Bind QI projects and present outcomes to insurers, accreditors, and others
Bind QI projects and present outcomes to insurers, accreditors, and others
Massachusetts agency shows many QI successes
Since attention to costs and efficiency seemingly rules in these days of the prospective payment system, the quality manager’s role sometimes is overlooked. Quality is expected, right? Well, it might be time for quality managers to dramatically display just how important quality improvement (QI) projects are to a home care agency. And they can do this by creating a QI notebook or binder.
The book should be brief and indexed so a quality manager easily can find a particular project, results from customer satisfaction surveys or Outcome and Assessment Information Set (OASIS) benchmarking, suggests Diane Leclair, MSN, RNC, director of quality management at the Community Nurse Association of Fairhaven Inc. in Fairhaven, MA. The agency serves southeastern Massachusetts from four offices.
Leclair created her agency’s QI binder as a way to organize performance improvement projects and their outcomes. The book allows her and other home care managers to see at a quick glance how the agency is doing on ongoing QI projects, and it serves as documentation of progress on problem areas, which makes it ideal for showing to state regulators or surveyors for the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL.
QI binder is good HMO marketing tool
It also works well as a marketing tool to show to payers, a presentation tool for the agency’s board of directors, and a community outreach tool when managers speak to local groups about the agency.
"We hope to use it on an ongoing basis to show people," Leclair says. "We’ve been around for 85 years; we think we do a good job, and this will give people a realistic picture of where we’re at, which areas we’re trying to improve, and how we’re doing a good job."
It may even help with contract negotiations between insurance companies and the agency.
"Just the other day, we got a call from an HMO wanting information on quality improvement, before renewing a contract, and they wanted us to submit a QI plan," Leclair says. "So I was so glad I had decided to put this book together."
Leclair pulled out some pertinent sections of the book, along with supporting graphics, and copied them to show the HMO. If the book hadn’t been available, it would have taken her a great deal longer to find and pull together all of the important information, she adds. "I can keep track of things with the binder."
The binder is a loose-leaf folder that is indexed according to performance improvement activities. The first section features the Joint Commission/ ORYX initiative. Scores and benchmarking comparisons about the ORYX indicators are included in this part. For example, one of the agency’s home care indicators is "How Patients Perceive Their Involvement in Planning End of Services, Discharge Planning."
The binder includes data on how well the agency did on customer surveys that asked questions about discharge planning. It has data collection material and analysis, and includes an introduction that discusses why the agency selected its particular indicators. When the Joint Commission required two additional indicators, those also were added to the section. (See story on agency’s improvement to customer satisfaction, right.)
Add JCAHO storyboards to binder
The agency, which was accredited with commendation by the Joint Commission in 1998, will have its Joint Commission storyboards in the binder after the next survey, Leclair adds.
Since the agency has a hospice organization that also has QI projects, Leclair includes those in the binder, as well.
In forming the book, Leclair met with the agency’s quality improvement coordinator and planned it jointly.
They included protocols and samples of the agency’s customer satisfaction survey. The binder also describes the purpose and scope of the agency and its responsibilities for all staff with regard to the survey.
"The binder is a joint effort," Leclair says. "And with it, I think we can demonstrate how everyone in the agency — from administrator on down — is involved with quality improvement."
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