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FPX4004 Assessment 2

Paper Details

School: Capella University
Subject: Nursing
Topic:Risk Management Program

Course: NURS-FPX4004 

Referencing: APA
Pages: 5

Risk Management Program Part 2

As noted in part 1, risk management entails all the clinical and administrative processes, reports, and systems employed by an organization for the sole purpose of monitoring, detecting, evaluating, and eradicating any risks and threats that may be faced by the organization. For example, the risk management program (reducing nursing shortage) that was analyzed in part 1 of this assignment has been beneficial to my hospital and may benefit other community healthcare organizations that wish to implement it in their risk management policies and procedures. Therefore, this paper intends to further expand the elements provided in part 1 of the assignment as follows:

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Role of an organization's MIPPA-approved accreditation body in the evaluation of an institution's quality improvement and risk management processes.

The Congress passed the "Medicare Improvements for Patients and Provider Act (MIPPA)" in the year 2008, which was an extensive piece of legislation that entailed the provisions to strengthen Medicare for low-income beneficiaries, reduce ethnic or racial disparities among Medicare patients, and raise the accountability measured for Medicare Advantage programs, among several other provisions (American Nephrology Nurses’ Association, 2015). Moreover, the American College of Radiology (ACR), Joint Commission (JC) and Inter-societal Accreditation Commission (ACR) are some of the bodies accredited by the MIPPA. These bodies also play a substantial role when it comes to quality improvement and the assessment of risks and threats through risk management. One of the main roles of the accreditation bodies is to resolve the nursing shortage by assuring that there is appropriate funding to address the shortage of nursing faculty and the availability of nursing mentors for new nursing graduates and nurse with less practical experience (American Nephrology Nurses’ Association, 2015). This idea will make sure that more nurses are trained and those with less experience receive mentors, which in turn uphold patient safety within the healthcare organization (Friend & Kohn, 2018). 

Further, the MIPPA accredited bodies in my organization are responsible for ensuring continued support for educational programs for the healthcare professionals, thus addressing the shortage of nursing professionals through appropriate identification of potential nursing graduates. Another role of the MIPPA accredited bodies is to support the interdisciplinary approach to health care and ensuring that registered nurses must be major participants in the planning, delivery, and evaluation of that care to ensure patient safety (American Nephrology Nurses’ Association, 2015). Lastly, the MIPPA accredited bodies are also tasked with the role of setting and updating standards of patient care, educating practitioners, stimulating research and disseminating findings, promoting interdisciplinary communication and cooperation, and addressing issues that may affect the practice of nursing professionals (American Nephrology Nurses’ Association, 2015). This role performed by MIPPA accredited bodies will enhance decision making and problem identification within the organization, which consequently improves the quality of the services provided.

The role of different levels of administrative personnel in healthcare ethics and establishing or sustaining employer/employee-focused organizational risk management strategies and operational policies.

No doubt that the administrative personnel possess a moral and legal obligation to ensure that safety is upheld at all times within the hospital. As a result, each administrator within the facility must be assigned a distinct administrative position with a differentiated job description. One of the major roles of the organization’s employees at different administrative levels is to adapt and educate on the healthcare rules, laws, and regulations concerning risk management and quality improvement (Brand et al., 2017). The other role is to enhance the overall efficiency of risk management programs like solving the problem of nursing shortage to guarantee patient safety and quality services (Friend & Kohn, 2018). The top management personnel in the hospital are also expected to ensure that national and state rules are strictly adhered to by everyone in the facility, including when recruiting nurses. This idea will help in the eradication of illegal and unlawful practices such as employing unqualified nurses within the facility, which subsequently improve the quality of care offered (Clark, 2017). If these roles are legally adhered to by every employee in the facility, the risk management programs, policies, and strategies will be of significant benefit because there is sufficient support from everyone.

An Illustration of how our organization's risk management and compliance programs support ethical standards, patient consent, and patient rights and responsibilities.

