Strategies for Creating a New Quality Process You Can Believe In

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By Carolyn J. Humphrey, R.N., M.S., F.A.A.N. 
CJ Humphrey Associates

Strategies for Exception Based Quality Review Home HealthOrganizational and staff acceptance of quality review by exception are critical for a successful transition, as well as realizing the savings and increased productivity that go with it.

Your staff may perceive mandates to change their established processes and forms as not respecting their work and performance. To be clear that this isn’t the case, review the general benefits outlined in the previous post, and share with them why it’s beneficial to work with an automated system rather than clinging to outdated processes.

The reasons include:

  • