Healthcare Quality Management Organization Structure
Maverick Healthcare Consulting is a firm with a passion for improving healthcare quality

Healthcare Quality Management Customer Service Model

Budget
Quality / Cost Management
Targets and Priorities
Resource Management
Communication
Facilitation
Consultation
Utilization Review
Pathways, Order Sets
Evidence Based
Practice
Data Strategy
Peer Review / Support
QMIS Reporting / Dashboards
Research and Data Mining
Benchmarking / Analytics
Service Line Support
Regulatory Compliance
Mock Surveys
Data Submission
Peer Review
National Patient Safety Goals
National Quality Forum
Standards Expertise
Adverse Event Activities
Ensuring Safe Environment of Care
Historically, “UR/QA” or “Utilization Review and Quality Assurance” departments
focused on the friction points between payors and clinicians. As “back office”
operations, their mission was to help make sure that the clinical services provided to
patients were going to be approved by the organizations who would be paying for
them.

Our view is that much more value can be derived from a robust healthcare “Quality
Management Services” function, especially if it operates as a “Customer Service”
organization whose mission it is to support and enable best practices at the point of
care – the triumph of “clinical appropriateness!”

There’s a clear culture and operating philosophy and attitude associated with being a
“Customer Service” organization – no longer a “back office” function, this new
generation organization provides:
Leadership – helping marshal the best and most appropriate
resources at the point of care
Safety – ensuring “Safe Environments of Care”
Accreditation/Regulatory – assuring compliance and continued
accreditation
Informatics – providing front line care givers the information they
need to make appropriate decisions
Evidence Based Care – the infrastructure to create, implement and
maintain order sets
Process Improvement – the expertise to develop and implement
continuous improvement

…all of which Enables Best Practice at the Point of Care!

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