Every healthcare organization has a quality department. It is usually focused on Quality Assurance and its purpose is ensuring compliance with the regulations as outlined by the various regulatory certifying bodies that oversee your organization. It is often staffed by people not actively engaged in clinical workflows or who are not clinically trained at all. But is obedience to all regulatory mandates your organization’s definition of “quality”?
Think about it this way. Regulatory and billing agencies can easily become your default strategists for what is important to your organization and how it defines quality performance if that is your only approach. Smooth, effective workflows and maximizing clinical interaction face time with minimal distraction for charting are what is important to your clinical workforce and healthcare customers. It is not to regulatory agencies. Does maximizing obedience to charting regulatory process steps as mandated for quality or billing mandates make your organization high quality? Or is the price for that “burn-out”. Or as I refer to it, organizationally imposed workforce injury.
Another way to approach this is taking a broader look at information management strategies.
There are 4 broad categories of data.
1. Regulatory (Joint Commission, NCQA, HRSA, CMS)
2. Grant or Contractual (payer contracts or grant deliverables)
3. Organizational Oversight (board scorecards or revenue/ margin/overhead)
4. Operational performance (visit volumes, screening rates, visit access, records completion)
Some data types fit all 4 categories. An example would be vaccination rates. JC,NCQA and HRSA will all want them. It can be applied to payer contract performance or a board scorecard. It could be segmented down to individual clinics or provider work teams as a clinical/operational metric.
Every single data category has common features.
1. It can be segmented down to divisions, programs, clinics or individual staff members. Or rolled up to whole organization aggregate summaries.
2. It can be applied to individual customers as performed or the above-mentioned work units who performed them.