...University Abstract: Care coordination refers to several forms of patient care management that is patient- rather than provider-focused and has the end goal of the “Triple Aim”-improved patient experience, improved population health and decreased per capita costs. These goals are achieved by developing healthcare models which promote collaborative care between providers, increase communication between health care entities, actively engage patients in health care and lifestyle choices and rely heavily on health technology to extend provider services, personalize care and monitor quality improvement efforts. The main barriers to care coordination implementation include poor reimbursement for services, difficulties with provider network communications, shortages of trained care coordination personnel and ambiguity in provider roles and responsibility, which can lead to provider accountability issues. When well-established, care coordination models allow patients to form substantive, long-term personal relationships with providers and increase personal accountability for health care choices. These relationships increase compliance with care regimens in the ambulatory setting and decrease costs with overall improvement in patient quality of life. Care coordination refers to several forms of patient care management which is patient- rather than provider-focused and has the end goal of the “Triple Aim”-improved patient experience, improved population health and decreased per capita...
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...Risk and Quality Management Jamaica Benton HCS/451 August 13, 2012 Matt Dennis Risk and Quality Management According to Valley Healthcare System (2012), “Valley Healthcare System formerly known as Community Health Center of South Columbus opened its doors August 1994. This name change is reflective of the growth in Valley Healthcare and the services that they provide to the community. Valley healthcare began as a small service within the Baker Village community of the South Columbus area” (p.1). Today, Valley Healthcare provide medical, dental, out-reach services, and pharmacy services to residents from the Chattahoochee Valley region and beyond. Valley Healthcare goal is to provide comprehensive primary healthcare, selected specialties and referral services to the population of the Chattahoochee Valley area regardless of circumstances. The ECRI Institute (2010) website, “The Patient Quality and Risk Management Program supports Valley Healthcare System philosophy that patient quality and risk management is everyone’s responsibility. Teamwork and participation among management, providers, volunteers, and staff are essential for an efficient and effective patient quality and risk management program” (p.3.). * Patient safety * Patient quality * Risk management is a policy that is enforced by Valley Healthcare to ensure that all patients are protected and free from hazardous conditions; medical errors; disclosure of privacy; infections and etc. All staff are...
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...Merline Peter Managed Healthcare Organization Keller Graduate School of Management Of DeVry University Professor Joseph Warren Friday August 14th, 2015 Report on contracting of Disease Management Company Many residents of Charlotte Mecklenburg area in North Carolina are continually suffering from diverse disease infections that are difficult to administer if lately diagnosed for instance cancer. The increasing demand for quality health care at pocket friendly prices necessitates the need for Regional Hospital to contract the services of a disease management company. The affiliate would further help the hospital improve health outcomes but also to reduce overall costs of health care. Disease management is a multi-disciplinary approach aimed at ensuring that patients suffering from chronic health infections receive the much needed scientific guidelines and health treatment procedures (Athur, 1999). Strategies and recommendations The following are the strategies for contacting with a disease management company to assist in providing quality health care services to patients with chronic infections and cardiovascular diseases. The company to be contracted should strive to adopt all available measures for ensuring that all quality services are offered at the Regional Hospital at lowest burden to patients. The company will work explicitly to adopt modern health equipment and personnel so to ensure that the population served is not over-burdened (American...
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...Risk and Quality Management Assessment Summary Beverly L. Rivera HCS/451 April 1, 2015 Kevin Stevens Risk and Quality Management Assessment Summary The healthcare industry is growing rapidly with significant changes directing new trends and advance technology for the future. Within recent years, the shift from manual medical records to electronic medical records allows individuals to be an active participant in direct control of their health care. As these changes continue to increase, the risk and quality departments within health care organizations has an enormous duty to enhance the quality of care for its internal and external customers. Gwinnett Medical Center is one of many healthcare organizations that embraces change along with enhancing the quality of care their patients receive. The executive summary assessment will describe details of Gwinnett Medical Center, the risk, and quality management department policies, and how the risk and quality management determines the quality outcome for the goals the hospitals. Gwinnett Medical Center Gwinnett Medical Center (GMC), also known as Gwinnett Hospital System, Inc. (GHS), was established in the early 70s and is a not-for-profit health care network. The hospital is a 553-bed facility, which includes 464-inpatient and 89-skilled licensed nursing and long-term facility. Gwinnett Medical Center has two acute-care hospitals, and facilities in different cities and the metro Atlanta area. The facility in Lawrenceville...
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...Risk and Quality Management Assessment Summary HCS/451 Barbara Smith 11/16/15 Alanna Vanderpool The organization selected to review is Milestones Management Group. Milestones is a management company that contracts with various long term care facilities and provides general oversight from a corporate level. Their primary focus and target type of facilities are Assisted Living and Memory Cares. The offer nursing and clinical oversight, operations management, growth and development support, quality and risk management support as well as other valuable services to communities in the Pacific Northwest. Milestones is a locally owned company that generally provides contracted services however they do own a few of the properties that they currently manage. Quality and risk management in health care are extremely important not only for an organizations level of success but also for the general wellbeing of its employees and the patients that it serves. To begin, the definition of quality management is “structured organizational process for involving personnel in planning and executing a continuous flow of improvements to provide quality health care that meets or exceeds expectations” (Sollectto & Johnson, 2013, Chapter 1). Most health care organizations, including Milestones, have quality management teams in place that review and evaluate the level of service that the organization provides to its patients. There are several ways for a quality management team to go about determining...
