Based on my experience as the former Director of Quality Management for an organization with more than 50 sites and as a Naturopathic Physician, I think you organization had a good plan in p

1.) Based on my experience as the former Director of Quality Management for an organization with more than 50
sites and as a Naturopathic Physician, I think you organization had a good plan in place.
In my research, I saw this interesting article titled: ” Different Roles, Same Goal: Risk and Quality Management Partnering for Patient Safety at https://www.ashrm.org/sites/default/files/ashrm/Monograph.07RiskQuality.pdf
What are the key points? Based on this article, what else would you recommend to your organization and why?
A.) risk management and quality often overlap regarding staff and safety. COVID PPE and sanitation were crucial in maintaining effective infection control. At our hospital in 2019, when COVID surfaced, an infection prevention task force was created to train and guide staff on the proper donning and doffing of various PPE and respirators. They would also audit staff around the units on hand hygiene and how to properly clean the PAPR hoods since supply was so limited then. Now PPE supplies are better, but hand hygiene audits are ongoing. DO you agree? why or why not?
B.) Risk management and quality improvement are systems for providing treatment and analysis while monitoring and reviewing risks and issues. There are many safety measures patients can take to prevent risks from occurring. It also also the health care organization’s responsibility to ensure that every patient receives the best quality care and safety. Do you agree? why or why not?
C.) This is interesting information showing how insurance coverage will affect patient options:)
Dive deeper and explore how risk management functions and quality improvement functions in an organization can overlap in terms of addressing patient and staff safety.
In my research, I came across this interesting article titled: ” Different Roles, Same Goal: Risk and Quality Management Partnering for Patient Safety at https://www.ashrm.org/sites/default/files/ashrm/Monograph.07RiskQuality.pdf
What is the synopsis of this article? Based on it would you add anything to your approach?
D.) The overlap between Covid19 safety precautions between patients and staff is vital. I remember a time during my clinical rotation in 2020 that involved full PPE, nurses and healthcare workers were taping up their worn out N95s to the wall after each shift. It was insane, but they just couldn’t get any more. I also recall a separate clinical where a nurse knowingly cared for a patient who was high risk for Covid while actively having Covid because she was afraid to tell her boss she was sick. It was not on the floor we had, but I believe the boss put a lot of pressure on the staff not to get sick. The end result was an entire floor getting Covid, we were no longer allowed work there and the whole floor was put under strict watch and retraining. Do you agree? why or why not?
E.) Risk management and safety measures in healthcare apply to staff as well as the patients. Below are two safety measures that overlapped:
First: A safety measure we enforced in our facility was when an employee or patient tests positive for COVID must then test negative before reentering the building. It was done in order to ensure the safety of other patients and staff. The patient could not be told not to return to the building while employees could still be infectious. We had an employee who was positive during her quarantine period and returned negative afterwards. She came back to work then started feeling sick again days later more severely than the days before. She was tested again and found to be positive for COVID and was immediately sent home. If you are aware or suspect that you are possibly unwell, you are not allowed to enter our buildings. Our team will come to your vehicle to conduct a swabbing once we receive your call. When negative results are confirmed, you may enter the building with a mask on, and you will be placed in a designated sick room. Just last week, our board of directors approved removing the requirement to wear masks every day at work. However, we still take precautions when entering a sick person’s room by wearing PPE. In a study conducted by Ismail et al., (2022) they noted that healthcare workers were at a greater risk of being infected with COVID-19. Their range was 15-20% of the infected population, which was a risk for the rest of the population. This precaution was not removed.
Second: Patients and employees are also subject to random drug testing as a safety standard. This is another safety measure in protecting our patients and staff. If suspected that an employee or patient who use drugs is possessing, buying, or selling drugs they will be asked to submit a drug test. For employees, a refusal to test results in termination and for the patients it is a discharge from the practice.
These policies work for our facility. Prospective employees are drug tested before hiring and made aware once we are hired that we could be randomly chosen anytime. Our patients also sign a controlled substance contract in which they are made aware they may have to bring in their controlled substances received from our providers. If chosen, this includes a pill count along with a urine sample for anything that is not listed as a medication from our facility or any of their other providers. Per Abdelrahman et. al., (2019) it was routine to randomly screen patients who received opioid medication from two clinics that were part of the Division of Internal Medicine at Wayne State University School of Medicine. The purpose of this was to ensure patient compliance with their opioid medications. They also checked for the presence of illicit drugs in their urine samples. During a study, it was found that at least one urine sample contained illicit drugs. They concluded that random drug testing contributed to the drop in illicit drug use.
Both of these policies work to ensure the safety of our employees and our patients. Do you agree? why or why not?
F.) There are six dimensions of healthcare quality: safety, effectiveness, patient-centred care, time management, and efficiency. Safe refers to avoiding harm to patients from care that is intended to help them and means that no unexpected deaths occur or near miss occurrences. Risk and quality functions in a healthcare organization overlap in patient safety. Examples include analysis of patient safety and critical incidents; ; building a culture of safety; handling of patient complaints; proactively assessing risk; public reporting of quality data; and incident reporting analysis.
Using my current employer – Dignity health hospital in Henderson, Nevada; I have explored the risk management plans within the organization and summarized two functions that commonly overlap. Medication standards and fall risk protocols are the two risk managements amongst many that stand out the most.
Preventing medication errors: This correlates with risk management because it is patient safety focused. It is set in place to prevent near miss or death events. The knowledge of the medication, packaging, dosing, contraindications and effects of the drugs are required. The administrator must not be distracted. Establishing the correct patient and matching the patient to the medication with two identifiers such as MRN number and DOB. Effectiveness of proper communication other interprofessionals and with also the patient.
Fall risk protocol :
Intrinsic factors include blood pressure, orthostatics; cognition; vision; spasticity, rigidity; strength; sensory deficit, cerebellar, parkinsonism; and musculoskeletal issues, antalgia.Extrinsic factors include medications, environment and other factors.Prevention methods included staff and patient education, environmental modifications, assistive devices, policies and systems, rehabilitation, medication management and management of cognitive impairment.
The structure works for my organization because it allows education for employees and allows the facility to track when there are risk management errors – when they are tracked then it can make it easier for improvement. Do you agree? why or why not?

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