...Achieving and Maintaining Accreditation in Managed Care Name: Institution: Devry Table of Contents Introduction………………………………………………………………………………………3 Background……………………………………………………………………………………….3 Importance of accreditation…….………………………...………………………………………3 Accreditation Bodies……………………………………………………………………………...4 Literature review………………….…………………………………………………………….....4 Challenges that are experienced in 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...
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...Schools (HLC), and the Western Association of Schools and Colleges (WASC). The reason I chose those organizations is that my present home located in San Diego, CA makes me curious as to how WASC operates. HLC was chosen because my future home, and ultimate target for a teaching position, is Bloomington, IN. Indiana is one of the19 states in HLC’s jurisdiction. This discussion will compare the ways that each association defines, addresses, and approaches an educational institution’s learning assessments program during the accreditation process. Higher Learning Commission Defining Learning Assessments HLC defines learning assessment structure in terms of their stated criteria and core standards. Evidence listed for these core components provides a more detailed definition of learning assessments. As of 1 January 2013, HLC’s accreditation process will be built on 5 criteria. HLC directly addresses learning assessments in 2 of its 5 accreditation criteria. Criteria #3- Teaching & Learning: Quality, Resources & Support Criteria #4- Teaching & Learning: Evaluation & Improvement Because Criteria 3 and 4 have specific learning assessment applications they alone will be discussed further. HLC derives Core Components for each of the Criteria. Two Core Components for criteria 3 are specific to student learning assessment: A) The institution demonstrates that the exercise of intellectual inquiry and the acquisition, application, and integration of...
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...facilities, clinical laboratories, health care networks and hospice. Numerous of accreditation organization is also taking place within the United States, but the Joint commission remains the largest The Joint commission accredits 20,000 organization” which” one third are Hospitals. The joint commission is assigned a special task to improve health care by evaluating health care of organization as well as encouraging health organizations to provide safe and effective care at the highest level. The Joint Commission believes that the only way to improve the quality of health care is to join together with other stakeholders and evaluate each health care organization. The Stakeholder consists of 29 broad members of commissioner and cooperate members such as the American Hospital Association, and the American Medical Association. In this paper I will analyzes key topics such as the Joint Commission source and its scope of authority, the structure of the Joint commission and how its responsibilities. The Joint Commission Structure The Joint commission broad members of commissioner provide leadership and oversight by evaluating healthcare organizations and encouraging health care organization to practice safe and effective care at the highest level. The broad members have seven standing broad committee and each member have diverse experience in health care, public policy, and business. The Joint commission structure relies...
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...Particular agency governs health care. Particular agency governs health care. The following agency has a place in governing the health care industry and the people of the world. The paper shall begin with the agency role and structure and follow with the impact it effects within the health care industry. The agency that will be discussed in the paper is center for disease control. (CDC). After the completion of the effect the discussion will transfer into what the duties are of this agency along with the regulations that are governed by the other agencies involved with the CDC. Along with the final part which, will be the accreditation of the agency and how they affect the public. To begin first point or item expressed her is the agency’s role. Level one - the agency’s role or structure. The agencies’ role or information given by The Cdc - Laws and Regulations (2012) It is your single source for accurate, timely, consistent, and science-based information on a wide variety of disease prevention and health promotion topics. The subsidiary to this agency is the department of health and human services when asked or told by the CDC has the responsibility for preventing the introduction, transmission, and spread of communicable diseases in the United States along with other countries and allies. This agency has many other agencies’ attached or associated to them and what they do with the main agency which is to help in the operation of quarantine service...
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...individual has demonstrated competency, authority and/or credibility to meet a predetermined set of standards is called Accreditation. It is also a mechanism that seeks to reassure external stock holders that quality and safety standards are demonstrated. A secondary and more recent goal in some applications, notably health care, is to provide a basis for quality improvement initiatives. Accreditation is an element in a network of activities that seeks to regulate conduct in the health sector. Health organizations, and individual professionals, are networked together, and their behavior is assessed by independent bodies through accreditation programs, standards,...
