1250 word Provisions and Reimbursement of Health care services essay

Approach to Risk Management in Physical Therapy

Joshua M. Garcia

Grand Canyon University: HLT-308V

January 16, 2020

Running head: ASSIGNMENT TITLE HERE

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Risk Management in Physical Therapy

There are many different approaches to risk management. Many plans have been created for organizations of all kinds to follow in order to maintain compliance, increase quality care and safety. Risks are present in many organizations; however, some are prone to more compliance issues such as hospitals. I will be discussing risk management in physical therapy. I chose this as my topic of discussion because I am currently a practicing physical therapist assistant in a outpatient setting as well as an owner. I think it is important to perform research in this field as it will increase my knowledge and make more aware of the compliance issues at hand. I will be able to create and enhance the current risk management plan that is in place.

The risk management applies to the overall practice of physical therapy and the common issues that arise. Risk management role is to improve quality care, safety and identify risks that affect the business such as scope of practice, documentation, patient relationship, and interventions, and malpractice. It is important to understand and know the business of physical therapy in an outpatient setting as it is different to a hospital, nursing home, home health, and an inpatient rehab setting. The risk management

Standard Risk Management

There is a standard to risk management that many organizations refer to create a foundation and incorporate their own ideas. It is imperative that specificity be used in each sector of healthcare. What is the standard of risk management? “Risk management which is forecasting and evaluation of risks together with the identification of procedures to avoid or minimize their impact which includes identification, analysis, assessment, control, and avoidance, minimization, or eliminate on of unacceptable risks through strategies like risk assumption, risk avoidance, risk retention, risk transfer, or any other strategy (or combination of strategies) in proper management of future events” (Chugh, 2015). The is the foundation on which a risk management plan derives from. Standard risk management follows risk management with specificity to physical therapy (health care) is: “A situation involving exposure to danger where a probability or threat of damage, injury, liability, loss, or any other negative occurrence that is caused by external or internal vulnerabilities exist and that may be avoided through preemptive action.” (Chugh, 2015). Physical therapy plan to risk management is “According to the Guide to Physical Therapist Practice, the elements of patient/client management include examination, evaluation, diagnosis, prognosis, and intervention.” (Anonymous, 2011). This the common strategy for the sector of physical therapy. “Work within the physical therapist scope of practice and professional competence. When appropriate, maintain separate files for personal injury claims and each worker's compensation claim. When documenting individual patient/client behaviors, document only those things observed. Avoid disparaging remarks which could lead to claims of defamation (e.g. "malingerer") or clinical labels which you might not be qualified to make (e.g. "patient/client is depressed'). Document only the intervention and avoid comments related to "secondary gain" or its origin. Avoid expansion of services at the individual patient's/client's request unless approved by appropriate referral sources and an additional examination/evaluation is performed.” (Anonymous, 2011). The accrediting body of CMS is important in maintaining compliance especially with documentation, safety, accreditation of a therapist, medical records and practicing of a therapist.

Agencies

Many agencies exist to govern the practice of physical therapy. There are also many standards and guidelines at the state level that are important to follow in order to avoid compliance issues. The Guide to physical therapist practice is one of the protocols that is followed in order to be in compliance. “Physical therapists performing patient/client interventions should ensure that their methods are accepted, safe, justifiable, and comply with the standards of care (see Guide to Physical Therapist Practice).” (Anonymous, 2011). The organization that regulates the administration of physical therapy is the American Physical Therapy Association. APTA is a national organization that has set up general guidelines in order to be successful regarding risk management. “In an effort to properly train and use support personnel in physical therapy, the American Physical Therapy Association (APTA) has differentiated training and function of PTs, PTAs, and therapy aides (Bashi and Domholdt 1993) and promulgated guidelines on delegation of responsibilities.” (Resnik & Hart, 2006). Every state has specific rules and practice regulations as well. The Texas Physical Therapy Association governs specific standard, polices and procedures that can and cannot be performed in the state is Texas. “Despite efforts to promote reasonable uniformity in physical therapy regulatory standards and practices (Federation of State Boards of Physical Therapy 2002), there are wide variations in the governance of practice.” (Resnik & Hart, 2006). All of these governing bodies follow and create guidelines based of CMS. CMS is the gold standard in every aspect of business and patient care. “State regulation of PT and PTA behaviors has the potential to influence quality of care and utilization of health care personnel.” (Resnik & Hart, 2006).

Evaluation

Every health care organizations fear is non compliance with governing bodies. There is a lot of work being done in the background in every business. Organizations have lost their accreditation due to non-compliance. My risk management plan is in compliance with all governing bodies. Most importantly with CMS. There are not many changes that occur in an outpatient setting. The most common changes that occur are documentation and charging. Privacy and patient safety are secured and are in compliance with the current risk management plan. In the sixteen year of the business in practice it has been compliant to all governing bodies.

Recommendations

There are many things that an organization can increase quality care, safety and privacy of patients. One proposal to increase overall quality is to in house continuing education and in-service’s so that all employee of the organization are learning the same policy, procedure and approach. With this proposal all employees will be working together in unison to achieve quality of care, privacy and safety. Healthcare professional can learn how to approach and provide care in the specific sector to avoid negligence and malpractice lawsuits. Health care professionals will also be up to date on interventions to avoid injury such as the use of physical agents and proper intervention with therapeutic exercise to avoid injury. With this we can achieve best practice skills and outcomes. “The implementation of best practices can help improve patient outcomes” (Pozgar, 2014).