Role Of An Early Careerist In Risk Management

Role Of An Early Careerist In Risk Management

Table of Contents

Order ID	53563633773
Type	Essay
Writer Level	Masters
Style	APA
Sources/References	4
Perfect Number of Pages to Order	5-10 Pages

Description/Paper Instructions

Role Of An Early Careerist In Risk Management

Health & Medical Questions

Prepare a workplace brief (8-10 double-spaced pages) to address a privacy breach that occurred in a health care organization. Include the consequences of failure to act and evidence-based recommendations for addressing the breach.

INTRODUCTION

Health care is one of the most heavily regulated major industries in the United States. Leaders are challenged to stay current and to comply with federal, state, and local laws and their associated regulations. Health care organizations are also responsible to meet industry standards. In some cases, payers equate meeting industry standards with achieving and maintaining accreditation. In fact, many payers consider accreditation a minimum condition of participation. In addition, individual licensure and certification requirements establish basic expectations for health care leaders’ professional conduct.

In summary, health care leaders are responsible to:

Meet ethical personal, professional conduct, certification, and licensure expectations.

Comply with local, state, and federal health care and human resources laws.

Provide evidence of compliance with existing regulations and scan the field for emerging regulations.

Identify and meet appropriate accrediting body standards (for example, Joint Commission’s National Patient Safety Goals standards).

As an individual’s health care leadership career advances, so does the corresponding level of accountability. Not knowing the laws or regulations is not an excuse for not complying with them.

This assessment allows you to demonstrate your knowledge of and skills relating to compliance concepts, and governmental and regulatory agencies that oversee health care service delivery, billing, and general operations. You will also have the opportunity to apply the components necessary to initiate and maintain an effective compliance program. Finally, you will consider relevant human resources laws that may pertain to your compliance recommendations.

INSTRUCTIONS

In this assessment, you are assuming the role of an early careerist in risk management and quality improvement at one of Vila Health’s community-based hospitals. Vila Health is a medium-sized system of health operating facilities in Minnesota and Wisconsin. You are working on a team-based initiative under the supervision of the Vila Health Chief Compliance Officer. Your role is to assist in addressing a specific compliance risk regarding a breach of privacy and a potential HIPAA violation. A Vila Health employee has disclosed—without prior written authorization—a patient’s protected personal health information.

Here is the information the team has collected about the privacy breach and potential HIPAA violations to date. A Vila Health supervisor instructed an employee to obtain pre-authorization for an upcoming surgical procedure for a patient. The Vila Health employee submitted confidential, protected health care information about the patient to the insurance company. The Member Services Representative at the insurance company contacted the Vila Health supervisor. The insurance company representative indicated that further discussion of the matter without prior written consent from the patient is prohibited.

As part of the team exploring the privacy breach, you will prepare a workplace brief with authoritative, evidence-based references to support your work.

PREPARATION

You are already familiar with HIPAA but may want to conduct independent research to enhance your knowledge. Consult this resource for additional guidance on how to conduct research using credible sources: Health Care Administration Undergraduate Library Research Guide.

INSTRUCTIONS

This is a workplace brief rather than an academic paper. Download the Compliance Program Implementation and Ethical Decision-Making Template [DOCX]. Be sure to address all of the following in your brief:

Background

Include a short paragraph of no more than five or six sentences describing the known details about the privacy breach and HIPAA violation.

Privacy Breach—HIPAA Violation

Summarize the relevant health care compliance concepts that apply to this privacy breach and HIPAA violation. Be sure to consider the following:

Federal, state, and local laws and associated regulations.

Disclosure.

Human resource concepts and laws.

Industry and accrediting body standards.

Seven Essential Elements of an Effective Compliance Program

Apply to this HIPAA breach the seven essential components of an effective health care compliance program, as determined within the Federal Register.

Privacy Breach Consequences

Provide a synopsis of the consequences for an individual leader and for other internal health care organization stakeholders for not taking immediate actions to address a privacy breach. At a minimum, be sure to consider all of the following in your synopsis:

Patient safety.

Financial losses.

Individual and organizational violations of the law.

Evidence-Based Recommendations

Construct evidence-based recommendations to resolve the HIPAA-related privacy breach. You may also want to include relevant information related to:

Human resource laws.

Professional codes of ethical conduct and standards.

Previous case precedents.

Current alleged health care legal violations.

For help in identifying appropriate evidence-based recommendations, you may want to visit some of the authoritative sources, such as the DOJ/OIG, CMS/HHS, et cetera, listed under the suggested resources for this assessment.

Ethical Decision-Making Framework for Health Care Leaders

Describe an ethical decision-making framework as one of your concluding recommendations. Tip: You may want to use the ACHE’s ethical decision-making framework.

Conclusion

Write a paragraph that summarizes the following:

Key concepts.

Importance of compliance.

Best practices to monitor for future quality improvements.

Short list of resources.

Be sure to include all appropriate citations.

