Module 1 – SLP
INTRODUCTION TO QUALITY ASSURANCE
Session Long Project
The Session Long Project for this course is to evaluate and critique a health care facility you are familiar with and compare it to the general principles and standards for quality assurance presented in this course. If you are not familiar enough with any particular health care facility to conduct a evaluation of their quality assurance practices you may find a health care facility on the Internet to use as the subject of the SLP. (Most major hospitals publish their quality assurance policies and practices online.)
The purpose of the SLP is to provide you with an opportunity to apply the knowledge and information presented in this course to a facility which must meet specific quality assurance practices and have adopted and implemented specific policies. Through this process you will acquire valuable knowledge on the significance and importance of a quality assurance program in the health care setting.
Session Long Project
The Session Long Project for this course will be divided into five modules as follows:
Module I. Identification of health care facility for the subject of the SLP. Brief description of facility is presented as well as their quality assurance program.
Module II. Discussion of the facility’s Continuous Quality Improvement program. A comparison will be made between the subject facility’s program and that of a model facility or whether the facility adheres to the recognized standard for a CQI program. A discussion of Total Quality Management (TQM) principles and how it relates to the subject facility will also be presented.
Module III. A discussion and critique of the subject facility’s Utilization Management program will be presented.
Module IV. A discussion and critique of the subject facility’s Case Management program will be presented.
Module V. Discussion of the subject facility’s Risk Management program will be presented.
Module VI. This is a summary or wrap-up module. You will complete your SLP and submit it, if you have not already done so.
For this module you are to complete the following tasks:
� Identify an appropriate health care facility for use in the SLP.
� Provide a description of the facility and it’s organizational structure.
� Describe the facility’s current Quality Assurance Program.
� Discuss the mandated requirements, if any, for the facility’s quality assurance program.
SLP Assignment Expectations
Length: SLP assignments should be at least 4-5 pages in length.
References: At least two references should be included from academic sources (e.g. peer-reviewed journal articles). When material is copied verbatim from external sources, it MUST be enclosed in quotes. The references should be cited within the text and also listed at the end of the assignment in the References section (preferably in APA format).
Organization: Subheadings should be used to organize your paper according to question
Format: APA format is recommended (but not required) for this assignment. See Syllabus page for more information on APA format.
The following items will be assessed in particular:
� Relevance (e.g. all content is connected to the question)
� Precision (e.g. specific question is addressed. Statements, facts, and statistics are specific and accurate).
� Depth of discussion (e.g. present and integrate points that lead to deeper issues)
� Breadth (e.g. multiple perspectives and references, multiple issues/factors considered)
� Evidence (e.g. points are well-supported with facts, statistics and references)
� Logic (e.g. presented discussion makes sense, conclusions are logically supported by premises, statements, or factual information)
� Clarity (e.g. writing is concise, understandable, and contains sufficient detail or examples)
� Objectivity (e.g. avoid use of first person and subjective bias)
Comparison of Quality Assurance Standards
Module I: Description of Facility and Quality Assurance Programs
The general purpose of this paper is to evaluate and critique a familiar health care centre or facility and compare it to the principles of quality assurance. This will, in turn, lead to an acquisition of knowledge regarding the importance and significance of quality assurance programs in health care settings. The health care facility that will be reviewed in this paper is the institute of medical sciences and research PSG hospitals. PSG hospitals belong to the PSG group of institutions that specialize in the provision of specialized training in medicine and management. The facilities in the PSG hospitals include ambulance services, blood banks, laboratories, nursing services, biomedical engineering, and health care insurance. The quality management department of this large institution is responsible for the entire group’s quality assurance program. The department focuses on the quality policy of the institution that is usually based on the mission and vision statements of the entire organization and stipulations of their quality policies. The organization, through this department, engages in four principal areas of quality management and assurance in the institution. They include customers or patients, systems and processes, performance measurement, and organizational team work (Hospitals, 2014).
Discussion of PSG Hospitals Continuous Quality Improvement program
According to PSG’s quality policy, the hospital is determined to provide total healthcare to its patients by using the highest level of professionalism, skill, experience, and ethical practices. This, in turn, results in more efficient and effective provision of high quality health care and treatment at affordable costs to the patients. The institution is also committed to continuous quality improvement in health care since it facilitates medical education and research. This goes hand in hand with the institution’s overall mission statement of providing quality health care and to constantly upgrade the quality of medical practice and education in the hospital. In modern day health care, the Six Sigma model has been used as an approach and a recognized standard for continuous quality improvement programs. Six Sigma is a five-step quality improvement process that involves the definition, measurement, analysis, improvement and control of health care processes and systems. Because this process is data driven, it is easily measurable making it an ideal tool for comparison between PSG hospital’s CQI program and the model itself (Lerman, 1995).
Comparison between the CQI program and Six Sigma Model
Four indicators used by PSG to define the levels of their performance in relation to the six sigma model include the service level, clinical excellence, healthcare service costs, and customer satisfaction. For example, to improve patient satisfaction, the hospitals measure the patient’s perspectives and outcomes using the Six Sigma by defining the scope and goals of the project. Performance baselines to compare data are also determined before performance is monitored and recorded. If the performance levels go below the limit of expected or budgeted outcomes, then an analysis of the root causes of the problem will be determined. After the analysis has been done, procedures to remove the cause of the problem will need to be implemented to improve the performance of the processes in the system. The final step of the process would be the evaluation of the performance of the system after the implementation of the improvement. This is done in order to be able to measure the impact of the improvement before and after the Six Sigma model has been implemented. The Six Sigma model can also be used in other parts of the continuous quality improvement initiatives such as reducing diagnostic test errors, reducing medication prescription mistakes, and improvement of medical and surgical procedures (Furterer, 2012).
Total Quality Management and its relation to PSG
Total Quality Management is a people-focused management system that aims at increasing customer satisfaction at lower levels of costs. TQM works across all functions, processes, and departments in PSG whose principles include constant improvements to the system, maintenance of proper and up-to-date records, top management support, and insisting on zero defects and eliminating numerical goals. In PSG, TQM stresses on learning and adaptation to continual change as the critical elements in organizational success (Lerman, 1995).
A discussion of the Utilization Management program at PSG
Health utilization management is defined as the evaluation of the efficiency, necessity, and appropriateness of the utilization of health care services. In PSG facilities, utilization review follows a systematic and clinically sound process that respects the rights of all patients and health care providers. The PSG standards are accredited to provide evidence-based guidelines and outline very specific reviewer’s guidelines for every level of review.
Case management, risk management, and mandated requirements at PSG
Case management is critical in PSG’s processes to improve the institution’s bottom line goals and objectives. The case management program at PSG ensures that outcomes are improved, readmission rates and risks are reduced, and also enhances risk and claims management. PSG hospital risk management procedures ensure that circumstances or actions that help the progression of an incident or circumstance that lead to the harming of patients or health care providers are mitigated and reduced. Therefore, a facility’s quality assurance program is essential in the effective day-to-day running of a health care facility such as PSG (Lerman, 1995).
Furterer, S. L. (2012). Lean Six Sigma for the healthcare enterprise methods, tools, and applications Boca Raton: CRC Press.
Lerman, D. (1995). Hospital-hospice management models: integration and collaboration. Chicago, IL: American Hospital Pub
Hospitals (n.d.) Â Quality Management Department PSG Hospitals.