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...quality patient services. If regulations with accreditation were not sufficient in health care, safety comfort would not be provided to patients/clients. JCAHO Also known as Joint Commission Accreditation health care organization which conducts survey done on site that complies as well verify the continuous standards of improvement for joint commission. The JCAHO ensures that health care providers and facilities are maintaining the required standards of care in place by the regulatory agency. JCAHO is constantly providing the most update in improvements in medical facilities History of JCAHO of Health Care Organizations In 1910, Ernest A. Codman, M.D., found that many health care practitioners were practicing medicine that was outside their scope of training. It was then that he “proposed the end result system of hospital standardization. Codman thought that if hospitals were to track every patient and the patient were treated long enough it could be determined whether the treatment was effective and use the results to improve care In 1913, the American College of Surgeons (ACS) was established and standards for hospitals were developed in the early 1917 by ACS. In 1918, the Surgeons’ of American college began first inspection within hospitals and found that only 89 out of 692 hospitals met the minimum standard requirements. Hospitals was established as an independent non-profit organization this took place in the fifty’s on accreditation the joint commission, with the purpose of...
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...To formally incorporate the early childhood sector into Australia’s educational system, the Commonwealth Government has, in recent years, introduced sweeping reforms designed to ‘professionalise’ early childhood education and care provision (Department of Education, Employment and Workplace Relations (DEEWR), 2014). These reforms were designed to replace the disparate licensing and regularity system previously administered by the state and territory governments, which had impacted negatively on the overall structure of early childhood service provision in Australia (DEEWR, 2014). To achieve this, legislation has been introduced which compels all early childhood workers to undertake formal training in early childhood education, which includes...
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...Johnniece Harris Long Term Care Facility Joint Commission Accreditation Long term care facilities use Joint Commission Accreditation as a benefit to show the quality and commitment to the health care organization. A long term care facility that is Joint Commission accredited will have a more appealing look to reimbursement centers and to the patient and families that they care for. Having this accreditation is also a risk management tool. The likelihood of a bad outcome is reduced if a facility is accredited by the Joint Commission. There is a team put together to come up with accreditation standards and to make sure facilities stay compliant with these standards. Performance is evaluated to ensure standards are followed. Joint Commission accreditation has been around for many years. Most Long Term Care facilities today are not joint commission accredited. There are eligibility requirements that must be met in order for facilities to become accredited. A facility has to have beds licensed by the state as nursing home beds, excluding intermediate care facilities specializing in care for individuals with mental retardation and other developmental disabilities. Beds designated as long term care beds under a hospital license, excluding beds belonging to a long term acute care hospital and hospital swing beds. Beds, units or facilities certified by Medicare or Medicaid as skilled nursing facility beds. Beds, units or facilities designated as long term care by a governmental...
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...Governance In Healthcare Gap analysis between governance in Egypt and in UK Reham Mokhtar Rashwan MBChB, MScs ,CPHQ, LGBSS What is clinical governance? • “A framework through which NHS organisations are accountable for continually improving the QUALITY of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.” Corporate Governance Vs Clinical Governance: • It addresses those structures, systems and processes that assure the quality, accountability and proper management of an organisation's operation and delivery of service • It applies only to health and social care organisations, and only those aspects of such organisations that relate to the delivery of care to patients and their carers; Corporate Gov. • Term emerged to refer jointly to the corporate governance and clinical governance duties of healthcare organisations. Clinical Gov. Intergrated Gov. How it started? • Clinical governance became important in health care after the Bristol heart scandal in 1995, found the high mortality rate for pediatric cardiac surgery at the Bristol Royal Infirmary More and More suffering for lack of Governance!!! “Medical error is the third most UK: blunders Britain frequent cause of death in by after cancer 40,000 doctors killand heart a disease…….kills four times more yearall other types people than die from of accidents.” Sunday Times, 19 Dec 1999 WAY OUT !!! SO; ...
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...HELLENIC GOVERNMENT GAZETTE Issue FirstSheet no: 163 September 21,2010 LAW under no. 3879 Development of lifelong leaning and other provisions. The President of the Hellenic Republic We issue the following law passed by the Parliament: CHAPTER A' GENERAL PROVISIONS Article 1 Objective – Scope of application The objective of the present law is to develop continuous learning, by acknowledging alternative educational routes, the networking of organizations offering continuous learning, and to assure transparency and quality, in order to achieve the connection between continuous learning and employment, the formation of an integrated personality for the students and in general, social and economic growth. The present law regulates the issues regarding continuous learning reaching outside of the standard educational system, including any issues concerning the continuous learning actions conducted by the organizations of the standard educational system. This informal learning is governed by the clauses of the present law only in regards to the aspect concerning the acknowledgment and certification of its results. In particular, the objectives of the present law are the following: […] Article 2 Definitions For the application of the present law, the following terms are used: “Continuous Learning”: Every type of learning activity during the life of a person, aiming to acquire or develop knowledge, skills, and abilities that contribute to the...
