1. Quest for Quality What contractors should know Cady Clark, MSN, RN, Branch Manager Patricia Palm, MS, RNC Claudia Himes-Crayton, BSN, RN Emily Garrison, RN, Graduate Student

2. Objectives Identify elements of the Quality Management Process Identify components of the QM plan Identify continuous monitoring activities Develop a corrective action plan

3. Why the Quest for Quality is Necessary To improve patient care To gain an ongoing, dynamic process through program evaluations To set priorities and allocate resources based on objective information To increase job satisfaction for staff To increase team building within staff To meet regulatory and funding requirements

4. Elements of the Quality Management Process Agencys mission supports the QM process Multi-disciplinary committee Committee meetings and minutes Internal QM review plan Monitoring activities

5. Components of the QM Plan A Work Plan Audit Tools Monitoring Schedule Quality Committee Meeting Schedule and Minutes

6. Agency Internal Work Plan JanFebMarAprMay Eligibility Records xx Method Specific Consent xxx Referral Follow - Up xx QM Committee Meets x

7. Continuous Monitoring Activities Evaluate administrative areas Evaluate the eligibility and billing functions Conduct ongoing clinical record reviews Evaluate the effectiveness of corrective actions Conduct client satisfaction surveys and use results to make improvements

8. Process for Improvement Lean Management A systematic approach analyzing the flow of information and materials in order to eliminate waste, process variation and imbalance while striving for continuous improvement. Lean – Institute for Healthcare Improvement (curiouscat.net/library/leanthinking.cfm

9. Processes for Improvement Focus The FOCUS model provides a process for identifying root causes of quality problems and for planning changes to improve a process http://www.aafp.org/fpm/FPMprinter/990400fm/25.html?print=yes

10. Process for Improvement PSDA: Plan – Do – Study – Act The PDSA cycle is a process for planning and testing improvements Plan, Do, Study, Act (http://psnet.ahrq.gov/glossary.aspx#p)

11. Corrective Action Plans Finding Document the finding, and the criterion Internal Action Plan Explain how the issue was or will be corrected Attach revised policies, procedures, training outlines and/or list of staff who attended the training

12. Corrective Action Plan Timeline List the date or planned date of corrective action Staff Responsible List the staff responsible for making corrections Follow-up Indicate the method of follow-up to ensure the action taken is effective Ex. Eligibility Records are reviewed Note how often the follow-up will occur

13. Corrective Action Plan

16. Improving Quality Measuring Quality Defining Quality Q M

17. QMB Website http://www.dshs.state.tx.us/qmb