Introduction To Quality Assurance Essay

Case managers also provide support and information to patients and their families. Next, is utilization review. `Its main objective is to review each case and determine the most appropriate level of services, the most appropriate settings in which the services be delivered, the most cost efficient methods for care delivery and the need for planning of subsequent care. Other methods used for utilization and control are choice restriction and practice profiling' (Douglas, 2003, p.328).

Improving the quality of discharge planning in acute care include addressing the lack of appropriate staff and patient education about appropriate planning for discharge (4). This includes implementing proper discharge teaching regarding signs and symptoms to seek medical attention, management and care of medical equipment, and access to community resources (4, 5). Other challenges are patients with complex comorbidities too difficult to discharge as well as lack of community supports and equipment for newly discharge patients and lack of rehabilitation and nursing home beds (4). Consequently, acute care units are pressured to vacate hospital beds in response to the growing elderly population. Hospital professionals tend to focus discharge teaching and preparation on medical areas such as diet, activity, treatments, and medications (5). Community referrals to appropriate services at the time of hospital discharge does not often happen contributing to poorer patient outcomes and re-hospitalizations

The overall process of discharging a patient from a hospital and the transition back home or to a care facility are critical advancements in the overall course of both acute and long-term care. It is important that the hospitals releasing these patients have ensured the proper overall course of care from beginning to end. The lack of consistency with both the discharge process and the quality of discharge planning has led to many avoidable readmissions. To reduce the amount of hospital readmissions, it is imperative that hospitals recognize the need for focused patient care and that programs are being implemented to assist in the care transition.

It is extremely important to plan and prepare for IQA activities to ensure that all requirements are met. A quality calendar and regular team meetings with a clear and concise agenda would ensure that any necessary points are addressed in manageable amounts. We are a small team and work closely together but unless we adhere to the above, things can get overlooked or forgotten. As the courses we deliver are ITQ, we have to continuously monitor the learning and the assessments to ensure we are up to date with most recent software packages that our learners may be using; this is something that has been

This model reimburses hospitals based on quality of care instead of the volume of patients. The quality of care is assessed by patient questionnaires and if hospitals are unsatisfactory penalties may be imposed (Edwoldt, 2012). The value-based system also affects Medicare and Medicaid. It was reported that Medicare readmissions within 30 days of discharge cost 17 billion dollars annually (Edwoldt, 2012). Due to the high costs of readmissions Medicare and Medicaid have implemented a Hospital Readmission Reduction program. A formula is utilized to evaluate readmission rates within 30 days of discharge for any medical reason related to their original admission such as heart failure and pneumonia. Upon review the hospital is potentially penalized. It is important that nurses strive to provide excellence in care despite their beliefs on the ACA. Nurses have the ability to provide a safe patient environment and reduce the risk of hospital associated infections by following hospital protocols such as hand washing.

Rio Grande Medical Center is a full service not-for-profit acute care hospital with 325 beds. Most of the hospital’s facilities are devoted to inpatient care and emergency services, but a 100,000-square-foot section of the hospital is devoted to outpatient (OP) services. Of the 100,000-square-foot OP section, the OP Clinic uses 80%/80,000-square-feet, and the remaining 20%/20,000-square-feet are used by the Dialysis Center. Increased patient volume at the OP Clinic has created a need for 25% more space than it is currently assigned. Due to its large size and patients’ need to access other departments the decision has been made to move the Dialysis Center to another location, and allow the OP Clinic to

Patients are surveyed about their recent experience and are asked about the quality of care, communication and timeliness. For example, there are condition categories that the CMS focuses on, such as Emergency department care. The CMS survey will measure the average time that emergency patients had to wait before being seen or receiving pain medication. The CMS report also provides statistics related to how likely patients will experience complications, readmissions and death. For example, hip or knee patients often experience complications after surgery. In addition to this, the CMS survey also monitors the use of medical imaging, such as MRIs and CTs, and how the patient payments match patient

Partnership for Patients (PfP) has made significant progress in decreasing the number of preventable hospital acquired conditions (HACs), hospital readmissions, hospital patient deaths, and health care expenditures. Nonetheless, much work remains to be done so that PfP is more effective in their mission to make and improve care safety and care transitions. The progress made is part of a program that has been in effect since April of 2011, soon after sections 3011 and 3026 of the Patient Protection and Affordable Care Act (PPACA) were signed into law. These sections allowed then Department of Health and Human Services (DHHS) Secretary, Kathleen Sebelius, and Center for Medicaid and Medicare Services (CMS) Administrator, Donald Burwick, to create and provide funding through Medicare for a dual program to reduce hospital readmissions and transition care services.

Utilization management is described as the implementation of guidelines which reduce unnecessary use of medical resources (Kongstvedt, 2007, p.190). There are a variety of methods used to ensure costs are kept at a minimum without compromising patient care. The use of utilization management (UM) are yielding financial benefits resulting in managed care organizations (MCOs) and facilities investing more into UM programs.

Using these measures, a hospital can understand where they stand among other hospitals in terms of providing quality care. This can help them to improve quality of care and also understand competitive advantage. The hospitals can find out whether they have the desired percentage and then compare its position with respect to other hospitals or hospital state average and national average (hospital). A lower percentage can help them to do a root cause analysis and help them in improving their percentage by adopting to strategies that will benefit them. An above average and good percentage will encourage and motivate them to achieve stability. The comparison is made not only on the basis of medical condition but also on wide range of categories like complications, Readmissions and deaths, payment and value of care etc. This

Facility quality and performance data is compiled through a variety of defined technical measures agreed upon by various “stakeholders” such as CMS, The Joint Commission (TJC), the National Quality Forum and the Agency for Healthcare Research and Quality (AHRQ). The seven categories which are used to calculate overall ratings are: “mortality, safety of care, readmission, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging”.

Quality assurance should be number one in patient care, on that note if the medication order is illegible Betty must get clarification from the doctor with a double check of looking in the patients’ medical record. All medication orders are to be entered in the patients’ chart if the physician did this Betty can easily verify the orders from the record. But, before administering the medication, the allied health professional must call the doctor’s answering service to locate the doctor and get advice on how to handle this situation. There’s still one more part of the professional medical triangle who dispensed the drugs, the pharmacist, she can check with the pharmacist also.

The cost of the health care industry has always been rising since the early 1980s. It has been a growing concern in both the industry and society. Massachusetts General Hospital (MGH) is no exception. Even though the average length of stay (LOS) for the patients in MGH has been declining (Exhibit 10), it is still the highest compared to their competitors (Exhibit 6). Besides the cost, there is no uniformity of process and standardization across different facilities and departments of the hospital. MGH lacks communication and coordination between the facilities.

A quality-assurance (QA) program ensures the highest quality of x-ray images are taken in your dental office. If you are competent in forming a QA program and running it in an organized, methodical way, you will become a more valuable employee in the eyes of the dentist.

With the expected growth in the allied health sector in the coming years due to increased patient care demands, healthcare organizations in the United State will need to take steps to maintain a high quality of care. These steps will include ways to ensure that well trained staff are hired, adequate new staff on the job training and orientation, continuous review of policies for improvements in safety, care, risk management and quality assurance. In addition to focusing on the integration of the incoming allied health personnel, healthcare organizations are expected to review how care is currently provided, and find new ways to provide care and meet the great increase in demand for care.