Comparison of Quality Assurance Standards

Module 2 – SLP

QUALITY MANAGEMENT METHODS

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.

In Module I you identified a health care facility for the subject of the SLP and presented a description of the facility and it’s quality assurance program.

For this module you will discuss 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 discuss 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.

In the remaining modules for the Session Long Project the remaining tasks are as follows:

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.

Session Long Project

For this module you are to complete the following tasks:

� Describe and discuss the facility’s Continuous Quality Improvement program.

� Compare and critique the subject facility’s CQI program to that of a model facility and whether the facility adheres to the recognized standard for a CQI program.

� Identify areas for improvement in the facility’s CQI program, if any, and any recommendations you think should be implemented to improve patient care.

� Does the facility’s CQI Program adhere to the principles of Total Quality Management (TQM)?

Please submit your M2 SLP when you have completed the assignment.

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

Introduction

Continuous quality management improvement is described as the process in which programs are designed to systematically improve and increase positive outcomes in an organization. For the purposes of the health care system, it is described as the data-driven process that continues to search for improvements in healthcare systems and processes, and is driven by the need of healthcare personnel to solve problems posed by their day-to-day activities of providing quality health care. 

Description of Institution

The health care facility that will be reviewed in this paper is the Baltimore Washington Medical Center. Baltimore Washington Medical Center is a hospital that is located in Glen Burnie, Maryland. It is part of the University of Maryland Medical System that specializes in the provision of specialized training in medicine and acute care services. The facilities in the Baltimore Washington Medical Center include the general hospital wing that contains general medicine and surgery services, and the emergency department that consists of ambulance services, blood banks, and laboratories and the diabetes, wound healing, joint replacement and spine centers. 

Institution’s Quality Assurance Programs

The quality management department of this large institution is headed by the director of quality assurance. He is generally responsible for the entire group’s quality assurance program. The department focuses on the quality policy of the institution that is usually responsible for the implementation of quality control procedures, the health services cost review commission of the hospital, and the coding quality review team. The organization, through this department, engages in four principle areas of quality management and assurance in the institution. They include patient and customer safety, clinical quality, patient experience, readmission rates, and timely and effective care.

At Baltimore Washington Medical Center

According to BWMC quality policy, the hospitals are 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 improvements in health care and as a result, it has been able to get quality and recognition awards over the past few years including the Delmarva Foundation Excellence Award, the Platinum Performance Achievement award, and the Health Streams Excellence through Insight award amongst others. The Six Sigma model has been used as an approach and a recognized standard for continuous quality improvement programs in BWMC.

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 BWMC hospital’s CQI program and the model itself. To apply six sigma effectively to the hospitals operations, defining the scope and goals of the project is the first process. 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 evaluation of the system’s performance after the implementation of the improvement to measure its impact before and after the Six Sigma model has been implemented (Inozu, 2012).

According to Mansir and Schacht, 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 BWMC. TQM principles in BWMC 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 BWMC, TQM stresses on learning and adaptation to continual change as the critical elements in organizational success for example get with the guidelines silver performance award was given to BWMC for reaching their aggressive goals in the treatment of patients who has suffered from a stroke (Mansir & Schacht, 1989).

Health utilization management is defined as the evaluation of the efficiency, necessity and appropriateness of the utilization of health care services. In BWMC facilities, utilization review follows a systematic and clinically sound process that respects the rights of all patients and health care providers. The BWMC standards are accredited to provide evidence-based guidelines and outline very specific reviewer’s guidelines for every level of review given for any particular treatment in the facility. Case management is critical in BWMC’s processes to improve the institution’s bottom line goals and objectives. The case management program at BWMC ensures that outcomes are improved, readmission rates and risks are reduced, and also enhances risk and claims management. BWMC hospital’s 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 (Stahl, 2004).

References

About UM BWMC. (n.d.). Home.

Inozu, B. (2012). Performance improvement for healthcare: leading change with lean, six sigma, and constraints management. New York: McGraw-Hill.

Mansir, B. E., & Schacht, N. R. (1989). Total Quality Management: A Guide to Implementation. Ft. Belvoir: Defense Technical Information Center.

Stahl, M. J. (2004). Encyclopedia of health care management. Thousand Oaks, Calif.: Sage Publications.

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