Healthcare Quality Standards discussion

timer Asked: Feb 7th, 2019
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Question Description

Question 1.

Quality is an ongoing objective for health care providers. What do you believe are the three most important indicators of quality care in a hospital? Why?

Question 2.

Locate a hospital patient safety initiative and explain the initiative. Do you think that this initiative is addressing an important issue(s) and do you think it will succeed? Why or why not?

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Clinical Quality Measures Basics comprises public domain material from the Centers for Medicare & Medicaid Services. Clinical Quality Measures Basics Clinical quality measures, or CQMs, are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals (CAHs) within our health care system. These measures use data associated with providers’ ability to deliver highquality care or relate to long term goals for quality health care. CQMs measure many aspects of patient care including: • health outcomes • clinical processes • patient safety • efficient use of health care resources • care coordination • patient engagements • population and public health • adherence to clinical guidelines Measuring and reporting CQMs helps to ensure that our health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. To participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs and receive an incentive payment, providers are required to submit CQM data from certified EHR technology. To participate in the Medicare and Medicaid EHR Incentive Programs and receive an incentive payment, providers are required to submit CQM data from certified EHR technology. 2014 Clinical Quality Measure Options In August May 2014, CMS released a final rule that grants flexibility to providers who are unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 CEHRT availability. The different 2014 CQM submission options are outlined below. 2011 CEHRT Providers scheduled to demonstrate Stage 1 or Stage 2 who are still using 2011 Edition CEHRT use 2013 CQMs. 1 2011 & 2014 CEHRT Providers scheduled to demonstrate Stage 1 who are using a combination of 2011 and 2014 Editions submit 2013 CQMs or 2014 CQMs, depending on whether they report 2013 Stage 1 or 2014 Stage 1 objectives. Providers scheduled to demonstrate Stage 2 using a combination of 2011 and 2014 Editions submit 2013 CQMs if they report 2013 Stage 1 objectives, or submit 2014 CQMs if they report 2014 Stage 1 objectives or Stage 2 objectives. 2014 CEHRT Providers scheduled to demonstrate Stage 1 or Stage 2 in 2014 who have fully implemented 2014 CEHRT use 2014 CQMs. 2 Recommended Core Measures comprises public domain material from the Centers for Medicare & Medicaid Services. Recommended Core Measures For 2014, CMS is not requiring the submission of a core set of CQMs. Instead we identify two recommended core sets of CQMs, one for adults and one for children. We encourage eligible professionals to report from the recommended core set to the extent those CQMs are applicable to your scope of practice and patient population. Measure Selection Process CMS selected the recommended core set of CQMs for EPs based on analysis of several factors: • Conditions that contribute to the morbidity and mortality of the most Medicare and Medicaid beneficiaries • Conditions that represent national public health priorities • Conditions that are common to health disparities • Conditions that disproportionately drive healthcare costs and could improve with better quality measurement • Measures that would enable CMS, States, and the provider community to measure quality of care in new dimensions, with a stronger focus on parsimonious measurement • Measures that include patient and/or caregiver engagement Adult Recommended Core Measures • Controlling High Blood Pressure • Use of High-Risk Medications in the Elderly • Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention • Use of Imaging Studies for Low Back Pain • Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan • Documentation of Current Medications in the Medical Record • Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up • Closing the referral loop: receipt of specialist report • Functional status assessment for complex chronic conditions 1 Pediatric Recommended Core Measures • Appropriate Testing for Children with Pharyngitis • Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents • Chlamydia Screening for Women • Use of Appropriate Medications for Asthma • Childhood Immunization Status • Appropriate Treatment for Children with Upper Respiratory Infection (URI) • ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication • Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan • Children who have dental decay or cavities 2 Principles for the National Quality Strategy (NQS) comprises public domain material from Working for Quality, Agency for Healthcare Research and Quality, U.S. Department of Health & Human Services. Principles for the National Quality Strategy (NQS) Principles The National Quality Strategy—and all our efforts to improve health and health care delivery—should be anchored in a core set of principles shared by stakeholders, including Federal and State agencies, local communities, provider organizations, consumers, clinicians, businesses, employers, and payers. These principles will provide a practical roadmap for achieving the Strategy's three aims of better care, healthy people/healthy communities, and care that is affordable. As part of soliciting public input on the Strategy, the Secretary proposed a set of four core principles. After receiving a wide range of public comments, six additional principles were added. In 2011 and in future years, the Federal government will report on how its policies support these 10 principles, as well as the Strategy's key aims and priorities. It is hoped that other public and private groups seeking to promote better health and health care delivery will also use these principles to hold themselves accountable. The following section describes the 10 principles in further detail. (Over time, a resource guide of examples of private and public sector efforts that embody these principles will be developed.) 