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By providing the highest
level of innovative and integrated consulting expertise, Clinical
Risk Solutions will partner with your physician practice to develop
and implement strategic initiatives that focus on care standardization,
clinical operational efficiency, team culture, communication, documentation,
regulatory compliance, and the development of a patient safety-centered
model of excellence.
Focus areas of review
and organizational program development include the following opportunities:
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Physician
Practice and Regulatory Assessment
- Enhance physician
practice organizational structures to integrate quality, safety,
regulatory compliance, and risk management
- Practice
Assessment: comprehensive clinical risk assessment of the practice
structures and regulatory compliance.
- Regulatory Compliance:
- Centers for Medicare
& Medicaid Services (CMS)
- Recovery Audit Contractor
(RAC) review
- Health care fraud
and abuse
- "Anti-Kickback"
law
- Stark I, II"/Self-Referral
Law
- Corporate Compliance:
- Audit tools and training
- Professional liability
insurance brokerage services:
- Broker RFP process
and selection criteria
- Broker performance
measures
- Bioethics/medical monflict
- Medical mediation and
conflict resolution process
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Medical
Staff Structure Review
- Credentialing: re-credentialing,
clinical privileging
- Bylaws: rules and
regulations
- Peer review process:
- Ongoing and focused
professional performance evaluation (OPPE and FPPE)
- Competencies (ACGME)
and the Joint Commission:
- Medical knowledge
- Patient care
- Interpersonal and
communication skills
- Professionalism
- Systems based practice
- Practice-based learning
and improvement
- The Joint Commission
and CMS
- Standard survey
readiness/tracer methodology
- Standard interpretation
and resource tools
- Physician leadership
training
- Hospital leadership
and medical staff relationships
- Conflict of interest
- Professional behavior
- Adverse event disclosure
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Education
and Physician Development
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- Culture and Staff
Performance: Developing a patient safety-centered culture of excellence
within the operational systems through staff education and engagement
- Communication: Developing
effective skills and techniques to enhance patient satisfaction
and decrease medical malpractice liability
- Documentation: strategies
to strengthen documentation skills and regulatory compliance,
and reduce liability
- Policy development:
Informed consent, end-of-life care, patient termination from practice,
critical lab and diagnostic test result management, resident and
AHP supervision
- Contract negotiation
- Medical error management:
- Documentation, investigation,
disclosure, mediation/resolution
- Reduction of health
care-associated infections
- Medication sample
handling/regulatory compliance
- Medication reconciliation
process
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