Reference no: EM133359627
The Act 13 Procedural Memo (APM) mimics an assignment you might receive in an entry-level position in health care management, health care risk management, patient safety, or quality improvement.
HERE'S THE SCENARIO: As the new CEO of Mount Elsewhere Hospital (MEH) in Philadelphia, I discover that MEH is not effectively following Pennsylvania's Act 13 patient safety provisions and is falling behind other PA hospitals. I have asked you to create a memo explaining how MEH can start from scratch and effectively comply with the Act. This memo will ultimately be distributed widely to MEH staff.
Steps 4 must be in a business memo format addressed to the staff at MEH and answer the following questions:
1. Risk Exposures: What can go wrong if MEH fully complies with MCARE? What are the consequences if MEH does not? For each (compliance and non-compliance):
Identify, explain, classify, and analyze one risk exposure. Discuss any correlated risks.
Risk mitigation: Suggest one or two risk mitigation techniques to manage each risk exposure;
What resources will you need? (Neither compliance or non-compliance is "cost free," but you
must consider MEH's limited means).
Internal Reporting:
What internal event reporting system should MEH use, and why? Support your ideas with evidence, including relevance to MEH.
How and when will staff file reports?
How will the reports get to the appropriate recipients?
How will you protect the confidentiality of the documents?
What will the reports look like?
Address the value of event reporting to improving patient safety.
Provide samples you found from other similar organizations.
External Reporting:
When and how do internal reports become external MCARE reports?
Who decides what internal report information becomes MCARE reporting and how will this person decide to report issues to MCARE?
How exactly will internal information from MEH incident reports go to the PA PSA and into PA PSRS?
What must be omitted from these MCARE reports?
Implementation and Employee Compliance: What should MEH do to encourage What have others done to encourage reporting? Could this work at MEH?