CU Quality Assurance and Risk Management Discussion

For this discussion use you’re Measuring Health Care: Using Quality Data for Operational, Financial, and Clinical Improvement by Yosef D. Dlugaczand the Internet to read and review the following:

-Read Chapter 3, “Using Data to Improve Organizational Process,” pages 41–64. This reading helps cement the thoughts behind gathering quality data and how this data is used in health care organizations. This chapter discusses the organizational process, noting the similarities and differences between different types of health care organizations.

-Read Chapter 4, “What to Measure and Why,” pages 65–93. This chapter provides a wonderful discussion on how we measure what we measure and why. While many may think measuring is all about patient satisfaction, it is not. We measure health care to ensure that we are providing the right treatment, at the right time, to the right patient, for the right reasons. Health care quality measurement is a growing field for health care employment.

-Review resources from the American Society for Quality (ASQ) regarding the

Plan Do Check Act (PDCA) Cycle

. Most health care quality initiatives are based on this simple complex first created by Deming to analyze management issues. This resource provides a nice application for health care use of this valued principle.

-Review the 2009

PQRI Measures List

. The Centers for Medicare and Medicaid (CMS) help forge a plan for health care providers to measure and report on quality. The Physician Quality Reporting Initiative (PQRI) is a very new concept of including physicians and other providers who bill using Common Procedural Terminology (CPT) codes. PQRI has front-line providers as part of the data gathering to ensure that evidence-based care is provided to patients. By being part of the PQRI project, physicians and other providers gain financial reimbursement. While providing incentives to physicians to apply evidence-based care may seem odd, the provision of evidence-based care does promise significant overall cost savings and better patient outcomes

***Click Launch Presentation to complete the Indicators of Quality drag and drop exercise. You will be asked to identify indicators of quality. Be prepared to share your experience in this unit’s discussion. I will upload the Indicators of quality sheet.

1. National Organizations: Measuring Quality

Based on the national quality management organization you were assigned in Unit 1, (the Agency for Healthcare Research and Quality (AHRQ)consider the types of measures that your organization is involved in on the national and local health care scene.

In a 250- to 300-word response, discuss one specific measure or quality assurance activity that the Agency for Healthcare Research and Quality works on. Do you see evidence of these efforts in the hospital or in your community?

.2. Using Data to Improve Organizational Processes

Chapters three and four of the Measuring Health Care Qualitytextbook concentrate on methods to collect data and to use this data to improve an organizational process. Both chapters provide several case studies to demonstrate this process. Consider the quality process called PDCA (Plan Do Check Act) cycle. From work within an health care organization, consider other situations where data may be collected and used to improve an organizational process.

In a 250- to 300-word substantive post:

-Provide your own unique case study of a process that could be improved within your own organization.

-Discuss what types of data would need to be collected and how that data would be used to seek improvements.

-Provide your post following the Plan Do Check Act (PDCA) method.

Indicators of Quality
AHRQ — Agency for Healthcare Research and Quality
Federal research arm of the U.S. Department of Health and Human Services.
AQA — Ambulatory Care Quality Alliance
Public-private partnership consisting of a large body of stakeholders that represents clinicians,
consumers, purchasers, health plans, and others.
CMS — Centers for Medicare and Medicaid
Federal agency responsible for administering the Medicare, Medicaid and State Children’s Health
Insurance Program (SCHIP), Health Insurance Portability and Accountability Act (HIPAA), Clinical
Laboratory Improvement Amendments (CLIA), and several other health related programs.
HQA — Hospital Quality Alliance
An initiative to make hospital performance information accessible to the public.
IHI — Institute for Healthcare Improvement
Private organization that focuses on large health improvement initiatives such as 5 Million Lives
Campaign.
IOM — Institute of Medicine
Private organization credited with starting the current quality movement with the publication To Err is
Human.
MedPAC — Medicare Payment Advisory Commission
Group of government and industry analysts and professionals who examine payment methodologies
and evidence-based medicine to recommend Medicare payment changes.
NCQA — National Committee for Quality Assurance
Private, nonprofit organization that works with federal and state governments; collaborates with other
organizations, credentials health plans and specialized medical practices.
NQF — National Quality Forum
Not-for-profit membership driven organization; public-private partnership working as a consortium for
Performance Improvements.
TJC — The Joint Commission
Organization that evaluates and accredits more than 15,000 health care organizations and programs
in the US.