Quest for Quality

1
Quest for Quality

• What contractors should know
• Cady Clark, MSN, RN, Branch Manager
• Patricia Palm, MS, RNC
• Claudia Himes-Crayton, BSN, RN
• Emily Garrison, RN, Graduate Student

2
Objectives

• Identify elements of the Quality Management
  Process
• Identify components of the QM plan
• Identify continuous monitoring activities
• Develop a corrective action plan

3
Why the Quest for Quality is Necessary

• To improve patient care
• To gain an ongoing, dynamic process through
  program evaluations
• To set priorities and allocate resources based on
  objective information
• To increase job satisfaction for staff
• To increase team building within staff
• To meet regulatory and funding requirements

4
Elements of the Quality Management Process

• Agencys mission supports the QM process
• Multi-disciplinary committee
• Committee meetings and minutes
• Internal QM review plan
• Monitoring activities

5
Components of the QM Plan

• A Work Plan
• Audit Tools
• Monitoring Schedule
• Quality Committee Meeting Schedule and Minutes

6
Agency Internal Work Plan
Jan Feb Mar Apr May
Eligibility Records x x
Method Specific Consent x x x
Referral Follow - Up x x
QM Committee Meets x
7
Continuous Monitoring Activities

• Evaluate administrative areas
• Evaluate the eligibility and billing functions
• Conduct ongoing clinical record reviews
• Evaluate the effectiveness of corrective actions
• Conduct client satisfaction surveys and use
  results to make improvements

8
Process for Improvement

• Lean Management
• A systematic approach analyzing the flow of
  information and materials in order to eliminate
  waste, process variation and imbalance while
  striving for continuous improvement.
• Lean Institute for Healthcare Improvement
• (curiouscat.net/library/leanthinking.cfm

9
Processes for Improvement

• Focus
• The FOCUS model provides a process for
  identifying root causes of quality problems and
  for planning changes to improve a process
• http//www.aafp.org/fpm/FPMprinter/990400fm/25.htm
  l?printyes

10
Process for Improvement

• PSDA Plan Do Study Act
• The PDSA cycle is a process for planning and
  testing improvements
• Plan, Do, Study, Act (http//psnet.ahrq.gov/glossa
  ry.aspxp)

11
Corrective Action Plans

• Finding
• Document the finding, and the criterion
• Internal Action Plan
• Explain how the issue was or will be corrected
• Attach revised policies, procedures, training
  outlines and/or list of staff who attended the
  training

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Corrective Action Plan

• Timeline
• List the date or planned date of corrective
  action
• Staff Responsible
• List the staff responsible for making corrections
• Follow-up
• Indicate the method of follow-up to ensure the
  action taken is effective
• Ex. Eligibility Records are reviewed
• Note how often the follow-up will occur

13
Corrective Action Plan
14
Corrective Action Plan
15
Corrective Action Plan
16
Corrective Action Plan
17
QMB Website

• http//www.dshs.state.tx.us/qmb