Quality Medical Care presentation made to a major Pharm mfgr in 1998 at a national meeting. Purpose is to explain how pharm company could use gov mandates to add value to contracts with MCOs.
Power Point Presentation made to a major pharmaceutical manufacturer in 1998. Identifies cause of Medical Crisis and how Pharm mfgrs can use regulations to add value to their contracts with MCOs.
Improving the Health Outcomes of Both Patients AND PopulationsCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 23, 2019 | 2 p.m. EST
In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
An introductory overview of the basic concepts of Healthcare Quality, a starter for beginners.
Prepared in 2014 for the new staff of the Quality Management Department in King Saud University Medical City in Riyadh as a part of their capacity building plan.
Acknowledgments:
*Dr. Magdy Gamal Yousef, MBBCh, MS, CPHQ - for his contribution in the scientific content
**Ms. Maram Baksh, MS, CPHQ - for the design of the full HCQ capacity building plan in KSUMC
Power Point Presentation made to a major pharmaceutical manufacturer in 1998. Identifies cause of Medical Crisis and how Pharm mfgrs can use regulations to add value to their contracts with MCOs.
Improving the Health Outcomes of Both Patients AND PopulationsCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 23, 2019 | 2 p.m. EST
In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
An introductory overview of the basic concepts of Healthcare Quality, a starter for beginners.
Prepared in 2014 for the new staff of the Quality Management Department in King Saud University Medical City in Riyadh as a part of their capacity building plan.
Acknowledgments:
*Dr. Magdy Gamal Yousef, MBBCh, MS, CPHQ - for his contribution in the scientific content
**Ms. Maram Baksh, MS, CPHQ - for the design of the full HCQ capacity building plan in KSUMC
Change Management And Contingency Planning in Transformation of Diagnostic De...Ruby Med Plus
Change Management and Contingency Planning: Case Study of Dental Hospital in implementing new Dental X-ray technology.Application of Kurt Lewin Force field Model. Kurt Lewin's three-stage model (1958) of organizational change,
Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.
Change Management And Contingency Planning in Transformation of Diagnostic De...Ruby Med Plus
Change Management and Contingency Planning: Case Study of Dental Hospital in implementing new Dental X-ray technology.Application of Kurt Lewin Force field Model. Kurt Lewin's three-stage model (1958) of organizational change,
Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.
This presentation gives you eight simple tips on how to make your PowerPoint presentation slides more visually engaging, creative and fun. Try out these advice and you will make your best PowerPoint presentation ever.
This presentation was created by my powerpoint design agency Slides. We are based in Spain but have clients worldwide.
Drop me an email and we will discuss your project.
Employee Engagement: Your Tool for Tackling Heath Care CostsDigital Measures
Everyone is concerned about increasing health care costs. This interactive session will review the various triggers that drive health care and insurance costs and cover the major communication and engagement strategies that companies use to reduce their trend. Case studies to be discussed include wellness, employee engagement and communication, benefit plan design and consumerism. Successful benefit incentive programs that support communication programs and have a quantifiable return on investment will also be discussed.
US Healthcare Delivery SystemsQuality Outcome MeasuresDonna .docxdickonsondorris
US Healthcare Delivery Systems
Quality Outcome Measures
Donna Wilson, RN MPH MSJ CPHQ
Director, Quality Improvement/Patient Safety
Mount Sinai Beth Israel
History Pre- 1913
The godmother of quality was Florence Nightingale. She was a wealthy woman who went to work in the nurse corp during the Crimean war. She studied illness – the dysentery that the soldiers were getting.
She was the first one credited with thinking about washing hands, how close the beds were to one another and sharing needles.
2
EMERGENCE OF Continue
Quality Improvement in Health Care
1913 - American College of Surgeons (ACS)- started to measure what we are doing and what difference it makes.
