If you do well in this course, you will be able to:
- Describe the evolution of healthcare quality management from its inception to the present day,
- Identify basic infrastructure and systems necessary to support quality management activities,
- Understand peer review immunity, principles of confidentiality in peer review activities and federal
regulations requiring reporting of peer review activity (National Practitioner Data Bank),
- Determine educational/training strategies for introducing and refining quality management
knowledge throughout an organization, recognizing key components of an organizations quality
infrastructure,
- Identify the basics of Joint Commission requirements for medical staff credentialing, recredentialing and delineation of clinical privileges,
- Describe Joint Commission requirements for leadership process,
- Differentiate between quality policies, procedures and standards of care,
- Demonstrate ability to write objective, measurable, valid and reliable indicators.
- Demonstrate competence in using tools of quality analysis and display,
- Discuss Joint Commission indicator monitoring system and current efforts to access quality of
services rendered in an organization,
- Describe various systematic approaches to improvement currently used in USA,
- Describe utilization management program concepts,
- Describe content requirements for a utilization review plan,
- Discuss various methods of performing utilization review,
- Understand impact of Medicare regulations in utilization management,
- Describe structure and purpose of HEDIS (Health Employer Data and Information Set),
- Define risk management, incident reporting program, occurrence screening, claims management
and professional liability,
- Identify key components of an effective safety management program,
- Identify Joint Commission standards supporting data collection and performance improvement,
- Define structure and operation of AHRQ (Agency for Healthcare Research and Quality),
- Describe standards of care and standards of practice, how they are developed and how they are
integrated with policies and procedures.
- Discuss various JCAHO survey types and use of standards manuals,
- Identify other accreditation organizations (AOA, NCQA, NCQA, AAAHC, and URAC),
- Describe CMS and Medicare Conditions of Participation and its impact on quality management.