develop a plan that addresses and remedies each of these risks.

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“Mercy Me” Memorial Hospital 

Mercy Memorial Hospital is located in a rural town in southwestern Wyoming called Friendship Circle. Most people in Friendship Circle have known one another all of their lives, as have their parents and grandparents, and for the most part, Friendship Circle is a peaceful little town.

Mercy Memorial Hospital treats emergency room patients; for example, last week a seven-year-old boy fell out of the tree house he and his friend were building and had to have his arm set in a cast and needed two stitches above his eyebrow. A few local doctors also perform minor surgeries at Mercy Memorial, but on a routine basis only. Sometimes patients are transferred to Mercy Memorial from the local nursing home if they get dehydrated or if they contract the flu.

The County Commission has always been pleased with the hospital administrator. Even though the hospital is small in comparison to others in the nearby “big city,” costs have been fairly well contained, the county has not had to float any bonds, and the commissioner has not had to sponsor any county government fundraising for the hospital budget.

This past year Ira Ames, longtime hospital administrator, retired at 78; he decided that he wanted to spend more time tending to his prize-winning decorative flower garden. The town gave him a grand send-off before hiring another administrator for the hospital. Finding someone to take Ira’s place was not easy, but a young man named Colton Pierce was chosen for the task. The hospital board thought Colton was a nice enough young man when he was hired, but actually, Colton has caused quite a bit of trouble for them lately. For one thing, the young man keeps talking about “hips” or “hippos,” or some such nonsense. The board chairperson, Dirk Howell, although a life long admirer of Ira Ames, has been doing some investigating on his own and has begun to realize that the hospital may actually need some revamping. Since Dirk is also on the county commission, he is afraid that if anything goes wrong at the hospital, that the way of life in Friendship Circle might drastically change. He decides that something must be done to help Colton Pierce and to ease everyone else’s concerns, so he hires you.

You are a consultant with Cannon Information Technology. You specialize in advising health care organizations on how to comply with the HIPAA security provisions. Dirk explains that although Mercy Memorial does not seem to have any security problems that he can see, he has been doing some outside reading and has become concerned about the level and quality of the hospital’s “technical security services.” He asks for your advice.

You discuss your services with him and agree to write a memo that advises and fully describes to Mercy Memorial Hospital the five (5) controls normally included in a technical security services program. In your memo, you will also explain how each of these five (5) controls helps to insure HIPAA compliance.

 

Risky Business 

You are the risk manager at Winston General Hospital. Each quarter you meet with the hospital’s malpractice carrier, the hospital attorney, the director of nurses, and the chief medical officer to review the status of malpractice claims.

This year, an alarming pattern of suits is attributable to improper patient care. Several cases have involved the improper administration of pharmaceuticals. Other cases have involved the improper supervision of staff nurses in the pediatric and emergency departments. An increased number of claims are related to physicians failing to diagnose patients’ symptoms properly. Additionally, several of the hospital’s employed and contracted physicians have not been properly credentialed.

In your analysis of the situation you determine that there are four (4) specific risks: medication errors, diagnosis failures, negligent supervision, and lack of proper credentialing or technical skill. You are asked to develop a plan that addresses and remedies each of these risks. Make eight (8) recommendations concerning medication errors, two (2) recommendations regarding diagnosis failures, two (2) recommendations concerning negligent supervision, and two (2) recommendations regarding proper credentialing or technical skills.

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