...15 Tenet Healthcare Page 16 Cleveland Clinic Stroke Improvement Plan Page 17 Conclusion Page 18 References Page 19 Introduction The issue of risk scenario carries immense importance for most of the hospitals that are part of the healthcare setting. However, there is not only one scenario that can affect the hospitals but there are several scenarios that can create an impact on the functions of the hospital. There are three scenarios that would be highlighted in the current topic. These three scenarios have a tendency to put a hospital at risk for financial stability. The first scenario that can produce a negative impact on the hospital risk is related to patient care and safety. The second scenario is related to the physical plant. The third and last scenario is related to staffing. The role of HIM practitioner in this regard would be very important. They would serve as a clinical quality assessment resource and as a team member to perform their tasks related to healthcare work. Therefore, all the issues related to three scenarios will be discussed in detail. The impetus for quality improvement has been driven in recent years by three main factors: 1. The amount of money that the US spends on healthcare per capita and as a percent of GDP is far higher than any other country in the world. We spend 15% of GDP, with the next-highest countries, Germany and France, at 10% of GDP. This high level of spending has not brought higher life spans or quality of life years...
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...Quality Improvement in Healthcare In today's healthcare industry, many facilities search for ways to obtain an advantage from other facilities in the market. One way to obtain an advantage over other facilities is to have a reputation of providing the highest quality of care to the patients. Maintaining and continuously striving to improve the quality of various processes and procedures within the facility is important. Foundation frameworks, stakeholder differences, roles of clinicians and patients, need for quality management, areas to monitor, regulatory agencies, and resources represent the various points that will be addressed throughout the paper. Foundational Frameworks of QI There are several foundational frameworks within the subject of QI. There are several QI models derived from ideas and theories of leaders. According to Ransom, Joshi, Nash, and Ransom, (2008) PDSA/PDCA, API, FOCUS PDCA, Baldrige Criteria, ISO 9000, Lean, and Six Sigma represent various frameworks used to improve the quality of healthcare. Edward Deming described the Plan-Do-Study-Act (PDSA) cycle a plan to learn and improve the quality of work dated back to 1950s. Later Walter Shewhart developed the Plan-Do-Check-Act (PDCA) cycle for the basis for planning and expressing QI endeavors. The PDSA/PDCA model helps the facility to focus on how to plan for the improvement, how the improvement will be implemented, how the improvement will be identified/monitored, and what was learned from the...
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... October 17, 2011 QI Plan Part I- Consumerism Healthcare organizations have a responsibility to its consumers and various stakeholders to ensure only the highest quality care is delivered. Quality measures such as performance measurement and quality improvement processes play a critical role in helping organizations achieve quality outcomes. This paper will contrast performance measurement and quality improvement processes. In addition, this paper will discuss a healthcare organization, Gulf Coast Medical Center, its mission and QI goals, and the role of the consumer and stakeholders in the QI process. Performance Measurement vs. Quality Improvement Processes Performance measures are an important element of the overall quality management of an organization. “Performance measures quantitatively tell us something important about our products, services, and the processes that produce them” (Oak Ridge Institute for Science and Education, n.d.). In the healthcare industry, performance measures are a tool used to help understand, manage, and improve what healthcare organizations do. Performance measures are composed of units of measure; a number to tell how much, a unit to give the number a meaning of what, each tying in to the overall target number. In contrast, quality improvement (QI) focuses on bridging the gap between current levels of quality and expected levels of quality. “QI uses quality management tools and principles to understand and address systems...
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...The evaluation of quality in healthcare has a long history. The beginnings of monitoring healthcare quality can be traced back to a surgeon, E. A. Codman from Massachusetts General Hospital in the early twentieth century who advocated for systemic performance assessments of the care he provided to his own patients (Kongstvedt, 2013). The Health Maintenance Organization (HMO) and the application of computers in healthcare in the 1970 led to the large scale ability to analyze data (Kongstvedt, 2013). In the 1990s with increased efforts to control cost and increase quality there were many drivers to implement quality management programs including: a) state laws requiring quality assurance plans in HMOs, b) federal regulations requiring quality...
