Behavioral Health: Risks and Quality

Introduction

Project management requires one to assess all prospective issues and difficulties that can arise throughout the course of operations to ensure successful achievement of goals. In addition, quality assurance plans allow the project manager to ensure that activities meet the highest standards of quality. The Risk Matrix will outline ethical, legal, and other issues that this project can encounter in the future, provide an action plan, and assign a responsible person for each task. This paper will examine three risk identification techniques, SWOT, root-cause, and brainstorming, and choose two to evaluate issues that Behavioral Health (BH) can encounter.

Legal and Ethical Risks

The Appendix provides the Risk Management Matrix and an overview of assessment techniques. Legal and ethical issues that BH may encounter include the disclosure of patient information and the establishment of trust between the case managers and individuals who will be enrolled, which is the primary ethical concern. In order to resolve these, one must consult a legal professional and ensure that the Electronic Health Record System used in this project complies with the national standards of data safety. From a legal perspective, the privacy of patient data that is crucial to identify individuals eligible for BH and contact information

The ethical implications of BH correspond with the general moral principles of healthcare operations. According to O’Brochta (2016), one aspect of project management is leadership, which requires a reassurance that a person in charge is trustworthy. This is especially crucial for projects connected to healthcare because they involve cooperation with vulnerable individuals; in this case, people who were recently discharged and experience mental health issues. Firmenich (2017) offers a constructivist strategy in accordance to which a holistic approach suitable for utilization is developed. BH will apply the two procedures described above to mitigate the ethical and legal risks associated with this project. Firmenich (2017) argues that one issue that cannot be reduced using her approach is the unwillingness of team members to participate in the development of the risk mitigation framework. The risk matrix presented in the appendix outlines the strategy that BH’s team will use to mitigate prospective issues.

Quality Assurance and Control Plan

One element of quality management is assurance, which allows determining whether the accomplished tasks correspond with those set in the beginning. The primary aim of developing a quality assurance process is to ensure that the project meets its objectives and the purpose of its functioning (Cîrţînă, Cîrţînă, & Davaris, 2015). This function has to be present throughout the lifecycle of a specific project.

Cîrţînă et al. (2015) offer a project definition process/project implementation process PDP/PIP model, according to which an improvement plan can be developed.

The project’s deliverables are patient information, eligibility criteria, and follow-ups with the physicians. Quality criteria for patient information are accuracy, swift time of access, and safety. For eligibility, the essential elements are the correspondence of BH requirements to patient data and the accuracy of information. Follow-ups have to be scheduled upon patient entering the program; thus, timing is the primary quality criteria. The project manager will monitor these elements over the course of BH execution and make necessary changes to ensure that the employees can meet project objectives.

Quality control tasks required to evaluate the work are an assessment of a number of patients contacted, people enrolled in the program and scheduled follow-ups, which will be carried out by the project manager. The manager will be able to validate the activities of the team’s members and make corrections. Quality assurance activities involve external audit that can be performed by the project sponsor, executives of the company, or a legal specialist to determine whether the events correspond with the legal and ethical requirements.

The action plan includes developing a guideline for adequate cooperation between team members for data transfer and establishing a model for communicating with patients and physicians. In regards to responsibility, case managers will monitor eligibility and follow-ups, while information technology professional will work on patient data. The timeframe for the patient data and qualification in a week prior to the initiation of the project, while follow-ups will be scheduled over the course of three months. Overall, the evaluation of risk assessment techniques allowed BH to choose appropriate strategies for mitigating issues that can arise over the course of this project.

References

Arshad, A., Noordin, M. F., & Othman, R. B. (2017). A synthesis on SWOT analysis of public sector healthcare knowledge management information systems in Pakistan. International Journal of Advanced Computer Science and Applications, 8(8), 130-136.

O’Brochta, M. (2016). Why project ethics matter. PM Network, 30(1), 29.

Cîrţînă, L., Cîrţînă, D., & Davaris, A. (2015). Quality assurance as major process of quality management in projects. Applied Mechanics and Materials, 809-810, 1305-1310. Web.

Firmenich, J. (2017). Customisable framework for project risk management. Construction Innovation, 17(1), 68-89, Web.

Kobo-Greenhut, A., Reuveni, H., Ben Shlomo, I., & Megnezi, R. (2018). Unstructured brainstorming is not enough: Structured brainstorming based on four verification and validation questions yields better hazard identification in healthcare. International Journal for Quality in Health Care, 1-6. Web.

Peerally, M., F., Carr, S., Waring, J., & Dixon-Woods, M. (2017). The problem with root cause analysis. BMJ Quality & Safety, 26(5), 417–422. Web.

Appendix

Risk Matrix

Project Title: Behavioral health.

