discussion questions 564

For this week discussion use the Risk Management Handbook for Health Care Organization text and the Internet to complete the following:.

*- Read Chapter 5, “Governance of the Health Care Organization, p. 157-180. This chapter pays attention to the importance and responsibility of governing boards, considers elements of a risk management program, and overviews specific legislation related to oversight.

– Read the U.S. Department of Health and Human Services’ 2003 “Corporate Responsibility and Corporate Compliance: A Resource for Health Care Board of Directors. You will use this resource for a discussion question in this unit. You may wish to print this resource to highlight the salient points. This is a useful document that you may also wish to share with others in health care organizations who have boards of directors.

-Review the 2003 Profile of Health Care Compliance Officers.

-Read the National Practitioner Data Bank’s 2008 “Fact Sheet on the National Practitioner date bank.

– Browse “The National Practitioner Data Bank: Healthcare Integrity and Protection Data Bank.

– Read the U.S. Department of Health and Human Service’s “Corporate Integrity Agreements Document List.

1. Corporate Board Responsibility

Corporate boards are tasked with the responsibility of ensuring that the organization remains in compliance with all areas of operation. Boards need to work in tandem with the administrative staff. Boards must ensure that they review all areas of health care organizations from financials, operations issues, medical error reporting, credentialing of providers, and other potential risk areas. Review the readings and the PowerPoint presentation in this week’s readings.

What should the Board know? Create a one-page, single-spaced memo as a member of a governing board for a health care organization. Direct this memo the organization’s CEO. List the reports that you would like to have prepared for next month’s board meeting.

2. The Credentialing Function

Credentialing of clinicians is a specific area that requires integration of quality improvement with risk management functions.

Credentialing is an official process that all health care organizations must complete. The National Practitioner Data Base (NPDB) is a specific source that organizations should use for assuring that licensed providers have no records of fraud, lawsuits, et cetera. In addition, state licensing boards must also be consulted to ensure that the clinician indeed has a license and may be employed by your organization.

You are the risk manager in charge of credentialing of a large, teaching hospital. All health care providers must be credentialed prior to working with patients. Consider the following:

aphysician with three pending lawsuits from patients injured by the physician.What type of credentialing needs to be considered for your choice? What databases should be checked? What type of background should be collected? Create a 250- to 300-word response.

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