Quality Improvement in the Health Care Organization Accreditation
The mandate for improving the way in which health care is delivered was stimulated by the public outcry over the estimated 98,000 deaths because of medical errors each year, according to the Institute of Medicine in 1999. Since then, health care organizations have sought means by which the public can be reassured that they were meeting quality and safety standards. Accreditation agencies (e.g., The Joint Commission) and quality awards provide a means for the public to evaluate where the agency is meeting minimum standards.
You have been assigned by your manager to determine which accrediting agencies or quality improvement programs your hospital will utilize in its upcoming revenue cycle. Your hospital is a magnet hospital in a large urban area that provides multilayered services. You have previously used The Joint Commission for your accreditation but feel that you might be better served by using another accrediting body. You have three months in which to gather data and present the information to your manager.
Complete the following for this assignment:
Choose 3 quality improvement or accreditation-related programs to consider in replacing The Joint Commission for your organization, and briefly describe them. Your agency accepts Medicare and Medicaid payments; therefore, you will need to explore, as background, the conditions of participation for Centers for Medicare and Medicaid Services (CMS). This is important information because you will need to compare your list of accrediting agencies and quality improvement programs with the conditions of participation to see if they meet the criteria.
Analyze the costs and benefits of each quality improvement or accreditation-related program by stakeholder group (e.g., patient, provider, and third-party payer).
Rank your quality improvement or accreditation-related program suggestions with rationale.
Analyzing Health Care Decision Making
A number of quantitative methods are utilized to make decisions and recommendations in health care. Quantitative methods are used to analyze and predict the demand for patient services, to determine capital expenditures for facility and technology enhancements, and to guide the manager in implementing quality controls. Whether or not you are familiar with quantitative methodologies, as a manager, you are responsible for the outcomes of implementing the decision based on the method used.
Your agency or institution has noted a negative trend in profitability for a diagnostic imaging cost center over the past 4 quarters.
As a manager, you need to make some recommendations to take to your board of directors to reverse the negative trend. Your first priority is to find a quantitative method to help you in making decisions. Complete the following:
Choose a quantitative method (e.g., the decision tree model).
Describe the model that you are using.
Outline at least 4 proposed solutions to your board of directors, and analyze the strengths and weaknesses of each with regard to return on investment, break-even analysis, improvement in patient demand, improved patient safety and quality, and so forth.
Summarize how the decision-making method helped you make objective recommendations to your board of directors.
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