Risk Identification Techniques

SWOT is commonly used in planning and evaluating risks of business endeavors because it allows one to access different internal and external aspects of operations, therefore providing an in-depth investigation into various elements impacting the work. Arshad, Noordin, Othman (2017) argue that in general, this tool was developed to help carry out large scale analyses in business; however, nowadays, it is commonly applied in healthcare as well. Moreover, the authors argue that SWOT is useful for determining areas of improvement and implementing innovation, which is a significant part of this project since the approach it uses is novel. The positive effect of this model is that it allows reviewing a broad scope of issues; however, the negative implication is that the BH project or initiatives of similar size and duration do not require this depth of analysis.

Root-cause analysis (RCA) is applied in many fields, including healthcare, and helps determine the issue and factors that enable it. However, Peerally, Carr, Waring, and Dixon-Woods (2017) argue that the model is a “method of structured risk identification and management in the aftermath of adverse events” (p. 417). The authors state that it is crucial to customize the tools that are a part of RCA to suit the specifics of healthcare in order for this model to work. The favorable implication of this is that one can use prior experiences or projects to develop models that help overcome difficulties and strengthen the quality of healthcare services. The negative aspect is that this technique focuses on the aftermath of the events.

Brainstorming is a model according to which a team discusses a project, and each member is encouraged to share their insight. In this case, BH will use the technique to address problems that can obstruct the project. It is crucial to use a structure or a framework for the process to ensure efficiency (Kobo-Greenhut, Reuveni, Ben Shlomo, & Megnezi, 2018). This is the primary downside of brainstorming because solely discussing possible difficulties will not help develop a proper risk matrix. The positive effect can be established if SWOT categories are used while brainstorming ideas with the team to ensure that all aspects of internal leverages and external issues are considered.

The RCA method will not be used for this project because it usually aids in identifying adverse events and their causes after they occurred, while this paper aims to predict issues that can arise in the future. From a practical perspective, brainstorming and SWOT will be the most suitable risk identification techniques for BH because the first one will allow carrying out a discussion with the team, while the second will structure the analysis in regards to internal and external factors as well as strengths or opportunities that can be leveraged by the employees.

The two techniques that are the most appropriate for this project contrast because of the difference in approaches they use. Barnstorming is based on cooperation and interpersonal communication, while SWOT can be applied either by an individual or a group. The similarities are in reflected in the fact that both require a review of the topic from different perspectives. Thus, one can argue that these techniques do not contradict one another; instead, they can be used simultaneously for better results.

BH Risk Assessment

Table 1. SWOT analysis for BH (created by the author).

Strengths
  • High skilled professionals with prior experience
  • Cooperation with NCB
Weaknesses
  • Lack of previous experience with managing behavioral health initiatives
  • Dependence on the patient data transfer speed
Opportunities
  • Developing a large scale BH project based on the outcomes
  • Leveraging collected information for creating chronic condition care models
Threats
  • Patient data privacy
  • Ethical implications of BH

Table 1 provides a brief SWOT analysis identifying the main aspects of operations that BH project manager should consider. Positive and negative aspects of the SWOT technique are in the ability to list a large number of elements and compare strengths and weaknesses. In addition, opportunities allow one to leverage external factors for success. Barnstorming, on the other hand, requires the participation of at least two individuals; however, this can result in a positive outcome because of different perspectives and viewpoints that team members can offer.

Risk Matrix

The brainstorming and root-cause identification will help evaluate both the positive and negative effects of the BH project and thus develop strategies that the team will use to minimize risks and overcome issues.

Table 2. Risk Matrix (created by the author).

Risk Number Risk Probability Importance Response to Risk Action Plan Person Responsible Status
01 Override costs lead to a need for increasing the budget Medium Crucial Control of expenses Develop a budget that considers unforeseen expenses;
Controlling the costs on a regular basis;
The project sponsor and project manager Ongoing
02 Patient data safety High Crucial Establishing a data safety protocol Consulting legal specialists;
Implementing data safety measures;
Instructing team members on the rules and guidelines regarding information technology safety;
Project manager and case managers Ongoing
03 Concerns regarding obtaining patient information and its legal implications High Important Informing patients about the purpose and ethical consequences of BH Preparing materials that case managers can use when talking to patients Case managers Ongoing
04 An ethical approach to operations within BH Medium Important Ensuring adherence to ethical standards Establishing a trustworthy relationship with patients; Project manager Ongoing
05 Inability to access patient information quickly Low Crucial Establishing cooperation with NCH Set up EHR;
Test the EHR;
Develop strategies for different data transfer models;
Information technology professional Ongoing
06 Not enough patients will register for BH Low Important Prolonging the project Develop a plan for current operations until the required number of individuals sign up Project manager Paused
07 Patients refuse to participate Low Crucial Contacting other individuals Developing a cohesive guide for case managers to explain the benefits of BH Case managers Paused