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...Dimensions of Quality in Healthcare Presented by: Connie Kirkpatrick, PhD, MS, RN Franciscan Health System Tacoma, Washington Quality Basics Series Taught by quality experts for staff in Quality Improvement Organizations, Quality Basics focuses on the fundamentals of quality in areas such as the history of quality improvement, methods and models, performance measurement and other key topics. 1 Quality Basics Dimensions of Quality in Healthcare Connie Kirkpatrick, PhD, MS, RN Director, Quality & Clinical Support Franciscan Health System, Tacoma, Washington Question from a seminar participant: “I can see that it must work in practice. But does it work in theory?” 2 Dimensions of Quality Learning Objectives Define Quality Define Quality Improvement Describe six key “Dimensions of Quality” Describe seven key “Pillars of Quality” Quality Institute of Medicine: “Quality of Care” is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. Institute for Healthcare Improvement (IHI): Quality is turning into outcomes management, and involves minimizing unnecessary variation so that outcomes become more predictable and certain. 3 Quality Basic Principles: All work is a process The process is the main source of quality defects (versus human error) Understanding variability in processes is the key to improving quality Quality Improvement A planned...
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...Running head: IMPROVING HEALTHCARE QUALITY AND PATIENT SAFETY !1 ! ! ! ! Quality Improvement Techniques: Improving Healthcare and Patient Safety ! HMGT 320 ! February 9, 2014 ! ! ! ! ! ! ! Quality Improvement Techniques in a Healthcare Setting !2 ! There is a great need to improve on the quality of healthcare we are providing to patients and it is a necessity to improve on patents safety also. Quality health care is defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (Chassin, 2006). According to the Institute of Medicine, To Err Is Human, the majority of medical errors result from defective systems and procedures, not individuals. Processes that are ineffective and flexible, changing case mix of patients, health insurance, differences in provider education and experience, and numerous other factors contribute to the difficulty of health care. With this in mind, today’s health care industry functions at a lower level than it can and should, and it put forth the following six aims of health care: effective, safe, patient-centered, timely, efficient, and equitable (Ferlie, 2005). The aims of effectiveness and safety are targeted through various processes that will measure whether providers of health care perform processes that have been demonstrated to achieve the desired aims and avoid those processes that are given toward maltreatment...
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...Healthcare Risk Control Risk and Quality Management Strategies 4 Executive Summary VOLUME 2 July 2009 Key Recommendations Assess current activities in risk management and quality improvement to evaluate their effectiveness in addressing overlap. Establish a structure to ensure that patient care activities are addressed in a coordinated manner involving risk management and quality improvement functions. Seek legal counsel to ensure that the structure for risk management and quality improvement activities maximizes legal protections granted by state and federal statutes while allowing for the flow of information. Align risk management and quality improvement plans with the strategic goals of the organization. Educate stakeholders on the role of risk management and quality improvement functions. Design systems to coordinate and streamline data collection, analysis, monitoring, and evaluation. Risk Management, Quality Improvement, and Patient Safety In the past, the risk management and quality improvement functions often operated separately in healthcare organizations and individuals responsible for each function had different lines of reporting—an organizational structure that further divided risk management and quality improvement. Today, risk management and quality improvement efforts in healthcare organizations are rallying behind patient safety and finding ways to work together more effectively and efficiently to ensure that their organizations deliver...
