The dangers of not preparing for potential problems can have significant long-term effects. Neglecting comprehensive risk management plans can impact patient care, increase liability risks, and result in financial loss. Therefore, potential risks must be assessed and measured based on their potential negative impacts. Based on the risk assessment, an organisation-specific management plan should be developed, implemented and monitored. As mentioned earlier, risk management plans are specific to different healthcare facilities. While it is a concern to avoid potential financial consequences, patients` needs are usually paramount. In clinical trials, for example, Institutional Review Committees (IRBs) monitor proposed research plans before they are implemented to ensure minimal risk to human subjects. Risk management plans should cover patient-specific risks and be well documented; they must also be accessible to those who work with patients. Other patient safety risks can be mitigated by patient-specific risk management strategies, such as: The risk of severity arises from patients being at a more advanced stage of the disease than expected. Fund members then need more intensive intervention and their treatment requires greater and more expensive care. Prevalence risk describes the risk that the fund member population will contain a higher number of patients with a particular disease than expected.
This risk is excluded if, in the case of specific indication contracts, reimbursement is made only for persons who already suffer from the disease. Medical quality: Medical quality (outcomes) must be improved or at least maintained through integrated care measures and services. Quality measurement can be carried out using quality indicators (performance indicators). These indicators can be used for external comparisons, but also for internal quality management. Healthcare managers identify and assess risks as a way to reduce injuries to patients, employees and visitors within an organization. Risk managers work proactively and reactively to prevent incidents or minimize damage after an event. Behavioural risk should be taken into account if members enrolled in the fund are prone to opportunistic behaviour or if there is a risk of increased demand without a significant increase in benefits [8]. Reviewing other studies is one way to develop risk management programs. Compliance with guidelines from government organizations such as the Department of Health and Human Services, the Food and Drug Administration (FDA), and the American Society for Healthcare Risk Management (ASHRM) ensures compliance with risk management. There is also a cost risk if cost increases due to factors of production and services are higher than expected. The necessary medicines, medicines and aids must be purchased and additional services must be obtained from external service providers. If prices in these supply markets rise unexpectedly, this can lead to losses [8].
Based on the analytical results, risk managers can compare the probability of different adverse events with their effects and classify potential risks according to their severity. Subsequently, risk reduction and appropriate risk management plans can be developed. Risk management plans are also subject to quality assessments to ensure that proposed interventions and actions are treated as potential real problems. Once a strategy is in place, it is monitored and modified as needed. Adaptation to risk factors: In order to demonstrate actual quality, satisfaction and cost effects, it is necessary to adapt the data to the risk factors […].