REFOCUS TO RECHARGE. Operational Awareness QUALITY MANAGEMENT ALLOWS YOU TO SEE OPPORTUNITIES AND TRACK EFFICIENCIES

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1 REFOCUS TO RECHARGE QUALITY MANAGEMENT ALLOWS YOU TO SEE OPPORTUNITIES AND TRACK EFFICIENCIES Operational Awareness Sometimes known as the 30,000 foot view Able to track multiple moving targets Real time knowledge of status and efficacy of organizational key functions Dynamic vision of organizational operations in line with regulations, rules and standards 1

2 Dynamic interrelationships of Malcolm Baldrige National Quality Award criteria Why are we discussing Quality AGAIN??? v Licensure v Payment v Industry Publicity Because we all get up everyday to make life better for our clients The Crag Business Group, Inc. 2

3 Quality Focus Impacts are Agency- wide Improve Organizational Efficiencies Ø HR Ø Medical Records Ø Customer Relations Identify leadership s scope of work Improve Survey Outcomes Public Information A View from Outside The Survey The surveyor only sees what is presented The surveyor cannot use what the agency expected was being done/taught/tracked Every previous deficiency an agency received is in view Is Trended - Is a lens used in this survey As is OASIS data 3

4 Recurrent top survey deficiencies Care Plans: Meeting client needs, followed, updating as needed Client s Record: Consistent, timely Coordination of Services: Documented communication Personnel record: Consistent, meets state & federal guidelines Complaint Management: Avoiding repeats, protecting client rights Triggers for Significant Deficiencies Ineffectual Complaint response Response to on- call issues that is either not visible or not effective Repetitive errors in any area A wide variance between what is planned with patient & what is delivered ALL UNDER THE UMBRELLA OF ADMINISTRATION 4

5 SUSTAINABILITY Sustainability Sustainable able to be maintained at a certain rate or level: sustainable fusion reactions able to be upheld or defended: sustainable definitions of good practice 5

6 REFOCUS COMPLIANCE SUBSTAINIAL COMPLIANCE SUSTAINABILITY REFOCUS COMPLIANCE Able to prove the organization provides service to the letter of the rules Able to document the service 6

7 REFOCUS Substantial compliance Compliance with all condition- level requirements, as determined by CMS or the State. If the survey results only in standard level deficiencies REFOCUS Sustainability - Able to demonstrate on- going systemic actions resulting in demonstrable compliance - The processes and outcomes are pervasive through the agency 7

8 REFOCUS CMS Sanctions - in addition to termination of the provider agreement are available: Civil money penalties; Suspension of payment for all new admissions; Temporary management of the HHA; Directed plan of correction; and Directed in- service training REFOCUS Licensure - Intermediate restrictions or conditions A) The department may impose intermediate restrictions or conditions on a license that may include at least one of the following: (1) Retaining a consultant to address corrective measures; (2) Monitoring by the department for a specific period; (3) Providing additional training to employees, owners, or operators of the home care agency; (4) Complying with a directed written plan to correct the violation, or (5) Paying a civil fine not to exceed $10,000 per calendar year for all violations 8

9 Quality Improvement Quality Assurance Quality Management Quality Improvement When does a graph fix a problem or prevent a disaster? The Crag Business Group, Inc. 9

10 Know the Measure of Effectiveness to Become Efficient Awareness of Agency Knowledge is Based on Factual Real- Time Data The whole new world of healthcare is DATA DRIVEN and PATIENT CENTRIC 10

11 Knowledge is Based on Factual Real- Time Data What is the scope of data gathered- And the scope of data used Where do you get data from and how often Who reviews for trends How is data validated When and with whom is data shared Knowledge is Based on Factual Real- Time Data Where do you get data from and how often Dashboards What do you do with this insight? Test validity Give feedback Identify Trends 11

12 Knowledge of Staff More than the statistics What is the staff awareness / perspective on the agency and it s scope of work? On the QI activities? What skill sets exist in your managers? in your field staff? Knowledge of Staff Define skills that will benefit each project Really involve those staff, and give them time to be effective Keep in touch with staff during any new implementation whether new to agency or individuals 12

13 Knowledge of Training More than the offerings Measure efficacy Training simply to meet a numerical target is a waste of resources Effectiveness & Efficiency Begin Now Willingness to be Proactive 13

14 READINESS IS KEY Quality Improvement Quality Team Who What training How Frequently Authority to Impact READINESS IS KEY QI Activities Documented Reviewed Implemented SHOWS IMPROVEMENT 14

15 READINESS IS KEY OPERATIONS Billing Hiring Medical Records Meeting READINESS IS KEY CARE SERVICES Referral to Admission Scheduling Supervision Discharge Planning 15

16 READINESS IS KEY SURVEY Be ready for a survey everyday Assume 1-2 years of work for success IF you don t have 1-2 years start NOW QUALITY IMPROVEMENT & YOURORGANIZATION S OVERALL PERFORMANCE 16

17 Effective & Efficient Operations - The Positive Reach Staff Matters From Application to Retirement 17

18 Medical Records Impacts surveys, timely & accurate billing Customer Service You have to be involved 18

19 1 Innovation is optional, but changes are coming 2 Start now become an example of success Mastery is not achieved overnight 3 The cost of integrating changes is less than the alternatives QUESTIONS? 19

20 Resources The Crag Business Group CragConsulting.org