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...Total Quality Management in Hospital Pharmacy Introduction Hospital pharmacies in the present day context face various issues including cost containment, productivity and leadership, patient safety, medical-legal and ethical considerations, human resource management and application of new technological developments in the functioning of the pharmacies. The pharmacists employed by the hospitals are expected to attend to a number of different functions that include writing down therapy management plans and desired patient outcomes, monitoring the drug-based therapies, educating patients and counseling them and writing medication histories. Despite these many different functions being discharged by the pharmacists, hospitals find it difficult to recruit pharmacists (Smith). At the same time many of the hospitals take initiatives like staff reductions due to lower patient concentration, reorganization of the hospital facilities, carrying out recommendations of external consultants, implementing automation in drug distribution and mergers and acquisitions of hospitals. In this context, a methodological review of the operations of a hospital becomes necessary for improving the efficiency and functioning of the healthcare settings. One of the recommendations is to apply Total Quality Management (TQM) for improving the performance of pharmacies in the hospitals. Although TQM has been practiced in manufacturing industries for quite some time, it is relatively a newer concept in...
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...Healthcare Leaders, “First, Do No Harm” The phrase “Primum non nocere” is Latin for “First, Do No Harm”, has been part of the Hippocratic Oath taken by healthcare leaders for centuries and has been a keystone of ethical practice in medicine (Rich, Singleton, & Wadhwa, 2013, p.171). It might be thought of as the first and earliest code of quality in medicine. The Oath is one of the oldest imperative documents, goes into more detail of quality care (Rich, Singleton, & Wadhwa, 2013, p.171). Healthcare leaders are responsible for business decisions, including decisions that impact the healthcare environment. Healthcare leaders may be held to an even higher standard of accountability than commercial industry leaders because of their commitment to...
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...achieving and maintaining accreditation…………………..…5 The role of the URAC as an Accreditation Body………………………………………………....5 How the URAC accredits healthcare institutions….........................................................................6 Quality assessment and control solutions in accreditation ……………………………………......8 Implementation of quality improvement and accreditation solutions…………………………......9 Justification…………………………………….…………………………………………………10 Summary and conclusion……………………….…...……………………………………………10 References ………………………………………………………………………………………..11 Achieving and Maintaining Accreditation in Managed Care Managed healthcare organizations and professionals encounter numerous challenges on a yearly basis in the course of offering services, whereas the state, stakeholders, and clients (patients) expect to be reassured that bodies that render managed healthcare services are well equipped to meet their demands. Accreditation is, therefore, a detailed evaluation process through which an independent professional body or authority assesses another organization’s systems, structures, and procedures to certify that it satisfies the set industry criteria and standards (Bialek, Duffy & Moran, 2009). The evaluation and accreditation processes that are conducted by bodies such as URAC help in maintaining the quality of care in organizations. Physicians and nurses receive professional certification and...
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...Search According to "Healthcare.gov “The Affordable Care Act was passed by Congress and then signed into law by the President on March 23; 2010. On June 28, 2012 the Supreme Court rendered a final decision to uphold the health care law”. The Affordable Healthcare Act affords new means to hold insurance companies responsible and offers strong selections for customers. For example as part of the recently upheld Affordable Care Act, all health insurers are required to spend a percentage of each premium dollar collected to pay claims and to provide clinical service and activities that improve health care quality. ("Healthcare.gov", 2012) The Medical Loss Ratio (MLR) is known as a percentage that healthcare insurers must meet or better known as the MLR requirement. Healthcare insurers are required by the Affordable Care Act to produce a reimbursement to its consumers. The Medical Loss Ratio financial measurement used in the Affordable Care Act to help ensure that health plans provide significant value to users. The following is an example of how insurers use the MLR According to "Healthcare.gov" (2012), “if an insurer uses 80 cents out of every premium dollar to pay its customers' medical claims and activities that improve the quality of care; the company has a medical loss ratio of 80%. A medical loss ratio of 80% indicates that the insurer is using the remaining 20 cents of each premium dollar to pay overhead expenses, such as marketing, profits, salaries, administrative costs, and...
