Q4: The Quarter That Can Transform Your Quality and Risk Management Year

Every year, I see it happen. By November, health center quality and risk management leaders suddenly realize they’re behind: the quarter’s risk assessments are incomplete, trainings lag far behind schedule, and end-of-year reports are looming. Panic sets in. They drop everything else to scramble through what’s overdue, all while the season fills up with holidays and vacations. Despite the celebrations, there’s hardly a moment to relax—they’re just trying to keep their heads above water. Then, almost overnight, it’s January. UDS reports are due, FTCA applications open, and the whole cycle starts again with new requirements for the first quarter.

If this sounds familiar, I understand—I've been there too. But here’s the truth: it doesn’t have to be this way, and the solution is well within reach.

Over the last few years, I’ve worked with health centers to reclaim Q4 as their “Quality and Risk Management Planning Quarter.” It’s made a remarkable difference. Let me walk you through a system that allows you to take control—so you can plan ahead, instead of always playing catch-up.

Start with a Quality and Risk Management Work Plan

A work plan doesn’t need to be elaborate. All you truly need is a method to see all required tasks and tie them to specific dates. When I was in your shoes, I created a simple plan, blew it up into a 4-foot by 6-foot poster, and tacked it up in the boardroom. Every meeting, we’d look at it together, track our progress, and make sure nothing was dropped. If it wasn’t on the plan, it didn’t get done. Q4 is the moment to sketch this plan out for the coming year, so those tasks never sneak up on you again. Log in to our site and access a free Work Plan sample.

Free Up Q4 Wherever Possible

One hard lesson learned: about 10–15% of staff will always need some nudging to finish their training requirements. It's not a flaw in you or your team—it’s simply reality. Instead of feeling frustrated or cornered by the year-end rush, set your next year’s training deadline for September 30. This way, you have a generous three-month window to gently follow up with latecomers—a very different experience from the year-end rush. Move other “must-dos” to earlier in the year so Q4 is clear for what really matters. If you’re a risk manager, block out time for your annual training long before the winter holidays hit.

Be Proactive with Your Training Plan

FTCA-deemed health centers are required to update or create a risk management training plan every year. But here’s the trap: most don’t start thinking about this until spring, when the FTCA re-deeming process calls for last year’s plan. By then, most trainings are done, and the written plan is just a formality—a “retroactive” record, not a useful tool. That’s a missed opportunity.

A good training plan reflects your health center’s unique needs. It’s built with your team’s risks and learning gaps in mind, and it provides a clear roadmap for timely, effective completion. If you wait until it’s too late, you rob yourself of the advantage of thoughtful planning. Use Q4 to build out next year’s training schedule. Set everything due by September 30 and watch the scramble disappear.

Review and Update Policies & Procedures

Each FTCA application requires documented procedures: credentialing, privileging, claims, and referrals/diagnostics/hospitalization tracking. Make it a point to review and update these policies every Q4. This ensures compliance and takes the pressure off when application season arrives.

Revisit Last Year’s FTCA Application Attestation Questions

It’s easy to treat FTCA attestations like just another box to check. Don’t fall into that habit. Every year, HRSA issues a new Program Assistance Letter, usually early in the year, outlining what’s required for the coming application season. Each Q4, take time to actually read through last year’s attestation questions. Ask yourself—are we truly doing everything these questions require? This reflection can reveal gaps and keep your health center on track with what matters most.

When you dedicate Q4 to thoughtful planning, you set up your health center—and yourself—for a much stronger start in the new year. Having a clear, systematic approach ensures your work isn’t just done, but done well. This proactive effort will support your team’s aim of providing high-quality care: care that is safe, timely, patient-centered, and provided with limited variation across the populations you serve.

Let Q4 work for you. Take this quarter to plan with intention, and watch how much smoother—and less stressful—the next year becomes.

If your team needs help operationalizing your plans, contact RegLantern today!