|
|
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! |
About Our Firm |