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...Quality Improvement Email Glorybel Rodriguez HCS/588 Measuring Performance Standards November 24, 2014 Dr. Debbie Simmons Quality Improvement Email Health care organizations aim to provide both quality and safe patient care. These two fundamental and critical concepts in health care require continuous effort. “Organizations must make an intentional effort to measure, assess, and improve performance” (Spath, 2014, pp.266). Quality improvement (QI) is essential for the continued success of an organization as it reveals specific guidelines and methods to provide consistent and dependable quality services. This paper will discuss QI while focusing on quality management’s role and importance in health care, stakeholder’s different views of quality, QI roles, and what areas in health care require monitoring. Additionally, involved accrediting and regulatory organizations in QI and helpful resources and organizations that affect QI will be discussed. Quality Management According to Kelly (2011), quality management refers to how managers operating in various types of health services organizations and settings understand, explain, and continuously improve their organizations to allow them to deliver quality and safe patient care, promote quality patient and organizational outcomes, and improve health in their communities” (pp. 9). Therefore, the purpose of quality management is to enhance the effectiveness, efficiency, and safety of health care processes to achieve quality...
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...201420-HAS-4383- Quality Improvement in Healthcare Dr. Jessica Sapp Eastern Florida State College August 3, 2014 Abstract Quality improvement is one of the most important topics within businesses for the past twenty years. This is mainly true for health care, as the debate continues on how our current American system should be restructured. The current health care reform is aimed at decreasing costs and guaranteeing access to all Americans. It cannot be allowed to put the quality of care at risk. Quality improvement has become the main element to strategic planning within the health care domain. A strategic concept can help save our healthcare business in more way than you think. This cannot be effectively applied unless quality improvement can be accurately defined, measured, evaluated, and monitored at all times. Through such analysis a hospital can choose how to narrow resources toward those quality improvement projects which will effect a customer’s perceptions of service quality the most. The purpose of this research paper is to establish a concept by which to approach the issue of quality improvement, define the numerous components of quality improvement that exist in health care, and understand how these elements will affect one another. Quality improvement is a hard topic to have success in within this century. I have chosen to speak to do my research on quality improvement within a hospital. Hospitals are always trying to improve their quality of service to...
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...QI Plan Part II- Quality Data Collection Quality data collection is an important tool used in health care organizations to collect data, using those data as information. Based on those results, the findings used for strategic planning, management, and effective decision-making plans. Data collection has been an important method and tool as an important quality for improvement in hospitals and health care organizations. Quality improvement is a process of measuring and improving services that can help leaders understand the direction of quality the organization needs. This paper will include areas of potential quality improvement for the St. Joseph hospital that was selected during the QI plan part one previously. The paper will also discuss the areas of potential improvement for the organization, data needed to monitor improvement in performance areas, data collection tools used for performance information, and contrasting those tools. Also tools to measure and display QI data are also identified with types of information each tool measures and displays. Finally, the tools will also be compared and contrasted as well as describing how helpful they are for healthcare organizations. Areas of Potential Improvement for the Organization Quality improvements in hospitals are an essential in maintaining patient satisfaction and services for better performance. The process is to advance the quality of care and outcomes for patients using the services offered at the facility (Walker...
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...Executive Summary One out of five falls results in major injuries such as fractures and head trauma. Medical cost for such falls are $34 billion yearly, and hospital cost account for two-thirds of the total of falls (CDC, 2013). Along with this information, hospital losses from falls occurring as inpatients have lost millions of dollars in revenue. Many of these fall can be avoided, and can also decrease extended inpatient care along with decrease profit loss. A process must be developed here at Davis Healthcare System (DHS), in response to patient falls, injuries and profit loss. In the Mission and Vision statement at the DHS, it states several key words: high-quality care, safety, innovation, patient-centered care, and that is the reasons that we must initiate the quality improvement plan immediately. Safety deals with lack of harm to the patient and Quality is an effective, efficient and focused direction that to get to safety. Our team of experts in quality improvement will use our mission, tools, communication along with collaborating with the patients to get to the root and cause of this problem. There are several ways to accomplish this goal, 1). Purchasing an item called Radio Frequency Identification floor mats 2). Lowering beds to the floor, 3). Hourly rounds, and 4). Identifying fall risk patients. The only cost involved would be the floor mats, which after discussing with the company of our needs, The Rainbow Company would negotiate a price value on the...
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