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...Organizational Behavior in Health Care Management Name Institution Date Abstract This paper seeks to look into organizational behavior in health care management and most importantly its impact on health care management and delivery. Organization behavior is crucial in guiding the regulatory activities, the staff activities and the overall culture that directs an organization. Organizational behavior in health care setting is paramount to ensuring patient safety, ethical behavior among the medical practitioners, patient-centered care and effecting change in the facilities which is bound to improve healthcare delivery and patients’ satisfaction. The strategic management of any health care organizations is linked to incorporate effective practices and standards that are obliged to improve health care services delivery and nurture a positive organizational culture to improve the delivery of services and maintain highly qualified and motivated medical personnel that will ensure professionalism and efficiency in the facility. Organizational Behavior in Health Care Management Introduction Organizational behavior refers to the study of personal and group dynamics with relations to relations and interactions within a corporate setting (Borkowski, 2016, p.1). The manner and mode of interactions between individuals and groups of people in an organization affect the way in which an organization...
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...manage all the aspects of a hospital operation, such as medical, administrative, financial, legal and the corresponding service processing. Traditional approaches encompass paper-based information processing as well as resident work position and mobile data acquisition and presentation. One of the most important issues is health services. Hospitals provide a medical assistance to people. The best introduction for hospital information systems has been made in 2011 International Conference on Social Science and Humanity Hospital Information Systems can be defined as massive, integrated systems that support the comprehensive information requirements of hospitals, including patient, clinical, ancillary and financial management. Hospitals are extremely complex institutions with large departments and units coordinate care for patients. Hospitals are becoming more reliant on the ability of hospital information system (HIS) to assist in the diagnosis, management and education for better and improved services and practices Hospitals are convenient settings for deployment of ubiquitous computing technology. Not only are they technology-rich environments, but their workers experience a high level of mobility resulting in information infrastructures with artifacts distributed throughout the premises. Hospital information systems (HISs) that provide access to electronic patient records are a step in the direction of providing accurate and timely information to hospital staff in support of adequate...
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...organization for cancer diagnosis, treatment and management in the private sector in Bangladesh. It's provides the full range of radiation therapy and has a close working relationship with consultants, surgeon, Medical Oncologist & other physicians. Using state- of- the- art equipment their specialists are able to provide the best possible radiation therapy at their centers. Their Radiation Oncologists participate actively in international meetings and conferences on radiation therapy and are experts in their areas of specialization to ensure that our patients get the best and most appropriate care, a team of cancer specialists using multidisciplinary approach manages all patients. Mission: The company’s mission is to provide world class health care services in general and specialized medical fields at an affordable cost. They are providing specialized treatment service for cancer patient and they efforts are direction to become specialized in the fields of cancer diagnosis, treatment and prevention & also trying to open other specialized department. Specialty: 1. Friendly environment for all patients. 2. Specialized by modern equipment for cancer patient. 3. Located in its own campus at Mirpur. 4. A team of trained & experienced consultants for cancer and general patients. 5. Computer based customized database. 6. Transparency in all sector of patient management. 24 hour’s medical service. 7. Collaboration with other organizations...
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...healthcare service quality Ali Mohammad Mosadeghrad* Abstract Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. Keywords: Healthcare Organisations, Quality, Pluralistic Evaluation, Iran Copyright: © 2014 by Kerman University of Medical Sciences Citation: Mosadeghrad AM. Factors influencing healthcare service quality...
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...Risk and Quality Management Assessment Summary Xxxxxxx Xxxx HCS451 September 24, 2012 Instructor Executive Summary Resolve, The National Infertility Association has been assisting and helping out individuals with infertility issues since 1974. Risk and quality management improvements in the organization have rallied behind the patient’s safety, while finding new ways in working as a team that is more effective and efficient when ensuring that the organization can deliver high quality and safe patient care. There have been issues regarding cost of visits and procedures with no insurance coverage while having to pay out of pocket for services that can cost hundreds or even thousands of dollars. The organization offers assistance in providing financial assistance for those in need and assist in finding the health care coverage that would best suit them. Infertility coverage is not a mandated health issue in many states that needs insurance coverage. Out of all the states only 15 are mandated to cover some sort of infertility. 1.1 Key Concepts The main problem was to determine what insurance provider would have some sort of infertility coverage that could assist their patients and avoid out of pocket expenses. The risk analysis will provide information that will help the risk manager realign the activities when dealing with quality care and improvement with the main focus on patient needs. * Review of the current functions of quality improvement and risk...
