Category: Healthcare

Initial Post
Review link for FAMILY Nurse Practitioner (my role-specific)
Read under Family/Across the Lifespan competencies
https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf

Throughout this course, you have examined occurrences of the types of health care noncompliance, fraud, and abuse that commonly take place in the context of the regulatory environment in which organizations must operate. To ensure the best chance of avoiding intentional and unintentional noncompliance, health care administrators should devise and adopt a risk management plan that identifies, assesses, and analyzes the risks and tolerances inherent in the organizations processes and operations.
One of the crucial aspects of a risk management plan involves strategies for actions that should be taken in the event of a violation or breach of any nature. These mitigating actions should be followed up with remediation aimed at finding the causes leading up to the incident. This is where root cause analysis comes into the picture.
Root cause analysis is a structured, retrospective analysis of events leading up to the noncompliant event. By developing an organization-wide policy for conducting root cause analyses that is adaptable to specific operations, a cause might be determined, and preventive actions and solutions developed.
In this assessment, you examine a case of fraud and try to determine why and how it happened.
Read Maryland Health Care Provider Sentenced to 10 years in Federal Prison for Health Care Fraud Resulting in Patient Deaths from the United States Attorney’s Office.
https://www.justice.gov/usao-md/pr/maryland-health-care-provider-sentenced-10-years-federal-prison-health-care-fraud
Use the Five Whys to conduct a root cause analysis to determine why the Medicare fraud occurred and Timothy Emeigh’s participation in the case.
Write a 700- to 1,050-word analysis that identifies and evaluates the root cause for Medicare fraud in this case.
Include the following:
Articulate the “Five Whys” for this case and provide an explanation for each.
Speculate how and why Mr. Emeigh participated in the scheme.
Explain what you, as an administrator, might have done to prevent this from happening.
Recommend risk management strategies the organization can utilize to prevent this and similar types of events from occurring in the future.
Cite your sources according to APA guidelines.
Submit your report and article.

14 pages does not include title, abstract, or reference pages. 
References must be from date range 2019-2024, scholarly, not all internet sources.
Title page, abstract, body, references page, double space, 12 pt font, times new roman, double spaced. 
They will use Turnitin to check for plagarism. 

The assessment should be 2000 words. in this format : 
introduction: the purpose of this assignment and what you are going to do in the order you are doing it.  this will be 200 words 
body: 
1. Describes how colonisation led to disparities in healthcare for Māori versus non-Māori
people. this will be 600 words and referenced 
2. Describe Te Tiriti o Waitangi (te Tiriti) and explain how te Tiriti is relevant to health
service delivery in Aotearoa New Zealand. this will be 500 words and referenced
3. Describe the principle
Equity/ Mana Taurite
and discuss how the
principle supports the delivery of equitable healthcare in Aotearoa New Zealand. this will be 500 words and referenced
conclusion: in conclusion it can be seen…..list out the findings. this will 200 words
use 10 recommended reading from the pdf and reference it in APA 7 

health promotion assinment between nurses , to care for patien , topics( stress , food disorder,smoking, abortion , alcoholism, healthy activity, mental health, topic infograpic)minimizing the risk, violonce, habits.

Description: A case study is provided. The case with an adverse outcome has been the subject of an incident review. You are a quality manager and have been asked to present a summary of the most important contributory factors relating to the adverse outcome at the departmental Morbidity and Mortality meeting. You will develop at least 3 contributory factors (The contributory factor is an issue where some change on the part of the organisation (a systems change) may have prevented the adverse event) that may have contributed to the adverse outcome. 
You must explain the rationale behind your choice of contributory factors to the Morbidity and Mortality Committee and provide references to support your rationale. You must put forward at least 3 contributory factors. You must also suggest at least one potential action and describe interventions (low or high level) for each contributory factor that could be taken to prevent the adverse event from happening again. 
The report on the case study should be set out as follows:
summation of the case in point form. (300 words).
Describe the 3 potential contributing factors you feel have been involved that may have resulted in the adverse outcome. (500 words).
Provide a summary of the rationale behind your choice of contributory factors (1000 words).
The rationale should cover the following for each contributory factor:
Which major category of issues the contributory factor relates to (it may be more than one of the seven) (e.g. communication, policies/procedures/guidelines, equipment, skills/knowledge/competence, patient factors, work environment/scheduling, safety mechanisms/barriers) and how it relates to this category.
How the contributory factor may have contributed to the adverse outcome.
Describe one potential action (for each contributory factor) and describe interventions (low or high level) that could be taken in relation to this contributory factor to prevent this adverse event from happening again.

