Risk management functions and quality improvement functions in an organization can overlap in terms of addressing patient and staff safety. For example, this includes the declared pregnancy safety requirement, any COVID PPE safety issue, quarantine, or sanitation occupational safety standards. Using information from your employer/organization's risk management plan, or that of an allied health care organization in your city or region, identify and summarize two functions that commonly overlap in this manner. What common factors lead to the overlap? Does the structure work for the organization you selected? Why or why not?
Provide a minimum of two references from the GCU Library to support your response.
Root Cause Analysis (RCA): When a significant adverse event occurs, both departments are involved in the RCA process. Risk management leads the investigation to understand "what happened" to mitigate liability and potential financial loss. At the same time, QI uses the RCA to determine "why it happened" by identifying systemic flaws in processes, communication, or training. The goal of the QI team is to implement new protocols to prevent recurrence, thereby improving the overall quality of care.
Common Factors Leading to Overlap
The common factors that lead to this overlap are data sharing and a shared focus on patient safety. Both departments rely on the same data—adverse event reports, near misses, and patient complaints—to perform their functions. The goal of both is to reduce harm and improve outcomes, making collaboration not just beneficial but necessary. The data from incident reports is the raw material for both risk assessment and quality improvement initiatives.
Evaluating the Organizational Structure
The success of this overlapping structure depends on the organization's approach. If the risk management and QI departments work in silos, the structure is not effective. This can lead to redundant efforts and a lack of communication, where risk management focuses only on legal liability while QI misses opportunities to address systemic risks.
However, if the structure promotes collaboration, with a shared reporting system and inter-departmental teams for RCA, the structure can be highly effective. In such a model, risk management can provide legal and financial context to QI initiatives, while QI can ensure that risk mitigation strategies are evidence-based and sustainable. This collaborative approach creates a unified front for safety, benefiting both the organization and its patients.
Sample Answer
At their core, risk management and quality improvement (QI) share the goal of creating a safer and more effective healthcare environment. In many organizations, their functions overlap significantly, particularly in areas concerning patient and staff safety.
Overlapping Functions: Incident Reporting and Root Cause Analysis
Based on the structure of many healthcare organizations, two functions that commonly overlap are incident reporting and root cause analysis (RCA).
Incident Reporting: Risk management requires a robust incident reporting system to identify potential risks and liabilities, such as patient falls, medication errors, or staff injuries. Simultaneously, QI relies on this same data to pinpoint areas for improvement. The data from a single incident, like a patient's fall, is crucial for both functions. Risk management documents the event for legal and liability purposes, while QI analyzes the data to identify system-wide patterns and prevent future occurrences.