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...Quality Management Assessment Summary HCS/451 Health Care Quality Management and Outcomes Analysis Quality Management Quality management is a systematic and continuous process that organizations use to deliver products and services that meet or exceed customer expectations. Quality management in healthcare has evolved over the years to address increased demands from consumers related to the quality of care and services, as well as to address problems in patients’ outcomes. The medical field tends to use quality management to focus on patient and staff safety, reducing medical errors, and avoiding or decreasing morbidity and mortality rates. In order to improve the quality of a facility requires the entire facility to be in consensus about what the definition of quality means, who is responsible for it, and how the employees in the facility should communicate with one another about any quality issues that may arise. Quality management requires top management commitment and a flow down through all other employees of the organization. It is a planned, organized, and systematic approach to the improvement, monitoring, and analysis of an organization’s performance. Purpose The purpose of quality management is to help organizations improve their performance by eliminating poor quality of service rather than by trying to fix the results after the service has already been given. Quality management allows an organization to continually improve the quality of...
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...say that the typical Health Information Management (HIM) area plays a critical role in the revenue cycle, largely due to the fact that the revenue cycle begins and ends with medical records (Anderson & Underwood, 2005). The term revenue cycle covers all events that take place in the patient care process that permits the organization to receive payment for the services rendered, and it is important to be aware that this is heavily reliant upon data (Dunn, 2009). In order to fully appreciate the participation of HIM in the revenue cycle process, it is imperative to first gain an understanding of who the key players are, and to summarize the flow of activities that comprises the revenue cycle of a healthcare facility. The key players in hospital revenue cycle management are Administration, Finance, Patient access, Health information management (HIM), Patient accounting, and Clinical services, which includes physicians, diagnostic services, and therapeutic services. Administration sees to strategic goals and operational efficiency and effectiveness. Finance deals with cash flow and contract management. Patient access is responsible for data integrity, demographic and financial data, insurance verification, and pre-certification. Clinical services is responsible for documentation of services, as well as documentation and recording of charges. Health information management takes charge of coding, abstracting, and data validation. Finally, Patient accounting oversees compilation of charges...
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...HLSA 3310 As a healthcare provider, I have gain interest in helping patients and families through the process of their medical stay. During their time of suffering, healing, and/or grieving, many families look for someone to communicate with to help them through this tough process. For my profession career project, I was able to interview. She has been involved in case management for over four years. Case managers “function as a key part of patient care in the modern hospital system. Responsible for organizing a patient's case from admittance to discharge, a case management nurse understands hospital processes and the importance of making cost-effective decisions (Education-Portal).” She has her Bachelor’s Degree in Nursing and has a Master’s Degree in Social Work. Qualifications for becoming a case manager include, an “associate degree in healthcare related field, a Bachelor’s degree is preferred. Bachelors or Masters Degree in related healthcare field (such as respiratory therapy or social work) may be considered. Minimum of two (2) years of utilization review/case management experience or social work experience. Minimum of one (1) year experience in discharge planning from a hospital is preferred. Maintain current professional licensure in nursing or professional field of certification. Appropriate certification in case management preferred (e.g., Commission for Case management Certification (CCMC); Association of Rehabilitation Nurses (ARN)) (Ocean to Ocean, Healthcare)...
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...with the routine operations of the hospital or the routine care of a particular patient are reported to the quality management department so that immediate attention and responses can be given to individual occurrences. Statistics can then be derived from the collective number of incidents reported and will serve as a basis for adverse patient trends, patient safety issues, or other risks and hazards to be identified, and risk reduction programs implemented. In order to promote a culture that promotes patient safety, the hospital’s Incident Reporting Policy is based upon a foundation of nonpunitive approach to incident/occurrence reporting. The hospital leadership will encourage open and honest reporting of injuries and hazards to patients, visitors and staff, this process will be nonpunitive in nature for all persons reporting incidents throughout the organization. Incidence/occurrence investigations will be viewed as an opportunity for education/process improvement, and will focus on processes and systems, rather than human error. Disciplinary action will be limited to only those employees who engage in willful or malicious misconduct, or those occurrences in which the employee failed to report an incident or hazard to patients in a timely manner. II. Responsibility A. All hospital employees, medical staff members, volunteers, and contract service members will participate in the hospital-wide incident reporting program. All...
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...Disease Management: Empowering Patients and Improving the Effectiveness of Patient Care Disease Management: Empowering Patients and Improving the Effectiveness of Patient Care Managed care organizations are continually searching for new ways to cut costs and people trying to manage an illness or disease are looking for ways to ease their symptoms, maintain their lifestyle, and stay out of the hospital. People with diseases are in the unique position for managed care organizations to focus cost saving programs on. Diseases can be incredibly expensive to treat and while people suffering from diseases are not a majority of patients, they are certainly the most costly (Lorig & Holman, 2003). Disease management programs can also motivate patients to change their lives by better managing their disease and get those diseases under control by giving patients the skills and expertise necessary. Disease management programs seek to change the approach to patient care with regards to difficult conditions by incorporating evidence based medicine techniques and outcomes that can contribute to the wellness of patients by using combinations of education, provider practice guidelines, consultations, appropriate drug utilization, supplementary drugs and services. Focus on these areas can keep patients illnesses from reaching emergent care levels as well as reducing the outlay associated with high–cost diseases. Disease Management History Chronic conditions make up more than 40...
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