10-530-161Health Quality Management
Course Information
Description
Explores the programs and processes used to manage and improve healthcare quality. Addresses regulatory requirements as related to performance measurement, assessment, and improvement, required monitoring activities, risk management and patient safety, utilization management, and medical staff credentialing. Emphasizes the use of critical thinking and data analysis skills in the management and reporting of data.
Total Credits
3
Course Competencies
  1. INVESTIGATE performance improvement principles, models, tools and considerations
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you examine the concept of quality and its importance in healthcare
    you examine performance improvement principles
    you investigate goals, purposes and features of performance improvement models
    you investigate quality monitoring and reporting tools
    you identify criteria for selecting an improvement project

  2. EVALUATE performance data for patterns, trends and opportunities for improvement
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you determine the scope of the performance improvement
    you compile appropriate data from various sources
    you organize data in a usable format
    you compare and analyze performance data
    you summarize findings of the data analysis
    you provide recommendations for improvement opportunities

  3. EVALUATE utilization data for patterns, trends and opportunities for improvement
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you explain the historical development and goals of utilization management
    you outline the utilization management structure and process
    you differentiate between the various types of utilization management reviews
    you investigate tools and techniques that contribute to the efficient use of resources in the provision of patient care
    you draw conclusions based on utilization data

  4. EVALUATE risk management/patient safety data for patterns, trends and opportunities for improvement
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you explain the historical development and goals of risk management
    you outline the risk management structure and process
    you differentiate between the approaches to risk reduction
    you investigate methods for risk identification
    you investigate tools and techniques to manage loss prevention and reduction
    you draw conclusions based on risk data

  5. REPORT facility-wide outcomes data (internally & externally)
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you identify internal and external reportable measures
    you prepare reports for monitoring performance
    you prepare reports for decision making

  6. EXAMINE the organization’s accreditation, licensure and credentialing processes
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you identify accrediting and licensing requirements and standards
    you collect data for required monitoring activities
    you report results of the review in compliance with accreditation/licensing requirements
    you summarize the credentialing process
    you outline the medical staff appointment/reappointment process
    you examine delineation of clinical privileges
    you examine peer review process

  7. UTILIZE data analytics for decision support, strategic initiatives, and research
    Assessment Strategies
    Oral, written or graphic assessment
    Criteria
    you conduct data mining activities
    you use decision support tools
    you recommend solutions for quality management and performance improvement
    you draw conclusions from data analytics related to strategic initiatives and research