1. Person-centeredness and family engagement, including understanding and valuing patient preferences, will guide all strategies, goals, and improvement efforts. The most successful health care experiences are often those in which clinicians, patients, and their families work together to make decisions. When patients' needs, experiences, perspectives, and preferences are taken into account—and when they get the clear and understandable information and support they need to actively participate in their own care—outcomes and patient satisfaction can improve. How patients rate their experience is now widely used as a measure of high quality care, but more can be done to empower individuals and make sure their needs and preferences are taken into account. 2. Specific health considerations will be addressed for patients of all ages, backgrounds, health needs, care locations, and sources of coverage. Patients' health needs and care requirements vary substantially depending on their age, location, condition, whether they live in an urban or rural location, and what type of coverage they have. In order to provide high quality care for all Americans, we need to address these special needs. 3. Eliminating disparities in care—including but not limited to those based on race, color, national origin, gender, age, disability, language, health literacy, sexual orientation and gender identity, source of payment, socioeconomic status, and geography—will be an integral part of all strategies, goals, and health care improvement efforts. 1 Health disparities continue to exist, largely due to gaps in access to care, provider biases, poor patientprovider communication, poor health literacy, and other factors. Despite significant advances in the quality of certain kinds of care, some populations remain at higher risk of receiving poor care. Collaborative efforts between clinicians and provider organizations; community, faith-based, and nonprofit organizations; academic institutions; foundations; and Federal, State, and local agencies have begun and must continue to address these disparities so that all populations, regardless of race, gender, socioeconomic status, or other factors, get high-quality care and have equal access to timely, effective, and safe health care services. 4. Attention will be paid to aligning the efforts of the public and private sectors. Many organizations are already committed to the goal of providing consistent, high-quality, safe, and affordable care. But these well-intentioned efforts often have the unintended result of putting competing demands on clinicians and health care organizations that can stand in the way of improvement. To raise the quality of health care across the country, both the public and private sectors will need to maintain a strong commitment to aligning their efforts. 5. Quality improvement will be driven by supporting innovation, evaluating efforts around the country, rapid-cycle learning, and disseminating evidence about what works. The best way to improve health care quality is to help health professionals evaluate their own performance and their colleagues' performance, quickly learn how interventions fare in the "real world," and see the benefits of innovation firsthand—and then widely share the lessons they learn. For this to happen, health professionals must have rapid access to information about what works in their own care and in care around the country. The National Quality Strategy also recognizes that quality improvement is an iterative process. Seemingly simple interventions can have powerful, positive impacts on patient outcomes. But clinicians need the flexibility to update and apply these interventions based on their own experience and the specific patient receiving care. In other words, quality improvement efforts can succeed best when they are tailored to local needs and resources. To that end, the National Quality Strategy will provide a shared set of priorities, while also continuing to support local approaches to achieving the aims of better care, healthier individuals and communities, and lowered health care costs. 6. Consistent national standards will be promoted, while maintaining support for local, community, and State-level activities that are responsive to local circumstances. National standards for health care quality and consistent approaches to measuring quality are essential components of the National Quality Strategy. At the same time, the old maxim that "all health care is local" still holds true. For that reason, the National Quality Strategy will promote national standards while supporting local, community, and State-level activities that respond to local circumstances. 7. Primary care will become a bigger focus, with special attention toward the challenges faced by vulnerable populations, including children, older adults, and those with multiple health conditions. 2 Many Americans receive care from multiple providers at multiple locations, with little coordination between them. Primary care can help fill this gap, especially for vulnerable populations such as children, older adults, and those with multiple health conditions. The National Quality Strategy will build on the efforts of multiple stakeholders who are working to strengthen primary care using models such as the patient-centered medical home, which organizes care around the individual to help each person stay as healthy as possible at all stages of life. 8. Coordination among primary care, behavioral health, other specialty clinicians, and health systems will be enhanced to ensure that these systems treat the "whole person." When health care services are fragmented, necessary care is often delayed. Other times, patients fail to get the care they need altogether. Often, this occurs when a patient needs behavioral health or other specialty services that fall outside the traditional scope of primary care services. To address this gap, the National Quality Strategy will enhance the coordination between primary care, behavioral health, and other specialty services to ensure that health systems treat the "whole person" and all of his or her health needs. 9. Integration of care delivery with community and public health planning will be promoted. One of the biggest opportunities for improving health care and overall health is improving the way we treat and try to prevent chronic illness. Clinicians can offer evidence-based recommendations about how to stay healthy to individuals and families, but making changes in diet, exercise, and other health behaviors is often difficult without community support and resources. For that reason, the Strategy supports close collaboration between health professionals who deliver care and individuals and organizations working to improve community and public health. 