As the manager of the CTU Health Care Information Systems Department, you recognize that change management is critical to the success of the implementation of the electronic health record (EHR) or electronic medical record (EMR). You also recognize that change management requires cultivating and managing realistic expectations of all of the departments involved when evaluating health records, including federal, state, and ethical guidelines.
For this assignment, you must explain how you would guide the change process among team members and departments. Consider the following questions:
Who are the stakeholders?
Who are the users?
How will you handle resisters to change?
In evaluating ethical guidelines of health records, how will you achieve security and confidentiality of patient medical information?
How will you address low computer literacy levels among physicians and employees?
CTU Health Care Systems has five clinics that serve nearly 2 million residents in a large metropolitan area and that treat over 500,000 patients annually. Now that you have successfully implemented the electronic health record (EHR) at the main facility, it is time to integrate the clinic’s information technology (IT) with the main hospital’s EHR. In preparation for the implementation of an EHR system for the five clinics, the healthcare system implemented an electronic document (ED) and content management (CM) system to handle the imaging, indexing, and storage of selected hard-copy documents from active patient paper medical records so that in the future, to support continuity of care needs, key documents would be retrievable through the EHR system. However, the healthcare system lacked the level of internal IT and health information services that staff resources required to manage the implementation of hardware and software to handle the actual paper conversion process, so these aspects of the project were outsourced.
Discuss the following:
As the healthcare system prepares to select an outsource company as its vendor for this project, what types of information should you gather from each vendor under consideration?
What are the potential benefits that a healthcare system could gain from implementing a document imaging and management project prior to implementing an EHR system?

How would you describe systems thinking in your own words?
What is the role of the nurse leader in transitions of care? What aspects of systems thinking do you believe might most contribute to an effective transition of care?

