The risk of not participating in continuous readiness efforts leads to organizations losing their accreditation status, failing to meet the needs and expectations of stakeholders, lacking a proactive approach to mitigate risks, and exposing themselves to reputational damage, adverse events, or financial losses. These risks subsequently result in bad survey performance, inconsistencies in patient care, and needless adversaries for individuals as well as organizations while not being able to execute and maintain high-quality safety changes. Therefore, healthcare leaders need to upgrade their compliance efforts through risk-based financing in terms of continuous readiness to maintain patient safety, a high level of preparedness for accreditation status, and quality improvement.
Risks Related to Continuous Readiness
If not practising continuous readiness, risks include missing opportunities to learn from benchmarks, termination from participating in Medicaid and Medicare programs, poor organizational reputation, and adverse medication events that impact patient safety (Brannan & Taylor, 2006). Poor organizational reputation means that patients would not visit the care facility or seek care from the healthcare organization. Termination from participating in healthcare benefit programs such as Medicaid and Medicare could be devastating for the organization. Loss of funds, in addition, would limit the types of care services small healthcare facilities provide to their target audience of the unhealthy population and will be out of business. Moreover, loss of accreditation status means that an organization has failed to meet the quality and performance standards set by accrediting agencies which results in losing credibility and recognition of the institution at different levels.
Risk-Based Financing
The risk-based financing approach in healthcare is the determination of the identification, assessment, and understanding that how an institution will pay for its loss events to mitigate continuous readiness risks. In the healthcare sector, some of the implications of fraud include manipulating the risk assessment, committing financial crimes such as cybercrime, health benefit programs fraud, and sanctions evasions, as well as trade-based money laundering to disguise illicit funds (Wu & Wu, 2018). Moreover, regulatory non-compliance exposes a number of risks including security breaches, poor patient care, license revocations, damaged reputation, financial losses, and erosion of trust. It occurs in organizations when the institution or individuals working in them do not follow rules and legislations that relate to healthcare practices. The consequences of regulatory non-compliance attempts result in loss of staff, security violations, punishments, penalties, and detrimental impacts on patient health. They also include loss of quality, productivity, and efficiency in the workforce as well as high costs of preventive and corrective actions that lead to patient safety and privacy risks (Kocziszky et al., 2017).
Importance of Continuous Readiness in Healthcare
Continuous readiness or continuous compliance in the healthcare sector involves maintaining a high-quality and safe environment for patient care that retains staff at all levels in the care facility for the right reasons. The process of continuous readiness in healthcare means following the laws and legislations of regulatory and accreditation bodies that can help institutions reduce risks, provide the best possible patient care, improve organizational performance, and prepare for surveys so that necessary corrective action can be taken within an organization. Furthermore, the purpose of continuous readiness in healthcare is to provide quality care and improve safety through the accreditation service in healthcare that ensures performance improvement (Vaishnavi et al., 2019).
Conclusion
In a nutshell, continuous readiness should be a priority in healthcare organizations which can be increased through medical care dimensions, well-trained staff, quality services, and strategic planning workloads. The practice of continuous readiness is important because it helps in service delivery, learning patients’ as well as stakeholders’ needs, meeting expectations, and preparing for accreditation surveys. Hence, it is an approach that structures healthcare education, patient care, and research which is a long-term and structured investment in healthcare institutions or organization’s health driven by committed and stable leadership.
References
Brannan, W. L., & Taylor, J. R. (2006). A model for enterprise risk management within a healthcare organization. ASSE Professional Development Conference and Exposition, ASSE-06-527.
Kocziszky, G., Veres Somosi, M., & Kobielieva, T. (2017). Compliance risk in the enterprise. НТУ” ХПІ”.
Vaishnavi, V., Suresh, M., & Dutta, P. (2019). Modelling the readiness factors for agility in a healthcare organization: A TISM approach. Benchmarking: An International Journal, 26(7), 2372–2400.
Wu, D., & Wu, D. D. (2018). Risk-based robust evaluation of hospital efficiency. IEEE Systems Journal, 13(2), 1906–1914.
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