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...for the inmates (National Commission for Correctional Health Care, 2012). The study also showed the correctional facilities did not flow national standards as far as the health care to the prisoners. The mission of the NCCHC is to improve the quality of health care provided to inmates and the commission has the support of several other organizations such as the Academy of Pediatrics, The American Dental Association, The American Medical Association, The American Bar Association just to name a few. Structure of the Agency The structure of the agency is very important for the agency to continue the mission of the organization. The organization has a board of directors from all of the supporting organizations, the administration, the accreditation department, and the professional services department. Each level has responsibilities to the prisoners and to the public. The Board of directors helps ensure the policies and procedures are followed. The accreditation department is the department that makes sure all of the standards...
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...With the number of changes in higher education, some good and some bad, one thing remains the same from all, the need for change and to evolve. A new development in American education is emerging. This new change is distance education. The internet has greatly helped evolve distance education into what it is today through online learning systems. Many do not see distance education as something of high credibility. However, distance education through online learning systems today has gained great popularity in a society filled with busy individuals who do not seem to have the time to go into a classroom setting day after day. While online college discussion and instruction is different, both online and traditional colleges have a similar structure, assignments and both are regionally and nationally accredited. Although class discussion of a traditional college is different from an online college, both use a course syllabus to provide a structured learning environment. In a traditional college setting, students sit in a physical classroom and engage in open discussion, collaboration and group learning. Students have a choice in traditional college to engage in discussion or to not. In an online program students will sign into a virtual classroom. These...
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...A…………………………………………………………………………………8 X. Appendix B…………………………………………………………………………………14 Strategic Audit of Abu Dhabi University & University of Dubai I. Current Situation: |Strategic Posture | |University of Dubai |Abu Dhabi University | |Vision: University of Dubai is working with a vision of being a leading |Vision: To provide high quality in education, apply and use research | |University across UAE offering the higher education in the American system|tools for economic development and gain international accreditation | |with internationally accredited degree programs on the platform of quality|plus to be the best in UAE, Gulf region and the world. | |in teaching research services for serving the business community. |Mission: The mission of ADU is to offer highly rewarding career | |Mission: To serving the needs of diverse group of UG, PG and professional |oriented undergraduate and graduate degree programs aligned with the | |educational courses, gain international...
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...Accreditation in Distance Education Katrina Dixon Spring 2012 Choosing the appropriate school for Higher Education is a major decision that all students must face. The world of accreditation is slowly changing, generally in the direction of dealing more with outcomes: how schools teach or train their students and how well the students perform (Bear, Nixon 2006, 37) Making sure that the school has the courses they desire, flexibility and if it is affordable to them are all issues that must be looked at but the most important aspect of the decision is finding out about the school’s accreditation. Accreditation is a validation process by which institutions of higher education are evaluated against established standards to ensure a high level of educational quality. Knowing the accreditation status of the school that you have chosen for your Higher Education is very important because the school’s accreditation can determine how usable a degree is once it is obtained. This paper will discuss accreditation in depth and what it means to distance education. Researching an institution accreditation can be tedious but it is necessary to have this knowledge. Asking college officials and current students is one way to gather information but a prospective student should also look for other signs that the institution is credible. One of the best indicators for quality of an institution is recognition from nationally recognized professional organizations. ...
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...The Joint Commission on Accreditation of Healthcare Organizations, JCAHO, is a not for profit professional standard setting agency that was founded in 1951. It was formed to determine compliance with standards designed to ensure quality care to patients. The JCAHO early standard requirements reflected a minimal standard of care. Later it expected hospitals to strive for the highest quality standard of care. In the late 1980’s the JCAHO developed the indicator measurement system . These indicators focused on the outcomes of clinical care rather than standards of the hospital processes and departmental structures. In 1998 the JCAHO required hospitals to submit intra hospital outcome measures . The JCAHO reviews healthcare facilities, policies and procedures, training, competency and formulary. It reviews the pharmacy practice, drug use and records of a health care system. The JCAHO reviews for compliance and changes in regulations. It makes recommendations and can change or upgrade its standards for hospital, pharmacies or other health systems. It conducts these reviews every 3 years and may conduct random inspections if they get a complaint. In an attempt to change the perception of it’s reviews as a 3 year event, the JCAHO also conducts random reviews to ensure that standards are being met everyday and not just during scheduled reviews. The JCAHO reviews and accredits many health care organizations, but mostly home care organizations. JCAHO expects quality and...
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