Instructions:
The purpose of this assignment is to gain real-world insight into how risk management programs operate within health care organizations.
Select a local health care organization where you can conduct an interview with an employee who is involved in risk management processes. This organization can be your current employer or a different health care facility in your community. Acute care, urgent care, large multi‐provider private medical clinics, assisted living facilities, and community/public health clinical facilities are all ideal options to complete the requirements of this assignment. Select an individual who can provide sufficient information regarding how their organization manages risk within its facility to answer the questions below.
In your interview, address the following:
Risk management strategies used in the organization’s risk control program, along with specific examples.
How the facility’s educational risk management program addresses key professional, legal, and ethical issues, such as prevention of negligence, malpractice litigation, and vicarious liability. 
Policies the facility has implemented that address how to manage emergency triage in high‐risk areas of health care service delivery (e.g., narcotics inventories, declared pregnancy policies, blood-borne disease vector, etc.), and identify how these align with Occupational Safety and Health Administration (OSHA) standards. 
Challenges the organization faces in managing and controlling high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4 narcotics/opioids, etc.), and include how cultural and religious beliefs affect the provision of patient care. 
Strategies the facility utilizes to monitor, evaluate, and maintain compliance within its risk management program.
After conducting the interview, compose a 750‐1,000-word summary analysis of the interview that includes the prompts above, in conjunction with the interviewee’s responses. In addition, include the following elements in your response:
An assessment of the organization’s risk management program, including how it attends to high-risk health care and legal concerns.
Action steps you would take to improve one area of the organization’s risk management program, along with your rationale for doing so.
Cite appropriate references as needed to support your statements and rationale.
My Interview: 
Hernandez Valdez Jr, Miguel (Associate Manager, Pharmacy Technician For Banner Estrella Medical Center)
Risk management strategies used in the organization’s risk control program, along with specific examples.
Our hospital utilizes barcode assisted technology to support every step in our medications procurement and administration process. Barcode verification is performed from when medication is received from our vendor, to order verification, and to patient administration. Our facilities run daily reports to ensure all employees, regardless of discipline, are compliant with barcode validation and that no steps are being overridden/circumvented.
How the facility’s educational risk management program addresses key professional, legal, and ethical issues, such as prevention of negligence, malpractice litigation, and vicarious liability. 
Our hospital addresses risks issues proactively and retroactively. Our facilities assigns annual learning curriculum to educate staff on professional, legal, and ethical issues and also provides education on best practices to proactively address possible negligence and malpractice. By continuously educating our staff, we are minimizing liability. When an issue does occurs, our facilities addresses these concerns both systemically and locally. Our facilities investigates the root cause of the issue and develops a best practice to prevent this issue from re-occurring. If the issue is more system wide or complex, then our system risk and safety team will assist with developing a practice and disseminating any information, and/or education. 
Policies the facility has implemented that address how to manage emergency triage in high‐risk areas of health care service delivery (e.g., narcotics inventories, declared pregnancy policies, blood-borne disease vector, etc.), and identify how these align with Occupational Safety and Health Administration (OSHA) standards. 
Our health system has developed multiple policies that address emergency triaging. These policies are usually system wide but often focus on certain disciplines of healthcare such as nursing, environmental services, pharmacy, laboratory, etc. For instance, our facility has a general policy on personnel protective equipment that addresses the type of precautions, supplies, and equipment to be used for patient care in high risks areas. This was a heavily referenced policy during our COVID pandemic and helped with maintaining the overall safety and well-being of all our staff members and patients. Depending on the department, there may be additional policies and procedures relating to the same topic. For example, pharmacy adheres to an additional PPE policy that is focused on the department’s cleaning of hazardous spaces. These policies are often dictated by certain compliance measures such as annual masks fittings and education, as required by OSHA. 
Challenges the organization faces in managing and controlling high-risk health care (e.g., infectious diseases, nuclear medicine, abortion, class 4 narcotics/opioids, etc.), and include how cultural and religious beliefs affect the provision of patient care.
One main challenge that our organization faces is navigating through national drug shortages. There are medications that are preferred agents for certain diseases, or disorders, and when these medications go on shortage we have to decide on the best alternative.
Strategies the facility utilizes to monitor, evaluate, and maintain compliance within its risk management program.
Our organization has a designated compliance team along with compliance officers for every facility. Our facility encourages all employees to report any compliance issues to our compliance officer, or via an anonymous tip line. If they are uncertain whether something is a compliance issue, we still encourage our employees to report the issue regardless. The compliance team will review all reports and investigate the issues to determine whether there is truly a compliance, or safety issue. Additionally, our compliance team assigns annual education to help maintain compliance and mitigate risks.

The purpose of this assignment is to analyze the role of managed care organizations within health care and risk management programs.
Reflect on and evaluate the role that the managed care organization (MCO) plays in today’s health care environment by developing 1,000-word response that addresses the following:
Explain what a health care organization’s administrative role is in executing risk management policies and ensuring compliance with managed care organization (MCO) standards.
Explain what value the regulatory statutes of a typical MCO provide to a health care organization and include strategies pertaining to policies such as conflict resolution and risk management that affect patients and families as well as employees and employers. 
Explain what MCO responsibilities relevant to the Patient Protection and Affordable Care Act (ACA) and Centers for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws.
Identify strategies that can be implemented for developing a culture of reporting and transparency.
In addition to your textbook, you are required to support your analysis with at least three credible health-related resources.