10. Providing patients, providers, and payers with the clear information they need to make choices that are right for them will be encouraged. Patients who want to partner with their health care providers in making decisions about their care too often lack the necessary understandable information. The National Quality Strategy will foster transparency so that patients have the information to make choices that are right for them, clinicians have the information they need to improve, and payers have the information to move to value-based payments. 3 Quality Initiatives-General Information comprises public domain material from Centers for Medicare & Medicaid Services. Quality Initiatives - General Information About CMS' Center for Clinical Standards & Quality CMS' Center for Clinical Standards & Quality (CCSQ), led by the CMS Chief Medical Officer and the CCSQ Leadership Team, is a cadre of professionals with diverse backgrounds in clinical, scientific, public health, legal, IT, project management, academic, and business management fields. We serve CMS, HHS, and the public as a trusted partner with a steadfast focus on improving outcomes, beneficiaries' experience of care, and population health, while also aiming to reduce healthcare costs through improvement. About CMS' Quality Initiatives Quality health care for people with Medicare is a high priority for the President, the Department of Health and Human Services (HHS), and the Centers for Medicare & Medicaid Services (CMS). HHS and CMS began launching Quality Initiatives in 2001 to assure quality health care for all Americans through accountability and public disclosure. The various Quality Initiatives touch every aspect of the healthcare system. Some initiatives focus on publicly reporting quality measures for nursing homes, home health agencies, hospitals, and kidney dialysis facilities. Consumers can use the quality measures information that is available on for these healthcare settings to assist them in making healthcare choices or decisions. Request for Information: Transforming Clinical Practices The Center for Medicare & Medicaid Services (CMS) seeks information about large scale transformation of clinician practices to accomplish our aims of better care and better health at lower costs. Practice Transformation is a process that results in observable and measureable changes to practice behavior. These behaviors include core competencies: Engaged leadership and quality improvement; Empanelment and improved patient health outcomes; Business and Financial acumen ;Continuous and team-based healing relationships that incorporate culture, values, and beliefs; Organized, evidencebased care; patient-centered interactions; Enhanced access; progression toward population based care management; State-of-the-art, results-linked, care; Intentional approach of practices to maximize the systematic engagement of patients and families; and Systematic efforts to reduce un-necessary diagnostic testing and procedures with little or no benefit. CMS seeks responses to questions listed in Request for Information (RFI) which can be accessed through the download below. CMS may use this information collected through this RFI notice to test new payment and service delivery models. Please take the opportunity to respond to the questions most appropriate for your organization. All comments are requested in the described format to the designated CMS representative noted in the RFI by 11:59 pm Eastern on April 8, 2014. 1 CMS Quality Strategy We are pleased to announce the CMS Quality Strategy, which is built on the foundation of the CMS Strategy and the HHS National Quality Strategy (NQS). The CMS Quality Strategy pursues and aligns with the three broad aims of the National Quality Strategy and its six priorities. Each of these priorities has become a goal in the CMS Quality Strategy. To learn more about the CMS Quality Strategy, and to provide feedback and public comment, please visit: Physician Quality Reporting System Physicians and other eligible professionals can participate in the Physician Quality Reporting System by reporting quality measures information to CMS about specific services provided frequently to their Medicare patients with certain medical conditions. This information helps doctors measure the quality of care provided to Medicare beneficiaries. More information about it can be found at Quality Improvement Organizations Successful quality initiatives rely on partnerships and support from many sources that encompass the healthcare community such as federal and State agencies, researchers and academic experts, stakeholder and consumer organizations, providers and advocates, and federal contractors such as Quality Improvement Organizations (QIOs). QIOs can assist Medicare beneficiaries and their caregivers understand and use quality measures information in their healthcare decision making process. Quality Measures CMS has developed a standardized approach for the development of quality measures that it uses in its quality initiatives. Known as the Measures Management System (MMS), this system is composed of a set of business processes and decision criteria that CMS funded measure developers follow in the development, implementation, and maintenance of quality measures. Post Acute Care Reform Plan CMS funded a project to review assessment approaches that could be used across post-acute settings to reduce care fragmentation and unsafe transitions, and to compare outcomes and costs for patients discharged to post acute care. It should be noted that the content of this report does not necessarily reflect the views or policies of the Department of Health and Human Services nor does mention of any trade names, commercial products, or organizations imply endorsement by the U.S. Government. CMS has developed a plan to improve Medicare's payment for post-acute care services and the coordination of these services. Post-acute care is care that is provided to individuals who need additional help recuperating from an acute illness or serious medical procedure. 2 Development of Quality Indicators for Inpatient Rehabilitation Facilities (IRFs) The overall goal of this project was to assist CMS in developing appropriate measures to monitor and evaluate the quality of rehabilitation services provided to Medicare beneficiaries in IRFs. The key questions addressed by this report include: What are the expected outcomes of an inpatient rehabilitation stay? What factors affect those outcomes? Do we have appropriate measures of those relationships? And if not, what measures do we need? Funded by CMS, in considering these key questions, Research Tria ...
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