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Assessment Instructions
Complete the following:
Describe the role of a quality-management organization.
Identify the educational needs of a quality-management organization as related to the delivery of services.
Give detailed examples of how quality efforts impact the following groups:
Patients.
Medical administrators.
Select two national organizations from this list that are focused on quality management or quality assurance, and compare and contrast them. Carefully investigate the organizations that you select. You may consult the organization’s Web site, textbooks, and the Capella library.
-National Committee on Quality Assurance (NCQA).
-Institute for Healthcare Improvement (IHI).
-Agency for Healthcare Research and Quality (AHRQ).
-Ambulatory Care Quality Alliance (AQA).
-The Joint Commission (TJC).
-The LeapFrog Group.
-The National Quality Forum (NQF).
Resources
Suggested Resources
The following optional resources are provided to support you in completing the assessment or to provide a helpful context. For additional resources, refer to the Research Resources and Supplemental Resources in the left navigation menu of your courseroom.
Multimedia
View Expert Interview: Quality Assurance.
Course Library Guide
A Capella University library guide has been created specifically for your use in this course. You are encouraged to refer to the resources in the BUS-FP4123 – Quality Assurance and Risk Management Library Guide to help direct your research.
Internet Resources
Access the following resources by clicking the links provided. Please note that URLs change frequently. Permissions for the following links have been either granted or deemed appropriate for educational use at the time of course publication.
American Society for Quality. (n.d.). Plan-do-check-act (PDCA) cycle. Retrieved from http://www.asq.org/learn-about-quality/project-planning-tools/overview/pdca-cycle.html
U.S. Department of Health and Human Services (HHS): Office of Inspector General (OIG). (2014). Work plan for fiscal year 2014. Retrieved from http://oig.hhs.gov/reports-and-publications/archives/workplan/2014/Work-Plan-2014.pdf
Health Care Compliance Association. (2019). Code of ethics for health care compliance professionals. Retrieved from https://www.hcca-info.org/code-ethics-health-care-compliance-professionals
Institute of Medicine (IOM). (2000). Executive summary of to err is human. Retrieved from http://www.iom.edu/en/Reports/1999/To-Err-is-Human-Building-A-Safer-Health-System.aspx
National Committee for Quality Assurance (NCQA). (2013). Improving quality and patient experience: The state of health care quality 2013. Retrieved from http://www.ncqa.org/Portals/0/Newsroom/SOHC/2013/SOHC-web_version_report.pdf
National Committee for Quality Assurance. (2019). 2019 HEDIS summary table of measures, product lines and changes [PDF]. Retrieved from https://www.ncqa.org/wp-content/uploads/2018/08/20190000_HEDIS_Measures_SummaryofChanges.pdf
Institute of Medicine (IOM). (2009). The learning healthcare system workshop summary. Retrieved from http://www.nap.edu/openbook.php?record_id=11903
Office of the Inspector General (OIG), U.S. Department of Health and Human Services (HHS), & American Health Lawyers Association (AHLA). (2011). The health care director’s compliance duties: A continued focus of attention and enforcement. Retrieved from https://oig.hhs.gov/compliance/compliance-guidance/docs/Health_Care_Directors_Compliance_Duties.pdf
U.S. Department of Health and Human Services (HHS): Agency for Healthcare Research & Quality (AHRQ). (n.d.). National healthcare quality & disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/
U.S. Department of Justice: U.S. Attorney’s Office: District of Maryland. (2009). Johns Hopkins Bayview Medical Center settles false claims act case. Retrieved from https://www.justice.gov/archive/usao/md/news/archive/JohnsHopkinsBayviewMedicalCenterSettlesFalseClaimsActCase.html
Institute for Healthcare Improvement (IHI). (2014). 5 million lives campaign. Retrieved from http://www.ihi.org/engage/initiatives/completed/5MillionLivesCampaign/Pages/default.aspx
5 million lives campaign. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available on www.IHI.org)
Institute for Healthcare Improvement (IHI). (2014). IHI improvement map. Retrieved from http://www.ihi.org/IHI/Programs/ImprovementMap
IHI improvement map. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available on www.IHI.org)
Association of periOperative Registered Nurses (AORN). (2013). Just culture tool kit. Retrieved from http://www.aorn.org/Clinical_Practice/ToolKits/Just_Culture_ToolKit/Just_Culture_Tool_Kit.aspx
Health Care Compliance Association (HCCA). (2019). Retrieved from https://www.hcca-info.org/
Institute for Healthcare Improvement (IHI). (2014). Develop a culture of safety. Retrieved from http://www.ihi.org/resources/Pages/Changes/DevelopaCultureofSafety.aspx
Develop a culture of safety. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available on www.IHI.org)
Institute for Safe Medication Practices (ISMP). 2014–2015 targeted medication safety best practices for hospitals. Retrieved from http://www.ismp.org/Tools/BestPractices/default.aspx
U.S. Department of Health and Human Services (HHS): Health Resources and Services Administration (HRSA): National Practitioner Data Bank (NPDB). (n.d.). Healthcare Integrity and Protection Data Bank. Retrieved from http://www.npdb-hipdb.hrsa.gov/
U.S. Department of Health and Human Services (HHS): Office of Inspector General (OIG). (n.d.). Compliance education materials: Compliance 101. Retrieved from http://oig.hhs.gov/compliance/101
U.S. Department of Health and Human Services (HHS): Office of Inspector General (OIG). (n.d.). Corporate integrity agreement documents. Retrieved from http://oig.hhs.gov/fraud/cia/cia_list.asp
U.S. Government Accountability Office (GAO). (2014). 2014 Annual report: Additional opportunities to reduce fragmentation, overlap, and duplication and achieve other financial benefits. Retrieved from www.gao.gov/assets/670/662327.pdf
Institute for Healthcare Improvement (IHI). (2014). Reducing door-to-balloon time for AMI patients. Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/ReducingDoortoBalloonTimeforAMIPatientsatBaptistMemorialDeSoto.aspx
Reducing door-to-balloon time for AMI patients. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2014. (Available on www.IHI.org)
Centers for Medicare & Medicaid Services (CMS). (2014). Medicare and Medicaid EHR Incentive Program basics. Retrieved from http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Basics.html?gclid=COmo3YW2ybwCFepFMgodLQMA4g;
National Committee for Quality Assurance (NCQA). (2009). Appendix 2: HEDIS Roadmap. Retrieved from http://www.ncqa.org/portals/0/hedisqm/HEDISRoadmap/Section_GI_General_Information.doc
Capella University Library Resources
Carroll, R. (2009). Risk management handbook for health care organizations (5th student ed.). Hoboken, NJ: Wiley. ISBN:9780470300176.
Dlugacz, Y. (2006). Measuring health care: Using quality data for operational, financial, and clinical improvement. San Francisco, CA: Wiley. ISBN:9780787983833.

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