Q:
What is the role of Colorado Health Networks’ Quality Improvement Department?
A: Colorado Health Networks’ Quality Improvement Department is committed
to the tenets of continuous quality improvement. The outcome management
system that has been developed consists of a comprehensive set of performance
measures that are continuously monitored and refined. These performance
measures include such things as consumers’ satisfaction with the services
they receive, consumers’ access to care, readmission rates, and a variety
of other quality of care indicators.
In addition to monitoring indicators, the Quality Improvement Department
develops studies and performs research at the direction of the Quality
Improvement Steering Committee (QISC). Membership and the role of the
QISC are described in more detail below.
Finally, Colorado Health Networks has an internal quality improvement
committee that is facilitated by the Quality Improvement Department. This
committee identifies opportunities for improvement at the Colorado Health
Networks Service Center and oversees the implementation of solutions.
Q: What is PDCA?
A:
The PDCA (Plan, Do, Check, Act) process improvement model is the underpinning
of Colorado Health Networks’ continuous quality improvement efforts. It
is the basis for interventions aimed at correcting problems and improving
the efficiency of processes, as indicated below.
- Plan
- Identify and select the area of concentration. Define the problem.
Isolate the most probable cause. Identify the potential corrections
and select the most appropriate solution.
- Do
- Apply the correction.
- Check
- Compare the new process with the old process and evaluate the changes.
- Act
- Maintain the gain. Repeat the PDCA process, if necessary.
Q:
Who oversees Colorado Health Networks’ quality improvement program?
A: The Board of Managers for each of the partnerships that comprise Colorado
Health Networks assigns authority for the review and approval of the program
description, program implementation and direct oversight of the quality
improvement program to the Quality Improvement Steering Committee (QISC).
The QISC reviews all quality reports and monitors the performance of the
quality improvement program on a monthly basis. The QISC recommends policy
decisions, reviews and evaluates results of quality improvement activities
and quality indicators, institutes needed actions and ensures that appropriate
follow-up occurs.
Implemented in September 1995, the QISC has held regularly scheduled meetings
since that time. The committee meets monthly under the chairmanship of
the Director of Quality Management. There are currently 20 committee members
including practitioners, consumer representatives, CMHC Quality Improvement
representatives and Colorado Health Networks’ staff.
While the QISC serves as the committee that oversees quality improvement
activities, Colorado Health Networks maintains an integrated committee
approach. This approach includes the QISC, the Clinical Advisory/Utilization
Management Committee, the Member Outreach Advisory Board and related subcommittees.
