Regulatory Challenges that Hospital Would Face


RegulatoryChallenges that Hospital Would Face

RegulatoryChallenges that Hospital Would Face

Hospitalscomply or adhere to specifications, guidelines, laws, and regulation.Failing to comply with regulatory compliance regulation, results inlegal punishment such as federal fines. However, to provide a patientwith high-quality care at lowered cost the regulation can turn intoburdens or challenges for the hospitals. How do hospitals deal withthe regulatory challenges? The regulatory challenges that mosthospital encounter includes HIPAA safeguard frequent reassessment,audit overload, burdensome documentation and resource-intensive datareporting. Various strategies can be used to ease the burden ofregulatory challenges such as automating task by using technologyimplementing technology partnering with physicians creatingcompliance program building appropriate infrastructure always beprepared be reality based and access necessary resources. This studypaper will narrow down the regulatory challenges to two and discussmeans of overcoming these challenges.


HIPAAregulatory requirement requires hospitals to carry out a riskanalysis and come up with measures that sufficiently reduce risks andvulnerabilities to an acceptable level. This requirement applies toboth large organizations and small healthcare systems. The challengeof this regulation for hospitals is on risk analysis. HIPAA does notspecify a process that can be used to conduct a risk analysis thatbecomes a problem because hospital whether big or small has to comeup with a reasonable means of overcoming the challenge. Besides,HIPAA regulation poses a challenge because of the changing technologyand time requirement that creates a patient security risk. This is inspite of the hospital attempts always to be ahead in case oftechnology change that is a challenge to a hospital because of rapidtechnology that is used to leak patient information (Lorenzi &ampRiley, 2004).

Theburden documentation and audit overload are regulatory challenges inthat the required documentation demands great paperwork burden thatdemand for employee additional time to complete the task. Forinstance, the increasing complexity of reimbursement criteria andmedical records require resources and time for careful documentation.On audit overload, the challenge is not on government making fraud apriority rather it is an issue because of the number agenciesmonitoring audit that is unnecessarily large. The audit agencies endup wasting valuable hospital time and finding legitimate errors.

Regulatoryis an overload to hospitals because there are often two or moreregulatory agencies in hospitals checking on patient complaints,audit records and licensing. Despite the fact that this is relevantit takes away valuable employees time, time that primarily ought tobe concentrated on the patient care.


Regulationcreates challenges for hospitals due to complexity, time and resourceusage. The following are some strategies that can be used to relievethese burdens. Using technology to automate task this will play atremendous role because it allows hospital staffs to reassign toother areas of the hospital which not only saves time but alsoincreases efficiency. All in all, hospital leaders ought to showcommitment necessary in attaining the buy in and concentrate on thecompliance of physician and staff. Also, implement technology servesto ensure that employees do not take too much time trying to complywith the regulations. The electronic health records and codingsupport reduces chances of an employee being caught not complyingwith the regulations and test for noncompliance (Healey &amp Evans,2015). Additionally, Partnering with physicians is another strategythat can be used to overcome the regulatory challenges. By engagingthe physician in implementing EHRs and coming up with solutions todifferent issues hospital will find it easy to overcome challengescaused by the regulation.

Standardizingpractices, this involves benchmarking and sharing the best practicesthat help hospitals to remain compliant. The standardizing processensures a system-wide adherence to effective and safe care.Benchmarking facilitates hospitals to make a comparison betweenthemselves and other organizations thus, providing insights into whatought to be improved and what the hospital is doing well. Furthermore, coming up with a compliance program, a well-integratedcompliance program into business practices and culture could play atremendous role in overcoming the compliance challenges. Hospitalleaders ought to investigate organizations regulatory environment anduse the compliance program that include an internal system forauditing and monitoring. This kind of system will prepare thehospital management for regulatory agencies and point out the areasnecessary for improvement. The best and convenient way of integratingthe compliance program is by transparency with all hospitalstakeholders.

Buildingappropriate infrastructure, this can be done by having teams ofin-house regulation expert and selecting people to act as acompliance officer in every key department. Strengthening theDepartment of conformity will enforce a culture of compliance in thehospital. A compliance committee can be formed comprising ofcompliance operation teams, general council chief finance officer,and other staffs the members meet quarterly (Vincent, 2010). The teamof conformity will play a great role in relieving the hospital theburden of being caught not complying. The compliance team meets todiscuss new regulations and reports to the compliance committee. Inaddition, the team trains and educates other staff on how to complywith the regulations. Redouble efforts for care coordination isanother crucial strategy for overcoming the challenges. Herehospitals ought to bolster care management programs and at the sametime take steps toward improving population health and utilizeanalytics and data. In addition, understanding the patient risk isparamount because hospital tends to be at higher audit risk when thepatient stay is shorter. On the other hand, hospitals with a greaternumber of inpatient are at financial risk due to a decline of patientdays. Thus understanding the patient mix will help overcome thisproblem.

Accordingto Joint Commission on Accreditation of Healthcare Organizations,accessing appropriate resources, this is an effective strategy forattaining the regulatory requirement by having the sufficientresources, tracking systems and incident management system (2003).People are also an important resource for managing and controllingthe regulatory issues. In addition to this, staying always preparedis crucial because it helps adopt a posture of readiness when itcomes to regulatory. Preparedness means that the hospital is ready toencounter the challenges that come with change and regulations.Assuming a state of readiness would fit with being reality basedwhereby the hospitals embrace the necessity to be compliant.

Tosum up, hospital face compliance challenges to both new and oldrules. Nevertheless, a hospital has an obligation of ensuring thatthey adhere to the set regulation while at the same time offeringbest medical attention to patients. Compliance bodies expecthospitals to remain compliance to HIPAA to assure that they areworking to keep patient data secure. Thus, to ensure that they complywith regulation and are less burdened by the regulations hospitalsshould optimize technology use, standardize practice, partner with aphysician, create compliance program and always be prepared to facethe challenges associated with regulations.


Healey,B. J., &amp Evans, T. M. (2015). Introductionto health care services: Foundations and challenges.

JointCommission on Accreditation of Healthcare Organizations. (2003).Hospitalpatient assessment: Meeting the challenges.Oakbrook Terrace, Ill: Joint Commission Resources.

Lorenzi,N. M., &amp Riley, R. T. (2004). ManagingTechnological Change: Organizational Aspects of Health Informatics.New York, NY: Springer New York.

Vincent,C. (2010). PatientSafety.New York, NY: John Wiley &amp Sons.