1918 - Hospital Standardization Program
1951 - Joint Commission on Accreditation of
Hospitals Organizations (JCAHO)-certifies 99% of hospitals
1963 – Corporate Liability introduced to Hospitals 1st lawsuit
1986 - Corporatization of medicine (HMO’s started, PPO’s)
1988 - Harvard Health Care Demo Project
Need for objective information on physician performance
Data on cost/ outcomes of medical care used by CMS
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3
1913
First step toward improving quality care in American hospital. Developed minimal essential standards of care for hospital. Became the Hospital’s Standardization Program (HSP).
1951
HSP became JCAH - assumed responsibility for accreditation
Shift focus from structure to process
Increasing demand for availability of data on quality outcomes, and cost
1963
Hospital can be held accountable for failing to establish system of safe practices as defined by the industry.
EMERGENCE OF CQI IN HEALTH CARE
1990 - Introduction of TQM/CQI principles to hospital management by industry people
1999:Institute of Medicine (IOM) Report said that over 100,000 patients died from medical errors
Started Patient Safety
Transparency in Healthcare
Creation of Institute for Healthcare Quality (IHI)
2000 - CMS Core Measures
2006 – Pay for Performance
2009 – Present on Admission & Readmissions
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4
70’s-80’s
Organization demanded data on cost, use patterns and practice patterns because such information was crucial in managing care in these systems. Essential to evaluating costs and quality of care.
TQM
Growing focus on using scientific methods. TQM was introduced to hospitals to change the way certain hospitals approached quality.
Physician Performance
For appointment and reappointment process
Cost and Out come
Medicare Prospective Payment System - Center for Medicare and Medicaid (CMS)
Continuous Quality Improvement
This term started in 1990s and started to look at quality on a continuum
We would say “ this is the problem” then we would collect data to see where we were weak and then come up with a solution
Then we would measure it ( the outcome) to see if what I put in place actually helped.
If it worked we move onto a different problem. If not, we tried a new solution
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5
CQI came from Japan’s car industry
Toyota wo ...
ISSUES IN HEALTH MANAGEMENT AND ITS CURRENT NEEDSrithi12
The Indian healthcare scenario presents a spectrum of contrasting landscapes. At one end of the spectrum are the glitzy steel and glass structures delivering high tech medicare to the well-heeled, mostly urban Indian. At the other end are the ramshackle outposts in the remote reaches of the “other India” trying desperately to live up to their identity as health subcenters, waiting to be transformed to shrines of health and wellness, a story which we will wait to see unfold. With the rapid pace of change currently being witnessed, this spectrum is likely to widen further, presenting even more complexity in the future.
Engage Front-line Care Team Using Clinical Audit Checklists iCareQuality.us
The culture of patient safety, quality, and transparency is central to improving care delivery at the organization and industry level. Implementing a sustainable frontline solution like quality checklists will require new leadership, innovative thinking, applications of human factor engineering, and patient voices who demand better. We need to reward staff engagement and quality patient safety efforts which can translate into better patient outcomes. CCG, PSO developed a Clinical Audit Checklist program that can support a culture of transparency and accountability, thereby reducing healthcare costs and delivering positive patient outcomes. Together, we can make continuous daily improvement a standard practice at the hospital and system level. Patients are counting on us to make care delivery safer today for a better patient experience tomorrow.
Patient often has at least some anxietyFear of dia.docxdanhaley45372
Patient often has at least some anxiety
Fear of diagnosis
Discomfort with lack of privacy
Fear of high costs/ time off work
Fear of pain or discomfortDifficult for MD’s and nurses
Administrative role to provide a supportive environment
Patient judge medical care based upon their entire experience, not just physician quality
Parking
Registration
BillingDemeanor of manager may dispel complaints
Listen, empathize, change what you can, however….
