Health Care Management (Ambulatory Care Admin)
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week_2_hca_346_1.pptxHCA 346 Ambulatory Care administration
Keep structure simple.
No need for layers of committees or layer of employees
Ambulatory programs benefit from being small
Employees & physicians must play many roles
Pick the right people
Tie your quality strategy to your mission, vision, and values
Susan G. Komen for the Cure
If mission, vision, and values are nonexistent, engage a committee to create your purpose, direction, and beliefs
Table 2.1
Chapter 2: Creating a structure for quality & safety
To meet MCR, licensing, and other guidelines, most ambulatory clinics should have a governing body that takes on full legal & fiduciary responsibility for policies that govern the program’s operation and to ensure that policies are in implemented & administered so that high quality & cost-effective care is delivered in a safe environment
Table 2.2
Creating a structure for quality & safety
A physician or group of physicians may own the ambulatory service program, but identification of someone to serve as an administrator or manager is crucial for success
Governing body must clearly communicate expectations and updates the expectations to match changing environments
Expectations should include: measurement results from physicians, financial viability & profitability; clinical & quality measures, and growth & business development
Figure 2.1 & Table 3.3
To keep the number of committees low, combine the Medical Executive Committee and the quality committees.
Leader selection
When an outpatient program allows physicians and nonphysicians practice within the services provided, the guidelines for privileges and membership need clearly outlined.
Physician must agree to directly supervise these non-physician providers & that all will work in the scope of their licenses
Sanctions for practicing outside limits
Nurses must not complete tasks outside the scope of their license
The defined scope and services of the program defines what can and cant be done in each facility where the practitioner will practice
Health professionals
Numerous ways to set up quality studies, reporting, and outcome measures
In order to set up,
First, define scope
Then define what categories require ongoing measures, preventative strategies, and innovation opportunities exist
Finally, implement strategies
Categories for quality programs include:
Preventative quality efforts
Medication safety and practices
Utilization management of resources
Infection prevention
Surgical and procedural case review
Clinical documentation
Medical staff processes and peer review
Competency, skills training, and knowledge based assessments
See complete list on pg. 31
Quality program topics
Staying true to your mission, vision, and values
Ex: Dolly Parton
Important to provide easily readable and comprehendible documents for your staff and patients
Written documents should reflect the organization’s mission, vision, and values. If written correctly, policies and procedures will help improve, sustain, or revamp processes within an organization.
Procedures represent a realization of policy & will vary over time
Policies replicate the standards governing the execution of the facility’s processes
Plans offer a series of steps. Attached to goals and define what the organization is to accomplish
Chapter 4: policies, procedures & plans
Users of documents include clinical and nonclinical staff, and customers of services
Make widely accessible
Don’t reinvent the wheel. Use other resources to create documentation
Users of policies & plans
When outpatient service is accredited, licenses, or given status by Medicare, document review is required
Evaluate policies, procedures, and plans yearly if possible
If documents are kept electronically, allowing easy access for staff and physicians, make sure you have at least one hard copy available
Assess any written document against a set base of criteria such as:
Application to your mission, vision, & values
Necessary to meet state, federal, or regulatory requirements
Need to enhance competency
Requirement to define quality and safety for the organization
Ability to guide employees and physicians on how to care for patients
Documents to create and have on hand
Read chapters 2 & 4 with this lesson and complete the Discussion Board homework assignment
