BHA FPX 4006 Assessment 3 Compliance Training

Sample Answer

Introduction

In the late 1990s the public raised concern on the extent at which investigators and the IRBs were adhering to the federal regulations that protect human research. The public were calling for the reorganization and refocusing of various government units responsible for the regulatory oversight on issues related to health (Peter, 2018). These policies majored on regulating the conduct of healthcare professionals and offering better healthcare outcome.

Accreditation Compliance

This is a voluntary certification that institutions, programs or facilities have adhered to the set standard of protection in healthcare. This compliance certifies that a particular institution has met the required certain specified by the board. The accreditation compliance implies that healthcare institution has met the required certifications that allows the to dispense healthcare services within a particular setting (Peter, 2018). Accredited healthcare organizations are able to mitigate various risks that arise in the healthcare sector.

Ethical Consideration

Ethical framework governing healthcare workers allows nurses to act as advocates for patients and find a balance of delivering effective care. Ethical consideration allows patients to have their rights in making their decisions based on beliefs and values. Breaching any of the ethical principles may attract heavy disciplinary penalties from the council. Healthcare professional need to understand these ethical considerations to reduce the impact of these penalties on both a healthcare worker and healthcare organization (Murray et al., 2018). The healthcare provider has the obligation of explaining the health status to the patient and gain their consent of the required medical operations. Therefore, adhering to the ethical standards reduces legal complications.

Risks and Consequences of Non-Compliance

The potential risk involved in these areas is far-reaching. While the risks may be ranging with the type of non-compliance, both employers and employees are at risk. The non-compliance leaves an institution at the risk of license revocations, financial losses, security breaches, poor patient care, decreased trust, business disruptions and damaging reputation (Murray et al., 2018). The fines and penalties of non-compliance might be costly ending up affecting the entire operations of the healthcare unit. Various departments like HIPPA, Department of Human Services (HHS) and Office of the Civil Rights (OCR) would be ready to penalize the institution according to the magnitude of noncompliance.

Lawsuits and Settlement of Non-Compliance

After the fines and penalties on any healthcare worker or institution, non-compliance would as well trigger lawsuits. These cases come with heavy legal fees that would have adverse impact on the financial status of the company. If the employees are the non-compliant, the cost of settling the suits would be high implying that healthcare institutions must be ready to say no for malpractice (Murray et al., 2018). Therefore, the impending cost of selling noncompliance suits always compel healthcare institutions to remain vigilant on compliance issues. The training of employees on these issues limits a company from facing such court cases that might affect the normal operations of healthcare institutions.

Important Healthcare Regulations

Today, federal, state, and local authorities and other various regulatory agencies have established rules intended to protect the public, promote access to care, and ensure that medical professionals both adhere to high standards and receive the compensation that is their due (Murray et al., 2018). Some of the important healthcare regulations include, HIPPA and The HITECH act. Health care managers and leaders are must be familiar with laws, regulations, and the associated organizational policies and procedures that reinforce compliance. The government has availed enough resources to enhance comprehension of laws, regulations, and steps to take when suspected or actual incidents occur.

HIPPA

The passing of HIPAA in 1996 had a primary goal of introducing efficiency in health care delivery and more health insurance coverage. The three major provisions at that time were tax provisions, portability provisions, and administrative simplification provisions. The congress has little concern for privacy rights at the onset, which prompted them to pass on the responsibility of privacy protections to the HHS. Four iterations later took effect, including HHS issuing a proposed version for public comment, a second version based on the comments, a modification of the privacy rule in 2002, and a final version incorporating the suggestions. Later in 2009, however, the HHS secretary gave the Office for Civil Rights the responsibility of enforcing the HIPAA Security Rule.

HITECH Act

HITECH act align with the data confidentiality of patients in health care organizations. These rules have widely been applied in the healthcare sector to improve care efficiency and enhance patient outcomes through better decision support systems. This Act creates incentives linked to the information technology in healthcare, including the use of the EHR system that Vila health would be implementing (Murray et al., 2018). This Act expands electronically protected health information (ePHI) as it heightens privacy and security protection under the HIPAA guidelines. This would allow healthcare organizations to increase the legal liability of its non-compliance, and employees get to understand the enforcement actions that come from such violations.

