A reimagined risk assessment

Like many hospitals today, Hospital X faced risks on multiple fronts. Using a traditional risk assessment approach, its internal audit team could identify risks and develop an internal audit work plan. Hospital X wanted a way, however, to zero in on the risk areas that most significantly affect their ability to achieve their business objectives—and best serve their patients. Working with Kodiak’s risk assessment experts, Hospital X underwent a six-step reimagined risk assessment process to better identify the risks that directly impact them. Follow along on their journey below.

STEP 1

Prepare and discover

Kodiak gathered data from Hospital X, including organizational information, metrics, scorecards, and strategic plans in areas such as IT, clinical, patient safety, finance, and coding and compliance.

Next, Hospital X and Kodiak worked together to identify risk assessment points of contact, focus group participants, and interviewees. Hospital X chose to conduct focus groups in finance, clinical, IT, and pharmacy. The Kodiak team ran data analytics to give Hospital X insights into the organization’s charge description master and surgical processes, two areas where problems were occurring frequently. The analytics uncovered missing surgery and recovery charges and invalid and duplicate CPT codes, among other findings.

STEP 2

Deploy AI technology

Armed with the data analytics results to guide their questions, Kodiak’s team conducted four anonymous, virtual focus groups with 132 participants from Hospital X. Participants were asked about several topics, including those related to CDM variances, charge capture for surgery, and duplicate CPT codes. An AI-powered tool automatically measured audience members’ responses during the focus groups, and questions were adjusted in real time based on audience feedback. Following the focus groups, the moderator gathered all the data and charts that identified risks across Hospital X.

STEP 3

Perform interviews

The internal audit team interviewed 25 executive leaders at Hospital X from the organization’s finance, supply chain, administration, IT, clinical, revenue cycle, legal, and compliance departments. Having the results from the analytics and focus group feedback allowed interviewers to ask the executive leaders deeper, more-informed questions and have a more productive discussion overall about risks.

STEP 4

Aggregate insights

Kodiak subject matter experts merged the results of the data analytics, focus groups, and executive leadership interviews and developed a comprehensive list of Hospital X’s risks. Then, to further home in on Hospital X’s most pressing risks, Kodiak employed a sophisticated ranking process, including a scoring matrix with a multifactor ranking system.

STEP 5

Identify the risk landscape

The outcome? A consolidated list of Hospital X’s most critical risks. The team used a heat map to visually represent Hospital X’s risks. The heat map showcased which risks are most urgent and who within the organization could potentially be responsible for addressing those risks.

STEP 6

Risk and mitigation plan

Finally, the Kodiak team created a comprehensive report for Hospital X featuring a targeted outline of risk areas that the organization's internal audit team and other departments can mitigate and prepared a list of suggestions for specific audits. For example, CDM and clinical operational performance management were identified as top-tier risks for Hospital X and were included on the internal audit plan. Additionally, risk areas not selected as part of the internal audit plan may be remediated by individual departments. With a detailed list of audit suggestions, several objectives to consider for mitigating risks, and Kodiak by its side, Hospital X is now on a path toward success.