1. SHOPS is funded by the U.S. Agency for International Development. Abt Associates leads the project in collaboration with Banyan Global Jhpiego Marie Stopes International Monitor Group O’Hanlon Health Consulting Business for Health Business Skills for Private Medical Practices Module 11: Understand Quality in Your Health Practice

2. A Quick Start Welcome! While you are waiting for the class to begin, please take the Pre-Test and make sure your name is on it before you hand it to the facilitator. While you are waiting for the class to begin, please take the Pre-Test and make sure your name is on it before you hand it to the facilitator. Thank you!. 2Business Skills for Private Medical Practices

3. Agenda Welcome What Does Quality in Health Care Include? Three Areas of Quality in Health Care Administrative Quality Standards Fiscal Quality Standards Clinical Quality Standards Clinical Quality Management Summary and Evaluation Close 3Business Skills for Private Medical Practices

4. Learning Objectives During this session, you will: 1.discuss what quality of health care services means to you; 2.describe three key focus areas for quality in health care; 3.propose administrative quality standards for a small health care practice; 4Business Skills for Private Medical Practices

5. Learning Objectives 4.propose fiscal quality standards for a small health care practice; 5.propose clinical quality standards for a small health care practice; 6.determine where your practice does not currently meet your proposed quality standards; 5Business Skills for Private Medical Practices

6. Learning Objectives 7.Propose how to handle quality management issues; 8.discuss the next step; and 9.state your key take-away from this session. 6Business Skills for Private Medical Practices

7. Always follow your national clinical guidelines and protocols Business Skills for Private Medical Practices7

8. Introduction You will have 1 minute to introduce yourself: 1.Your name 2.Your position 3.Your business 4. How long you have been in business 8Business Skills for Private Medical Practices

9. What Does Quality in Health Care Include? Business Skills for Private Medical Practices 9

10. The Quality of an Experience How is the experience of going to a restaurant similar to the experience of going to a doctor’s office? This is a competitive brainstorming activity. Your tables will have 5 minutes to list as many answers as possible to this question. The group with the longest list will win a prize! 10Business Skills for Private Medical Practices

11. Quality Issues in Health Care StepsPossible Barriers to a Smooth Process Making an appointment 11Business Skills for Private Medical Practices

12. Three Key Areas of Quality in Health Care Business Skills for Private Medical Practices 12

13. Quality in Health Care “The safety and quality of patient care depend both on the decisions and actions of clinicians as well as the reliability and effectiveness of processes and systems in the physician practice.” 13Business Skills for Private Medical Practices

14. Quality in Health Care “The greatest potential gains in patient safety may result from improving the infrastructure of information management, communication and coordination of care.” 14Business Skills for Private Medical Practices

15. Three Key Focus Areas for Quality in Health Care Clinical Fiscal Clinical FiscalAdministrative 15Business Skills for Private Medical Practices

16. Administrative Quality Activities 16Business Skills for Private Medical Practices  Human Resources  Medical Records  Facility Management  Procurement  Inventory Management  Compliance  Reception  Safety  Risk Management  Information Technology

17. Fiscal Quality Systems 17Business Skills for Private Medical Practices  Patient Billing  Collection  Payment of Invoices  Taxes  Payroll

18. Clinical Quality Activities 18Business Skills for Private Medical Practices  Medication Administration  Infection Control  Accurate Diagnosis  Ordering & Tracking of Tests & Test Results  Appropriate Referral to Specialists

19. Administrative Quality Standards Business Skills for Private Medical Practices 19

20. What Would Have Avoided This Problem? 20Business Skills for Private Medical Practices

21. Proposed Administrative Quality Standards 21Business Skills for Private Medical Practices  The office is clean  The office is free of trip hazards  Patient medical records are kept confidential at all times  All telephone communications between patients and staff are documented and placed into the patient’s medical record  ?

22. Readiness and Ability to Meet These Administrative Standards 22Business Skills for Private Medical Practices Missing Standards Barriers to Achievement What Needs to be Done

23. Fiscal Quality Standards Business Skills for Private Medical Practices 23

24. What Would Have Avoided This Problem? 24Business Skills for Private Medical Practices

25. Proposed Fiscal Quality Standards 25Business Skills for Private Medical Practices  Charges for services are clearly posted  Patients receive a bill that details the services received and the cost of those services  Clinic maintains a monthly cash flow and has an overdraft facility with a bank to cover cash short falls  ?

26. Readiness and Ability to Meet These Fiscal Standards 26Business Skills for Private Medical Practices Missing Standards Barriers to Achievement What Needs to be Done

27. Clinical Quality Standards Business Skills for Private Medical Practices 27

28. What Would Have Avoided This Problem? 28Business Skills for Private Medical Practices

29. Proposed Clinical Quality Standards 29Business Skills for Private Medical Practices  Staff and providers are trained on hand hygiene and follow hand hygiene procedures, such as washing before and after patient care, and washing after using the bathroom  Staff and providers follow the 6 R’s when administering medicine  ?

30. Readiness and Ability to Meet These Fiscal Standards 30Business Skills for Private Medical Practices Missing Standards Barriers to Achievement What Needs to be Done

31. Quality Management Business Skills for Private Medical Practices 31

32. Why Care About Quality? 32Business Skills for Private Medical Practices Please pop up out of your chair if you can say something to support this statement: Quality is not just the right thing to do- it makes good business sense.

33. Case: Beta Health Services, Ltd. 33Business Skills for Private Medical Practices Working with your table group, please: 1.Identify the administrative, fiscal and clinical issues at Beta Health Services, Inc.; and 2.Recommend necessary quality health standards.

34. Audit Findings and Recommendations Audit Findings and Recommendations 34Business Skills for Private Medical Practices FindingsRecommendations Administrative IssuesQuality Standards Fiscal IssuesQuality Standards Clinical IssuesQuality Standards

35. Summary and Evaluation Business Skills for Private Medical Practices 35

36. Evaluation Sheet 36Business Skills for Private Medical Practices

37. The Next Step 1. Create an action plan to establish the clinical, fiscal and/or administrative quality standards that your practice does not currently meet. [Please see the Sample Action Plan on page 25.] 37Business Skills for Private Medical Practices

38. Action Plan 38Business Skills for Private Medical Practices

39. The Next Step 2. 2.Identify and implement quick wins- low-cost or no-cost actions that can be taken to establish necessary quality standards. 3. 3.Set priorities. 39Business Skills for Private Medical Practices

40. The Next Step 4. 4.Incorporate the quality standards into your practice’s operating policies and procedures. 5. 5.Plan how you will manage staff performance to ensure that the quality standards are implemented properly. 40Business Skills for Private Medical Practices

41. Let’s See How Much You’ve Learned Please take the Post-Test. We will compare it to your Pre-Test to see how much you’ve learned in this session. Thank you. Business Skills for Private Medical Practices41

42. My Key Take-Away 42Business Skills for Private Medical Practices