Medical decisions are still the MD’s responsibility
Timeliness
Respect that their time is as important as yoursProvider attitude
Happy doctors and nurses, good “bedside manner”Complaints may be a symptom of a larger problem
Patient anxiety
Financial concerns
Too little time with MDMD didn’t listenStaff was rude, uncaringWait too longMD took calls during examPoor teaching, no explanation for testsPoor explanation of billing, insurancePoor communication between specialist and primary care
Top complaints revolve around time, respect, and patient instructionGather facts, information
Remember subjective patient information is only one side of the story
Patients may be misunderstanding the purpose for tests or MD decisionsEasier to resolve when organizational systems are in place
Identification of the problem
Reactive: Complaints
Proactive: Data collection such as surveysAnalyze data to identify trendsCommunicate information in an impartial way to staff, leadersImplement actions to reverse trendsContinuous evaluation to assure effectiveness
Inform patients of why the survey is being done
What the data will be used for
Confidentiality; that answers won’t affect future medical careProvide a stamped envelope
Put no burden on the patient
If a patient puts their name and a personal note provide a personal responseCommunicate results to staff
Complaint resolution/ patient relations is an area where an administrator can make a tremendous impact
May reduce malpractice claimsNeed MD support
Establish peer review processes for MD’s
MD’s should be evaluated by other MD’s
Put in place a formal , objective complaint resolution systemCommunicate continuously with staff
Hca 346 ambulatory care administration
Professor Haislip
Chapters 3 & 5
Basis of any quality program is to figure out what the customer wants and needs while meeting or exceeding their expectations.
Driven from theme of customer-driven market
Customer service principles (ex: Six Sigma) and the common methodologies, combined with the ten commonsense principles (CSPs) and personal experiences, will deliver a customer-focused culture.
Figure 3.1
Chapter 3: Engineering the customer connection
Quality Function Development (QFD)- an effective team approach to designing products and services that involves key stakeholders from the organizations that are responsible for what the customer uses or purchases
notably called the voice of the customer
QFD and voice of the consumer refers to development of prioritized set of customers wants and nee.
HS410 Unit 6 Quality Management - DiscussionDiscussionThi.docxAlysonDuongtw
HS410 Unit 6: Quality Management - Discussion
Discussion
This is a graded Discussion
. Please refer to the Discussion Board Grading Rubric in Course Home / Grading Rubrics.
Respond to all of the following questions and be sure to respond to two of your other classmates’ postings:
1.
What are the steps in the quality improvement model and how is benchmarking involved?
2. What are the stages in which data quality errors found in a health record most commonly occur?
3. What is the definition of risk management?
4. What are the parts of an effective risk management program?
5. What is utilization review and why is it important in healthcare?
6. What is the process of utilization review?
Please paper should be 400-500 words and in an essay format, strictly on topic, original with real scholar references to support your answers.
NO PHARGIARISM PLEASE!
This is the Chapter reading for this assignment:
Read Chapter 7 in
Today’s Health Information Management
.
INTRODUCTION
Quality health care “means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results.”1 The term quality, by definition, can mean excellence, status, or grade; thus, it can be measured and quantified. The patient, and perhaps the patient's family, may interpret quality health care differently from the way that health care providers interpret it. Therefore, it is important to determine—if possible—what is “right” and what is “wrong” with regard to quality health care. The study and analysis of health care are important to maintain a level of quality that is satisfactory to all parties involved. As a result of the current focus on patient safety, and in an attempt to reduce deaths and complications, providing the best quality health care while maintaining cost controls has become a challenge to all involved. Current quality initiatives are multifaceted and include government-directed, private sectorsupported, and consumer-driven projects.
This chapter explores the historical development of health care quality including a review of the important pioneers and the tools they developed. Their work has been studied, refined, and widely used in a variety of applications related to performance-improvement activities. Risk management is discussed, with emphasis on the importance of coordination with quality activities. The evolution of utilization management is also reviewed, with a focus on its relationship to quality management.
In addition, this chapter explores current trends in data collection and storage, and their application to improvements in quality care and patient safety. Current events are identified that influence and provide direction to legislative support and funding. This chapter also provides multiple tips and tools for both personal and institutional use.
DATA QUALITY
Data quality refers to the high grade, superiority, or excellence of data. Data quality is intertwined with the concept of.
