a risk management plan in place and you are prepared for these scenarios, you will improve the
response time of your company and will deal with these issues in a timely manner.

3. Plan for Catastrophes

Another huge benefit of having a risk management plan is that it helps you plan for catastrophes. You never
know when you may experience an emergency when you are working in healthcare. These can range from
natural disasters to data leaks, and more.
Another common type of emergency in the healthcare industry are disease outbreaks. Especially if you work in
a hospital, it is vital to have a plan in place for when these types of outbreaks happen. Not only will this help
resolve the problem more quickly, but it also protects your patients.

Risk management plans help you accurately respond to and report about any disasters you experience.

The Health Care Risk Manager?

A healthcare risk manager is a professional who continually assesses and minimizes various risks to staff,
patients and the public in health care organizations. These health care administrators play a vital role in
reducing potential safety, finance and patient problems.

What Does a Health Care Risk Manager Do?

Health care risk managers are trained to handle different ongoing or unexpected PR,
personnel, operations or financial problems. They are part of the upper medical administration staff, but their
specific duties depend on the position itself and the health care organization. For example, they may work in
clinical research or they may help hospitals prepare for emergencies. On the other hand, they may work
directly with insurance and finance companies to streamline claims management. However, almost all health
care risk managers will assist with incident management involving minor, daily problems and major,
unexpected events.

What is a Normal Day Like for a Health Care Risk Manager?

The typical day-to-day activities of a health care risk manager involve sensitive patient,
legal and financial information. In fact, all of this information will directly affect the health care organization's
public image and legal or financial status. Their daily activities include managing legal and insurance claims
against the organization and communicating with internal and external legal counsel. They use software
programs to run reports and analyze risk management data. They also provide risk management training to
key health care organization staff, such as other managers or front-line supervisors. They must also ensure
compliance with industry standard risk management guidelines that are overseen by the Joint Commission and
other regulatory government agencies.

What Education is Required?

According to the Bureau of Labor Statistics (BLS), medical or health service managers
generally have a Bachelor's degree in health care management or administration. Understandably, many
health care organizations expect health care risk managers to have a Master's degree that will ensure
advanced training in budgeting, strategic planning, HR administration and hospital organization. Many health
care risk managers pursue certification through the Professional Association of Health Care Office
Management (PAHCOM), the American College of Health Care Administrators (ACHCA) or the American
Hospital Association (AHA). For example, the AHA offers a Certified Professional in Health Care Risk
Management exam and certification.
Anyone interested in learning more about health care risk management should explore the American Society
for Health Care Risk Management's website.
To recap, a health care risk manager plays a vital role in minimizing or eliminating legal, financial and health
care related risks. A healthcare risk manager is an administrative professional who coordinates, manages and
reduces these risks.