ADDITIONAL REQUIREMENTS

Written communication: Use the Compliance Program Implementation and Ethical Decision-Making Template linked above. Your workplace brief needs to be clear, concise, well-organized, and generally free of errors in grammar, punctuation, and spelling. The title page, citations, and references need to be in the current APA format.

Length: Approximately 8–10 typed, double-spaced content pages in Times New Roman, 12-point font, including the reference page. See the APA 7th Edition Example Paper [PDF].

Title page: Develop a descriptive title of approximately 5–15 words. It should stir interest, yet maintain professional decorum. Ensure that your title page conforms to the current APA format.

References: Include a minimum of six current, authoritative citations and references in the current APA format. See Evidence and APA for more information.

Scoring guide: Please review the scoring guide for this assessment so that you understand how your faculty member will evaluate your work.

COMPETENCIES MEASURED

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Analyze health care laws and regulations from a local, state, and federal level.

Summarize the relevant health care compliance concepts that apply to a HIPAA privacy breach.

Competency 3: Assess the importance of continuous readiness in the health care organization.

Apply the seven essential elements of an effective compliance program to a HIPAA privacy breach.

Recommend evidence-based actions to address a HIPAA privacy breach.

Describe a health care, industry-approved, ethical decision-making framework.

Competency 4: Explain how governing body and regulatory agency standards exercise oversight authority within a health care organizational setting.

Provide a synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach.

Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with the expectations of health care professionals.

Write a clear, concise, well-organized, and generally error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field.

Compliance Program Implementation and Ethical Decision Making Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Summarize the relevant health care compliance concepts that apply to a HIPAA privacy breach.	Does not summarize the relevant health care compliance concepts that apply to a HIPAA privacy breach.	Attempts to summarize the relevant health care compliance concepts that apply to a HIPAA privacy breach; however, omissions and/or errors exist.	Summarizes the relevant health care compliance concepts that apply to a HIPAA privacy breach.	Summarizes the relevant health care compliance concepts that apply to a HIPAA privacy breach. Summary includes multiple examples, specifics, and references to current, authoritative sources to explain concepts.
Apply the seven essential elements of an effective compliance program to a HIPAA privacy breach.	Does not apply the seven essential elements of an effective compliance program to a HIPAA privacy breach.	Attempts to apply the seven essential elements of a effective compliance program to a HIPAA privacy breach; however, omissions and/or errors exist.	Applies the seven essential elements of an effective compliance program to a HIPAA privacy breach.	Applies the seven essential elements of an effective compliance program to a HIPAA privacy breach. Narrative includes multiple examples, specifics, and references to current, authoritative sources.
Recommend evidence-based actions to address a HIPAA privacy breach.	Does not recommend evidence-based actions to address a HIPAA privacy breach.	Attempts to recommend evidence-based actions to address a HIPAA privacy breach; however, recommendations are not always evidence based or appropriate. Omissions and/or errors exist.	Recommends evidence-based actions to address a HIPAA privacy breach.	Recommends multiple evidence-based actions to address a HIPAA privacy breach. Recommendations include multiple examples, specifics, and references to current, authoritative sources.
Describe a health care, industry-approved, ethical decision-making framework.	Does not describe a health care, industry-approved, ethical decision-making framework.	Attempts to describe a health care, industry-approved, ethical decision-making framework; however, omissions and/or errors exist.	Describes a health care, industry-approved, ethical decision-making framework.	Applies an industry-approved ethical decision-making framework to the problem of a HIPAA privacy breach. Narrative includes multiple examples, specifics, and references to current, authoritative sources.
Provide a synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach.	Does not provide a synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach.	Attempts to provide a synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach; however, omissions and/or errors exist.	Provides a synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach.	Provides a succinct, substantive synopsis of the consequences to individual leaders and other internal stakeholders of not addressing a HIPAA privacy breach. Synopsis includes multiple examples, specifics, and references to current, authoritative sources.
Write a clear, concise, well-organized, and generally error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field.	Does not write a clear, concise, well-organized, and generally error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field.	Attempts to write a clear, well-organized, and generally error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field; however, significant lapses, omissions, and/or errors exist.	Writes a clear, concise, well-organized, and generally error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field.	Writes a clear, concise, well-organized and error-free workplace brief addressing a HIPAA privacy breach that is reflective of professional communication in the health care field.

Role Of An Early Careerist In Risk Management

RUBRIC QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points:  Student failed to submit the final paper. 20 points out of 50:  The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50:  The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately.  Elements of the required response may also be lacking. 40 points out of 50:  The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples.  The answer is complete. 50 points:  The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples.  No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points:  Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points:  Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points:  References to scholarly sources are occasionally given; many statements seem unsubstantiated.  Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points:  Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented.  APA 6th Edition is used with only a few minor errors.  There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points:  Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented.  APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points:  Student failed to submit the final paper. 5 points out of 20:  The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors  10 points out 20:  The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20:  The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points:  The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points:  Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements.  The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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