Key Ethical Issues

Effective analysis of ethical issue allows healthcare organization to identify the genesis of the problem and solve the problem from its primary cause. However, healthcare team must first understand some of the key ethical issues affecting their practice (Franco et al, 2017). For instance, if inadequate training was the main cause, then the organization would treat training as a main solution method that would limit the clinic from facing such issues in the future. These key ethical issues include informed consent, patient privacy and confidentiality and shared patient decision making

Informed consent can sometimes be an ethical battle for nurses. A dilemma can occur when there is concern that patients and their families have not been informed or do not understand the treatments used on a patient. On other side, patient privacy and confidentiality are significant ethical issues faced by nurses (Pierre-Francois & Guzman, 2020). If not done correctly, this can have legal ramifications and result in severe consequences for healthcare professionals. With patients’ medical information protected by the Health Insurance Portability and Accountability Act (HIPA), there are definite boundaries and guidelines for protecting patients’ privacy.

Concepts of Continuous Readiness

Assessment of an organization’s culture and readiness for change is critical as it offers insights into the organization’s cultural perspective and preparation for compliance. The integration of a compliance training to improve healthcare outcomes is essential for better healthcare delivery and quality (Franco et al, 2017). Assessment of an organization’s culture and readiness for change is critical as it offers insights into the organization’s cultural perspective and preparation for continuous training. The readiness to compliance implies that an organization has enough resources that would have an impact in the success of the compliance related training to employees.

Significance of Compliance Readiness

The readiness compliance would imply that a healthcare organization have the support of the leadership team helps the driving team make decision based on its strengths in obtaining the best skill sets, effective communication, decentralized structure, supporting technology, facilitating the availability resources, and stakeholders’ involvement. The department leaders will put together a team of champions (Franco et al, 2017). The team engagement or commitment to change is essential. The leadership team can start the communication with inter-professional teams that will play an essential role in the success of the change. Therefore, compliance readiness defines the strength of leadership in healthcare setting.

Training Staff on Compliance

An effective information sharing process would be important at the clinic as it would not allow employees to act on their own decisions but consult with other professionals to ensure an effective solution to any ethical issue at the clinic (Dębska et al., 2019). Some of the best practices on staff compliance include building a compliance-focused culture, focusing on the big picture, using the available resources, identifying potential weaknesses and majoring on patient survey.

Building a Compliance-Focused Culture

As with all endeavors involving people, perfection will be hard to come by. Instead, focus on building compliance into your company culture and creating an employee code of conduct. With that in mind, the goal of training program should be to “empower each individual employee to take ownership of the clinic’s compliance and to hold their teammates accountable (Dębska et al., 2019). To accomplish this a clinic will need to be crystal clear about its expectations and the potential consequences for non-compliance.

Focusing on the Big Picture

The big picture of a compliance program is to reduce the risk of healthcare fraud. Training and educating staff about compliance in general and your clinic’s compliance program in particular is one way to ensure that compliance program is a living, breathing thing that does not exist solely on paper (Dębska et al., 2019). The thoughts of the healthcare staff need to align to the needs and expectations the clinic where the training and learning methods needs to be aligning to the success of the main objective of compliance.

References

• Dębska, M., Polechoński, J., Mynarski, A., & Polechoński, P. (2019). Enjoyment and intensity of physical activity in immersive virtual reality performed on innovative training devices in compliance with recommendations for health. International journal of environmental research and public health, 16(19), 3673. https //doi.org/10.3390/ijerph16193673
• Franco, Z. E., Flower, M., Whittle, J., & Sandy, M. (2017). Professional ethics and virtue ethics in community-engaged healthcare training. In Professional responsibility (pp. 211-229). Springer, Cham. DOI 10.1007/978-3-319-02603- 9_13
• Murray, T. L., Calhoun, M., & Philipsen, N. C. (2018). Privacy, confidentiality, HIPAA, and HITECH implications for the health care practitioner. The Journal for Nurse Practitioners, 7(9), 747-752. https //doi.org/10.1016/j.nurpra.2011.07.005
• Peter, E. (2018). Overview and summary Ethics in healthcare Nurses respond. OJIN The Online Journal of Issues in Nursing, 23(1). https //doi.org/10.3912/OJIN.Vol23No01ManOS
• Pierre-Francois, W., & Guzman, I. (2020). Factors that influence HIPAA Secure compliance in small and medium-size health care facilities. https //digitalcommons.kennesaw.edu/ccerp/2020/Research/6