By definition, healthcare is human work and is characterized by relatively high influx, turnover, absenteeism, personnel changes and fluctuating roles. All this leads to changes in access rights for available information and communication technology (ICT) and healthcare systems. Organizations with fewer than 300 employees can track changes and rights manually, but for larger organizations, manual processing takes an enormous amount of effort and introduces the risk of errors.

As of January 1, 2009, most healthcare facilities that are accredited by the Joint Commission should have in place processes that address disruptive and intimidating behavior by staff, including medical staff members and individuals in positions of power. Although the requirement is new, the challenge has long existed. The Joint Commission’s adoption of this requirement, and its finding that disruptive behavior detracts from quality of care, offers healthcare executives a unique opportunity to establish legally protected mechanisms to address disruptive behavior.  

Hospitals are required to provide emergency medical services to all persons who present in the ED, regardless of immigration status. Once admitted, the illegal immigrant patient often becomes hostage to a system that does not provide Medicaid coverage for medically necessary post-hospital services. 

With healthcare budgets squeezed by the falling economy and declining reimbursements, alert executives are pruning costs in other areas. Legal costs, a traditional budget buster due to litigation and regulatory requirements, are a prime target for a number of reasons, including more progressive attitudes and the growth of domestic outsourcing.

As the overall healthcare delivery system places a greater emphasis on quality measurement, quality-based reimbursement, and regionalized networks such as accountable care organizations, the importance of carefully developed inter-provider patient transfer and discharge arrangements will increase. 

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