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Risk, Quality and Performance Management

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Submitted By lmhall30
Words 941
Pages 4
| |
|Risk ,Quality and Performance Management |
|Their role in Healthcare |
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|Linda Hyll |
|8/5/2013 |

| |

The purpose of implementing a quality management program should focus on developing and communicating a customer-focused mission, strategies and action plans; listening and responding to the customers’ needs and expectations; encouraging employees to continuously improve and increase their overall job satisfaction, processes and environment and the gathering and analyzing key performance indicators to improve overall organizational and process results.

A quality management system will help the organization to focus on prevention activities rather than the inspection or the failure of activities often driven by the regulatory process. An effective NMS provides the foundation for providers to achieve performance excellence and for the long-term care profession as a whole to achieve the core principles and outcomes set forth in “Quality First: A Covenant for Health, Affordable and Ethical Long Term Care,” which was adopted in July 2002 by the American Health Care Association (AHCA), American Association of Homes and Services for the Aged (AAHSA), and the Alliance for Quality Nursing Home Care.

A facility addressing the key criteria of a QMS is automatically communicating a quality focused mission statement, conducting patient satisfaction surveys, recording and acting upon customer concerns, gathering information and analyzing performance data and information and striving to continue improving their processes and outcomes. The three concepts of quality management is about defining quality so that staff and employees take ownership, discussing the importance of leadership in quality management and discussing why quality requires management.

Some of the long term goals include the improvement of accuracy or resident identification( at least two identifiers), improve the safety of using medication ( document the usage and know information on the medication and its possible side effects) reduce the risk of healthcare associated infections( proper hand hygiene is known to reduce infections among staff and residents) reduce the resident’s risk of harm from falls (monitor patients who are at risk and use devices that can help alert staff to possible movement ) and prevent healthcare associated pressure ulcers (decubitus ulcers)( monitoring patients, give proper care and turn the patient as needed to prevent ulcers). Some of the short term goals include the enhancement of consumer awareness and assistance ( having the availability of relevant and timely information can enable individuals to be active and informed participants in their care as well as having information that can also enable those individuals to hold the health care system accountable for the quality of services and support that should be provided),strengthen the survey process, standards and enforcement (The CMS Survey and Certification Group (SCG) acts to assure basic levels of quality and safety for Medicare and Medicaid beneficiaries. Within SCG, the Division of Nursing Homes (DNH) focuses on optimizing the health, safety, and quality of life for people living in nursing homes, through close coordination with other Divisions. Approximately 5,000 Federal and State surveyors conduct on-site surveys of certified nursing home every 12 months on average to assure basic levels of quality and safety for beneficiaries (Hillary Smith), national background checks (effective recruitment, screening, supervision, and training of direct and indirect care providers and supervisors are essential to ensuring a knowledgeable, capable, and sustainable workforce), and the improvement of fire safety( better protection, awareness and enforcement).There is currently a website ,www.Medicare.gov/NHCompare/Home.asp that allows individuals, family members and the general public to see how the quality of care rates between nursing homes.

The difference between risk and quality management is that they have different roles but have the same goals; patient safety. Even though they go about their roles differently, the end result is all about the patient and their safety. While risk managers have to keep current and up to date of regulations, the responsibility for compliance usually falls on the organization’s quality management department. Quality management can be thought of as the process of designing and executing products and services effectively, efficiently, and economically. In this context, effectiveness primarily involves the ability of the products and services to meet or exceed customers’ expectations, while efficiency involves the ability to provide products and services without wasting any resources. Economics involves the ability to generate requisite revenues from the process so that the organization can be sustained. Risk management is the process of identifying, addressing, prioritizing, and eliminating potential sources of failure to achieve objectives. Applying risk management means being proactive, preventive, predictive, and preemptive. Risk management is the process of identifying, addressing, prioritizing, and eliminating potential sources of failure to achieve objectives. Applying risk management means being proactive, preventive, predictive, and preemptive (Ed Perkins, 12/19/2011). Performance management (PM) includes activities which ensure that goals are consistently being met in an effective and efficient manner.

Working together, quality, risk and performance can not only be successful in meeting their goals and objectives, but can also maintain or exceed the rules and regulations set forth by the state and government while ensuring patient safety and ratification. Communication between staff and departments can offer insight as to what the strengths and weakness of an organization are, so that a new plan or an updated plan/procedure can be implemented and the staff will be in compliance because they are aware of what is going on and are made to be part of the team. These three departments together strive to maintain patient centered care, accountability and manage the escalating cost of healthcare. PATIENT-CENTERED CARE,
ACCOUNTABILITY, PATIENT-CENTERED CARE,
ACCOUNTABILITY

Resources Used:

http://www.ncbi.nlm.nih.gov/pubmed/121441

http://www.qpr.com/HealthcarePerformanceManagement.pdf

http://www.ihs.gov/RiskManagement/index.cfm?module=part01

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