4. 16 15 14 13 12 11 10 9 8 7 6 1970 1975 1980 1985 1990 1995 2000 National Health expenditures as a percent of gross national product. Calendar Year Percent Source: Health Care Financing Administration, Office of the Actuary. Data from the Division of National Cost Estimates. NATIONAL HEALTH EXPENDITURES AS A PERCENT OF GROSS NATIONAL PRODUCT BY YEAR
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6. Sample of Actual Medical Knowledge (Tested Knowledge) Knowledge Test Score Age (years) 100% 75% 50% 25% 20 40 60 80 100 0% 25% 50% 75% 100% A B C D Theoretical Test Scores “ Changes over time in the knowledge base of practicing internists” Paul G. Ramsey et al, JAMA, August 28, 1991 - Vol 266, No8 pp 1103 A B C D B C 0% 0
7. 100% Efficient Health Care* A Judgment Alone Maximum quality attainable using memory based system Quality of Care - Memory Base System * Most cost efficient, medically necessary, effective and best expected result for the patient. TIME
8. COMMUNITY HEALTH STATUS vs. UTILIZATION and EXPENDITURE RATE B C D A $/C H Conservative Style Elaborative Style Underservice Range of Acceptable Practice Overservice SERVICES and EXPENDITURES PER CAPITA Source: Booz, Allen and Hamilton Inc. HEALTH STATUS of the POPULATION
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11. TONS TIME Tons of Paper Printed in Medical Journals Not Shinola Shinola Growth of Medical Publishing Growth of Medical Knowledge
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13. 100% Efficient Health Care* B Judgment & Feedback A Judgment Alone Maximum quality attainable using memory based system Augmented memory based system + Other Feedback Quality of Care - Memory Base System Outcomes * Most cost efficient, medically necessary, effective and best expected result for the patient. TIME
14. B C D A Q O PRESSURE TO SATISFY PATIENTS Q = QUANTITY OF MEDICAL SERVICES CONFLICTING PRESSURES ON THE HEALTH SERVICE DELIVERY SYSTEM O = CLINICAL OUTCOME PLATEAU OF COMPARABLE OUTCOMES PRESSURE TO CONTROL COST
31. POINT FOUR End the practice of awarding business on the basis of price tag. Instead, minimize total medical cost (eliminate unnecessary procedures.) Reduce the number of suppliers for any one service (limited provider network) on the basis of a long-term relationship of loyalty and trust.
104. CR 9 Recredentialing Standards The MCO incorporates the following data in its recredentialing decision-making process for PCPs: CR 9.1 member complaints; CR 9.2 information from quality improvement activities; CR 9.3 utilization management; CR 9.4 member satisfaction; CR 9.5 medical record reviews conducted as part of MR 2.1; and CR 9.6 the site visits conducted as part of CR 10.1
105.
106.
107.
108.
109. CR 12 Initial Credentialing CR 12.1 The MCO should confirm review & certification by a recognized accrediting body, and is in good standing with state and federal regulatory bodies; and CR 12.2 Confirms that the provider has been approved by an accrediting body confirms that the provider has been reviewed and approved by an accrediting body; or CR 12.3 If the provider has not been approved by an accrediting body, the managed care organization develops and implements standards of participation CR 12.4 At least every three years, the managed care organization confirms that the provider continues to be in good standing with the state and federal regulatory bodies and, if applicable, is reviewed and approved by an accrediting body.
137. 100% Efficient Health Care* A Judgment Alone Maximum quality attainable using memory based system Quality of Care - Memory Base System * Most cost efficient, medically necessary, effective and best expected result for the patient. TIME
138. 100% Efficient Health Care* B Judgment & Feedback A Judgment Alone Maximum quality attainable using memory based system Augmented memory based system + Other Feedback Quality of Care - Memory Base System Outcomes * Most cost efficient, medically necessary, effective and best expected result for the patient. TIME
139. 100% Efficient Health Care* C Judgment & Computer B Judgment & Feedback A Judgment Alone Maximum quality attainable using memory based system Augmented memory based system Physician Judgment + Computer decision support Computer Assisted Physician Judgment + Other Feedback Quality of Care - Memory Base System Outcomes * Most cost efficient, medically necessary, effective and best expected result for the patient. TIME