Health care risk management assignment week 3

Chapter 7: Assuring Safety and Security in Healthcare Institutions

Safety and Security – Risk?

• Health facilities that experience adverse events due to safety or security issues can incur penalties ranging from large fines to loss of accreditation.

• An aggressive and well-organized safety and security management program can help minimize risk of and adverse event.

Regulation and Accreditation

• Medicare and Medicaid require a participating healthcare organization to satisfy the Conditions of Participation (CoP) relevant to the management of safety and security. – Accreditation by the Joint Commission, DNV

Healthcare Inc. or HFAP ensures that the facility meets the CoP requirements

• State Departments of Health also regulate safety and security in healthcare organizations

Safety vs. Security

• Safety can be a broad category with standard policies and procedures throughout a facility or system. – Hand-washing policy – Use of Personal protective gear – Hazardous waste disposal

• Security must be more site specific.

• Safety and security policies sometimes conflict.

High Risk Events

• A facility may incur major penalties if a “never” adverse event occurs (an event that should not occur if appropriate safety/security measures were in place)

• CMS may not reimburse costs of a never event and many third party payers have a non- reimbursement program as well.

Techniques for Managing Safety and Security

• Risk Assessment Estimate

• Failure Modes and Effects Analysis (FMEA)

• Root-cause Analysis (RCA)

• Technological Redundancy

• Crew Resource Management

• Red Rules

Potential Environmental Hazards

• OSHA has a list of the types of hospital-wide hazards and provides information on how to prevent and respond to them

• Three categories of hazardous materials – Biological – Chemical – Radioactive

Security: Unwanted Intruders

• Use of high-tech solutions to manage visitor and employee access – Automated turnstiles with card swipe readers for

employee entrances – Visitor areas/desk where all visitors enter and

sign-in. – Employee ID badges – Secured areas

Potential Security Hazards

• Theft of Patient Valuables/Employee theft

• Infant abduction

• Workplace Violence

• Gangs

Patient Valuables

• Provide a safe in the building to house

valuables

• Provide receipts for any valuable stored by

facility

• Encourage patients to leave valuables at

home or give to family to take home

Violence in the Workplace

• Patients have a right to treatment but staff

have a legal right to a safe workplace

• Watch for signs that may lead to violence

(in patients, visitors and staff) – Anger

– Stress

– Under the influence of drugs/alcohol

Gangs

• Many health facilities treat victims of gang violence and occasionally the dispute continues upon arrival at the facility.

• Use of metal detectors is increasing to prevent entrance of weapons into the health facility

Information Security • With increasing use of information management

systems, healthcare facilities must insure that the system itself is secure from unauthorized access or violate HIPAA regulation – Entry to system is password or thumbprint

protected – Use of firewalls to block unauthorized internet

access – Use of Virtual Private Networks

Fire Safety

• Health facilities must comply with NFPA standards for fire suppression systems, fire barriers, smoke compartments, detectors and alarms, and emergency exits and lighting

• Defend in Place

• Fire Safety Plans and Training

Facility Design and Operation

• The design of the physical plant can help ensure safety and security of the facility – Proper ventilation design can ensure indoor air

quality and safety – Use of improved technologies to keep water clean

and prevent growth of bacteria – Use of technologies to prevent scalding from high

water temperatures

Emergency Preparedness

• Dedicated resources for emergency

preparedness

• Designation of a command structure

• Culture of continuous training

• Frequent and critiqued disaster drills

• Constant updating of plan to reflect

changing risk and conditions

Types of Threats

• Security

• Utility Failures

• Geologic

• Structural

• Other

Plan for Information System Continuity

• As healthcare organizations rely more heavily on information technologies, it is imperative that there be a specialized disaster plan for information technology. – Backup data systems – Independent emergency power supplies – Alternative network communication

Summary

• Safety and security incidents can be

serious threats to the financial well-being

of the healthcare organization.

• The Risk Manager must be aware of

potential safety and security situations and

ensure policies and procedures are in

place to minimize the risk of an incident.