ABQAURP News
May / June 2012
Boundaries: Empowerment or Control
Recently a client asked me to discuss boundaries during a risk management presentation. The trigger was her concern that some staff did not understand that appropriate boundaries must exist between staff’s professional responsibilities towards all patients and their personal feelings for, and actions to serve, specific patients. Was she right? Does patient-centered care mean that clinical and non-clinical staff should do anything a patient needs or wants, from providing food and clothing to purchasing airline tickets? Is the answer different if the patient population is especially needy? Is it OK to treat some patients better than others?
I believe that boundaries are necessary, appropriate, and empowering if they improve overall patient care and outcomes by focusing limited resources on areas of greatest patient need, clarifying organizational priorities in support of improved patient care, facilitating the achievement of critical organizational goals by minimizing distraction, and enhancing quality by minimizing unwanted variation. Boundaries become barriers when they are created to support an individual’s power and position, define authority, maintain tradition, and substitute for independent thought and judgment in the care of a patient or population.
Of the many challenges most of us currently face, which boundaries could serve a useful purpose and which seem to exist for all the wrong reasons? How would you characterize EHR implementation, ICD-10, HIPAA, and Healthcare Reform?
Which types of boundaries are most prevalent in your organization: empowering or controlling ones? Would characterizing the boundaries existing in your organization into those that serve a useful purpose and should be supported (empowering boundaries) and those that are barriers only (control boundaries) help your organization to move forward in an increasingly complex environment?
Please send inquiries and comments to rwillog@abqaurp.org, please include
Quality Column in the subject line.
We look forward to your participation in this new column.
Congratulations to Dr. Lynn Helmer on her recent election as Secretary-Treasurer of the American College of Physician Executives!
Is Your Medical Education Accredited?
ABQAURP welcomes applications for joint sponsorship of educational activities for continuing education credit. ABQAURP accredits a variety of activities, including:
- Live Activity
- Internet Activity Live
- Enduring Material
- Internet Activity Enduring Material
- Journal-Based CME
- Performance Improvement
ABQAURP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians and is also accredited by the Florida Board of Nursing to sponsor nursing contact hours. As an accredited provider, ABQAURP is here to work with each joint sponsor organization to ensure the accreditation process runs as smoothly as possible. Benefits of working with ABQAURP include: one-on-one assistance, on-site assistance, contact for speakers and commercial supporters, evaluation compilation, one-time mailing list to drive attendance, website placement, and advertising in Patient Safety & Quality Healthcare magazine.
ABQAURP believes that ongoing continuing education in new research, identified problem areas in clinical practice, and areas of interest in the quality assurance, utilization review, risk management, and managed care fields is a worthy endeavor to pursue. Participants improve the efficiency, effectiveness, and quality of health care delivered to the patients to improve the overall clinical outcome. Plus, each activity encourages participants to put into practice knowledge learned and assess the impact. Innovative courses provide important updates and practical tools for all health care professionals. These activities ensure that participating health care professionals receive up-to-date information on the ever-changing health care environment.
For more information, please call Deborah Naser at (800) 998-6030, ext. 118.
2012 HCQM Board Certification
CMS goals include the delivery of seamless, high-quality care for Medicare beneficiaries, and to make patients and providers true partners in care decisions. Meeting these goals hinges on measuring quality improvement throughout the care continuum. Quality leaders offering clinical oversight should be: ”senior-level medical directors, board-certified physicians, licensed in the state in which the ACO operates, and physically present in that state.” Diplomates who have achieved certification in Health Care Quality and Management (HCQM) through ABQAURP have validated their knowledge and expertise in health care management.
Recognizing that there are no residencies or fellowships in medical management, ABQAURP established the Core Body of Knowledge and Certification in Health Care Quality and Management. The Core Body of Knowledge addresses topics including Transitions of Care, Quality Assurance, Utilization Review, Quality Improvement, Case Management, Risk Management, Patient Safety, and Peer Review.
The newly updated Core Body of Knowledge online and home study courses are integral steps on the path to becoming a Quality Leader by becoming HCQM Certified. Please call Barbara Chalmers at (800) 998-6030, extension 116, or visit our website (www.abqaurp.org) for more information.
Member Spotlight
A Glimpse into the Future of Healthcare Quality
As I got out of my rental car on a bleak November morning in Milford, Ohio, and faced the technology office building, I wondered why was I here and what was I doing? The nondescript business office of DNV (www.dnvaccreditation.com) was where I would commence my training and learning about a system that would change the way that quality healthcare could, and should be, practiced. At the end of two weeks of intense training, soul-searching, and introspection, the 18 motivated, curious, and dedicated members of my cohort became inculcated and indoctrinated as auditors for National Integrated Accredited Healthcare Organization (NIAHO) standards and certified as ISO 9001 reviewers.
This training demonstrated to me a fresh new approach that 30 years of medical and surgical practice experience, business experience gained through my Masters in Medical Management training from ACPE and the University of Southern California, and my quality training gleaned from the American Board of Quality Assurance and Utilization Review Physicians lacked. DNV and its policies actually are in the process of changing the culture of hospitals and other healthcare organizations; emphasizing a patient-customer focus and a patient safety agenda.
The first week, our cohort of clinical, generalists, and life and safety auditors comprised of physicians, nurses, medical support executives, and material management personnel were educated as to the NIAHO standards and processes. DNV, an internationally recognized risk management company, has modified the CMS Conditions of Participation to be more patient focused and quality based and have inserted them into the ISO 9001(International Standards Organization), as the backbone.
The NIAHO accreditation process has been chosen by CMS as a worthy competitor to the Joint Commission. Serious quality, consistency, and continual improvement in the process and the system approach to health care is enhanced by the meticulous and assiduous application of the ISO 9001 standard that has been used to review quality in the automobile and manufacturing sectors for years.
Combining the NIAHO accreditation review with ISO 9001 compliance squarely puts the onus of quality management accountability on the organization, where serious commitment of the organization towards a patient focus involving the leadership and all of the supporting personnel, including the physicians, is recognized.
The unique approach of the analysis involves converting the medical organization departments from a silo mentality and forces them to analyze global procedures in a complete systematic integration. Poor patient or process outcome may actually represent a process breakdown rather than be attributable to a single, blamable, individual event. By encouraging the organization to understand its nonconformances in a nonjudgmental manner and to allow it to be continually improved and part of the mechanism for change encourages the organization’s culture change and buy-in.
For years, all of the stakeholders in the health care system have acknowledged that the system is broken and have been begging for a new course of action. DNV, using NIAHO and ISO 9001 standards and principles, presents a logical common sense approach for customer (patient) focused process and system review with the ability for continual improvement.
Based on my experience of the last several weeks, I look forward to participating in the evolution of hospital and medical culture change, providing more patient safety and healthcare accountability and responsibility in the future.
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NEW for 2012 – Student Membership
We understand that the path to excellence starts very early on in the health care arena and that is why we have launched the ABQAURP Student Membership. Those enrolled in graduate or undergraduate courses are the future of health care, and we are committed to your excellence in the field. Get involved with your career future today by committing yourself not only to excellence in your degree pursuit, but to your craft as well.
Become more than just a professional in your field, become a LEADER! Students receive membership benefits at a special rate of $29 per year. For more information, visit: www.abqaurp.org/student-membership.asp.
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