According to Pozgar, Litt, Santucci, & MSCJ, J. (2016), every activity undertaken within the facility is guided by the outline of legal ethics within an organization. The activities include risk management programs such as the one that is currently operational (reducing nursing shortage) in my hospital. The laid down legal rules and regulations require that the risk management programs and strategies be undertaken in a safe setting (Khan, Rathnayaka, and Ahmed, 2015). In this regard, the risk management programs in the facility are undertaken in compliance with the legal laws because safety is given paramount priority during training and education facilitated by the operational risk management program. Moreover, the outlined legal rules and ethics advocate for inclusivity and diversity in all programs and services provided. The organization complies with this regulation because the risk management program is diverse and inclusive as it includes patients, workers, and visitors from different cultures, genders, and backgrounds who give their input on how to manage the risk of the nursing shortage (Brulin & Svensson, 2016). Everyone is allowed to give his or her opinion on all healthcare services affecting them. Further, the legal laws require that every healthcare provider be well informed on the services, programs, and activities that are undertaken within the hospital. Crucially, the current risk management program on operational also uses proper communication and relation skills to enhance the free flow of information concerning managing the shortage of nurses within the organization.

The legal and ethical responsibilities health care professionals face in upholding risk management policies and administering safe health care at our organization.

In my healthcare organization, healthcare practitioners such as doctors and nurses are the key players in developing and improving the safety programs following the risk management policies outlined to guide the risk management program. This fact will create awareness on the importance of upholding safety at all times and ensuring that at any given moment, there is enough qualified nurse within the hospital (Mannion et al., 2015). Again, all health care practitioners need to always comply with current legal rules, roles, and regulations put in place to guide the risk management program. When top management healthcare professionals lead by example, safety will be upheld, and quality patient-centered will be improved in the facility (Friend & Kohn, 2018). Most importantly, the law expects to urge the healthcare providers to efficiently and adequately communicate and relate with patients and the people close to them in a friendly manner. This fact will help to obtain meaningful information such as issues related to the nursing shortage that may be a significant help when making hiring decisions.

Relating on how the organization's quality improvement processes support and contribute to its overall journey to excellence

The organization is heading in the right path towards the journey to success. In this case, success simply implies to how far the program has achieved the organizational long-term and short-term goals towards risk management and quality improvement ((Brulin & Svensson, 2016). To begin with, after the risk assessment program in the organization was implemented, the number of registered nurses increased, and instances, as well as cases of unsafe conditions, declined considerably. This achievement is a step towards excellence in our journey to success. However, not all the threat and risks have been eliminated so far. Therefore, there is the need for more adjustments and evaluation of current practices and, more importantly, efforts and handwork is expected from all stakeholders involved in managing the risk of nursing shortage in the hospital.   

Overall, all healthcare organizations need to develop and improved risk management as a strategy to enhance safety in their facilities. By doing so, the healthcare organizations will eliminate medical errors and mistakes due to understaffing. If the major players in the risk management program uphold the rules and regulations, the outcome of the care offered will improve. Last, the healthcare agencies need to support risk management programs by offering moral assistance and providing financial assistance to train more nursing practitioners to solve the issue of a nursing shortage.     


American Nephrology Nurses’ Association (ANNA) (2015). Health Policy Statement. Retrieved 20 October 2020, from https://silo.tips/download/health-policy-statement

Brand, S. L., Thompson Coon, J., Fleming, L. E., Carroll, L., Bethel, A., & Wyatt, K. (2017). Whole-system approaches to improving the health and wellbeing of healthcare workers: a systematic review. PloS one12(12), e0188418.

Brulin, G., & Svensson, L. (2016). Managing sustainable development programmes: A learning approach to change. Routledge.

Clark, S. (2017). An analysis of the relationship between new employee onboarding and intent to leave of new employees at large healthcare systems (Doctoral dissertation, Capella University).

Cohen, J. F., Coleman, E., & Kangethe, M. J. (2016). An importance-performance analysis of hospital information system attributes: A nurses' perspective. International journal of medical informatics, 86, 82-90.

Friend, M. A., & Kohn, J. P. (2018). Fundamentals of occupational safety and health. Rowman & Littlefield.

Khan, F., Rathnayaka, S., & Ahmed, S. (2015). Methods and models in process safety and risk management: Past, present and future. Process safety and environmental protection, 98, 116-147.

Mannion, R., Davies, H., Freeman, T., Millar, R., Jacobs, R., & Kasteridis, P. (2015). Overseeing oversight: governance of quality and safety by hospital boards in the English NHS. Journal of health services research & policy, 20(1_suppl), 9-16.

Pozgar, G. D., Litt, D., Santucci, N. M., & MSCJ, J. (2016). Legal Ethical Issue

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