Refine policy management to protect from healthcare operations liabilities

Hospital operating margins are down almost 49% year-over-year. As a result, health systems are desperate to reduce administrative burden so they can focus on patient care. Enter standardization through disciplined policy management. Defined as the guideline for an organization’s guidelines, policy management affects compliance, quality, supply chain purchasing, payer reimbursement, and more.

For example, patient safety, of course, is crucial. From a business standpoint, patient safety is especially important for protecting the organization from potential legal liability—and policies play an outsized role in doing so. By maintaining robust policies focused on compliance, quality, and safety, organizations can better avoid adverse events in patient care.

Beyond the obvious benefits for patient care, organizations with effectively managed policies often enjoy improved communication between providers and staff, and between staff and management, which minimizes the potential for miscommunication that can lead to patient safety errors and compliance violations. Further, it creates a more efficient and reliable environment that providers and staff enjoy being a part of.

We also know that standardization and the reduction of unwanted clinical and administrative variation can lead to efficiencies that cut costs, reduce burdens on staff, and deliver a more consistent patient experience.

The harsh economic environment, coupled with the need to achieve outcomes that accompany value- and risk-based models, make it a prime moment for hospitals to streamline and standardize policy management. Without disciplined control of policies enterprise wide, daily hospital operations would not be possible, nevermind the achievement of outcomes goals.

A formal policy structure enables health systems to seamlessly roll out policies and procedures at every level and for every role. Healthcare operations staff then use the same playbook and work toward the same goals. Typically, the quality or compliance department of a healthcare organization owns policy management and may appoint a hospital policy administrator. Those individuals use policy management software to gain a holistic view of all policies throughout their life cycle.

Hospital policies come in all shapes and sizes, but there’s a common thread: They should be designed to help the hospital avoid risk. Typically, hospital policies fall into a general category, such as administrative and HR, information management, medicine and drug handling, patient care, coding and billing, general compliance, and more.

To begin, it’s important to distinguish between policies and procedures. Policies are your organization’s general principles and goals. Procedures are the concrete steps that staff, providers, and administrators are expected to follow to ensure goals are achieved.

These guidelines provide a great start or a refresher on policy management.

  1. Conduct policy audits: Reviewing existing policies helps identify those that are working and those that should be amended or retired. An audit identifies gaps and streamlines processes governed by multiple competing or conflicting policies. The latter could be a red flag for compliance issues or wasted resources, for example. Finally, a policy audit is also an opportunity to review and identify effective methods for communicating change.
  2. Create new policies: The next step is to draft new policies to address gaps or to pre-emptively address future needs. It’s an opportunity for healthcare organizations to standardize policies and to ensure that all future policies will use the same template, making them easier to adopt and implement enterprise wide. Policy templates typically include the basic information such as approvers, associated procedures, and applicable statutes, regulations, or other related source documents.
  3. Communicate consistently: As most healthcare operations leaders know, writing the policy itself is only the beginning. Even the most carefully crafted policies are unlikely to succeed if they’re not communicated effectively. Ideally, communication about new, amended, or retired policies uses the same approach and standardized delivery structure every time to minimize the risk of misunderstandings or oversights.
  4. Take the long view: To manage policies throughout their lifecycle, ensure there isn’t a “set it and forget it” approach. Use technology and automation in your commitment to managing hospital policies by:
    • Creating a policy on policies
    • Creating a policy committee
    • Maintaining and archiving policies
    • Appointing a hospital policy administrator
    • Controlling access and security

The value and benefits of policy management should be clear. But for many healthcare organizations, the challenge is often less about building policies than it is about maintaining them through their life cycle. Policy management software provides a holistic view of where your organization is right now, helps create a roadmap to where you need to be, and provides the analytics to ensure you’re on the right track.

A document and policy management solution can also assist with the challenges of managing the document review and approval processes, as well as ensure that when documents are due for review, the appropriate individuals are made aware. Learn how symplr can help.

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