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What are some challenges associated with quality and risk management in healthcare?

01 Aug 2023

Nowadays, healthcare services are affected by three waves of intervention and change: quality management, risk management, and patient safety.  

Managing risk and providing quality care is essential to any healthcare organization’s longevity and financial stability. By 2030, healthcare will be omnipresent, increasing the risks for health care organizations. Organizations must identify possible problems that may compromise the quality of care or compromise the organization when facing these risks. 

In this blog, we will discuss the key challenges associated with quality and risk management in healthcare. Also, we will look at the possible solutions to overcomes these challenges effectively. 

What are the Risks and Quality Issues in Healthcare? 

Management of risk involves identifying and preventing potential harm to an organization. Common business risks affect the health care industry, including workplace violence, workers’ compensation injuries, automobile liability, general liability, employee actions, financial risk, technical failure, and natural disasters. Healthcare institutions must address these risks in time to avoid severe consequences – in terms of safety, quality, and compliance.  

In addition, the healthcare industry faces risks in areas such as medical malpractice, patient complaints, HIPAA violations, data breaches, and medical accidents or near-accidents.

Quality issues are considered part of risk management. However, they pose the most significant risk to health care employers. Ineffective or inappropriate procedures and medical negligence are all Quality-Related issues in health care. 

Quality issues can also affect risk management procedures. For example, as a result of hospitalization issues, secondary conditions arising from surgical sites or blood clots are among the most common, as are hospital readmissions due to inefficient hospital care or lack of follow-up treatment, and sepsis or blood infections undiagnosed leading to death.

Related Article: 5 Essential Components of Quality Improvement in HealthCare

What is the Impact of Risk Management and Quality Issues in the Healthcare?  

There are various risk-management issues in the health care industry, but the most significant impact often falls on employers’ finances. For example, general liability insurance premiums can rise because of general liability issues. In addition, employer insurance premiums will increase due to workers’ compensation claims. Furthermore, the cost of health care will rise due to more severe claims. 

Health care has already experienced changes due to a growing focus on quality and safety. Some healthcare providers are rewarded for following clinical guidelines and meeting standards of care through the use of HMOs and other players within the healthcare industry. In addition to increased attention to patient safety, the risk management profession has also changed. It is expensive to settle claims when an organization has quality issues. This puts the organization’s financial status at risk. Furthermore, it can negatively impact the public’s opinion of health care and harm an organization’s reputation. 

The Role of Risk Management and Quality Management Technology in Healthcare 

The key to success in healthcare management is combining risk management and quality management technology. 

The problem, however, is that many healthcare organizations use different point solutions for other aspects of patient safety, compliance, claims, patient experience, etc. A lack of connectivity makes it impossible to organize, report, or act promptly and effectively. Slow response times can lead to other patients being harmed before a problem is resolved. 

There are cases in which hospitals report patient safety events in one place and patient complaints in another. A third party manages claims arising out of these incidents. In the absence of communication between these point solutions, it is necessary to manually aggregate, correlate, and analyze information to get a consolidated picture. As a result, the response time can be delayed. In addition, the use of manual processes can result in the loss of important information due to errors. 

Related Article: Know How Quality Management and Risk Management Inter-related

It won’t work going forward with that fragmented view. The healthcare industry needs to make fast, accurate, and strategic decisions by integrating real-time views of all risks. Let’s look at how you can utilize technology to improve quality and risk management programs in healthcare organizations: 

  • Ensures better patient care

    Integrated technology makes data connected and accessible to all stakeholders, breaking down silos. As a result, it is easy to share, discuss, and analyze all patient-related information in one place. As a result, you can also pick up on minor warning signs before they become big problems for patients.

  • Ensures compliance

    With powerful software that consolidates your risks, information, and action plans into one location and tracks each step of your plan, you can better comply with healthcare reimbursement requirements.

  • Ensures consistency

    The integrated approach to risk management breaks down information gaps. Using a comprehensive technology solution, you can gain actionable insights from data analysis, visualizing risks and their relationships.

  • Ensures that fewer suppliers/vendors are needed

    By integrating software platforms, healthcare organizations can reduce the number of suppliers and vendors. The software helps you establish a fully validated supplier selection process. This aspect is becoming increasingly important in light of security breaches and other risks associated with third parties.

  • Ensures Resilience

    With integrated technology, you can mitigate hazards and take advantage of opportunities in changing markets by identifying both upsides and downsides of risk.

  • Improves Process Efficiency

    Communication and collaboration across the organization are made easier with integrated technology by eliminating silos, eliminating duplicate efforts, and facilitating communication. With fewer resources, you can accomplish more, improve patient safety, and build a safety culture simultaneously.

Technology plays a crucial role in streamlining healthcare quality and risk management processes. With an integrated solution like Qualityze EQMS Suite, you can manage all safety and risk management initiatives from one place. As a result, your data is more accurate, faster, and actionable, while you are less exposed to third-party risks. 

To become resilient, healthcare organizations must have the right resources, processes, and systems to manage quality and risk. And Qualityze EQMS Suite is designed with all the amazing in-built capabilities an organization may need to overcome the challenges associated with quality and risk management in healthcare. 

If you want to experience Qualityze difference, you can request for a demo right now. 

For more information on effective quality and risk management in the healthcare industry, please feel free to contact our customer success team at info@qualityze.com, or you can give us a call on 1-877-207-8616, and our team will get back to you as soon as possible. 

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