COMPREHENSIVE INTRODUCTION TO CASE MANAGEMENT-SECTION 5-QUALITY PATIENT CARE, MEASURING EFFECTIVENESS OF CM & LINKING JCAHO T

Course overview

OBJECTIVES 1. Discuss the characteristics of quality. 2. Discern the difference between: Quality Assurance Quality Improvement Performance Improvement 3. Discuss the five quality categories of organizational values 4. Discuss the relationship between healthcare a. costs, b. quality, and c. case management 5. Identify examples of variance(s) as they relate to: Patient Family Hospital-institution Community Practitioner 6. Discuss outcomes related to patient health. 7. Discuss organization-specific outcome measures. 8. Discuss strategies for making variance data reporting easy. 9. Explain the purpose of clinical pathways / practice guidelines and their relationship to case management. 10. Discuss the relationship between case management and JCAHO standards. 11. Explain documentation standards according to JCAHO (2001). OUTLINE Chapter 1: Quality Patient Care A. IMPORTANCE OF QUALITY B. MEANING OF QUALITY C. CHARACTERISTICS OF QUALITY D. SETTING THE STANDARDS FOR QUALITY E. A HISTORICAL REVIEW OF QUALITY F. USING STRUCTURE / PROCESS OUTCOMES TO MEASURE QUALITY G. QUALITY CATEGORIES OF ORGANIZATIONAL VALUES H. CASE MANAGEMENT AND CQI I. CONSUMER / PATIENT SATISFACTION J. QUALITY / COST / CASE MANAGEMENT K. CASE MANAGEMENT AND OUTCOMES MANAGEMENT Chapter 2: Measuring the Effectiveness of Case Management A. OUTCOMES AS INDICES OF QUALITY B. OUTCOMES NOT DIRECTLY RELATED TO PATIENT'S HEALTH C. OUTCOMES RELATED TO PATIENT HEALTH D. CLINICAL OUTCOMES E. PATIENT CARE VARIANCES F. OUTCOME MANAGEMENT AND OUTCOMES CLASSIFICATION G. ORGANIZATION-SPECIFIC OUTCOME MEASURES: EVALUATING THE DEPARTMENT OF CASE MANAGEMENT H. ORGANIZATION-SPECIFIC OUTCOME MEASURES: EVALUATING THE CASE MANAGER I. NATIONAL QUALITY INDICATORS J. REPORT CARDS Chapter 3: Linking JCAHO to Case Management A. OVERVIEW OF THE JCAHO STANDARDS B. CONTINUOUS SELF-EVALUATION AND IMPROVEMENT C. RELATIONSHIP OF CASE MANAGEMENT TO JCAHO STANDARDS D. CASE MANAGEMENT AND ROOT CAUSE ANALYSIS E. DOCUMENTATION STANDARDS F. INTERDISCIPLINARY APPROACH TO PATIENT CARE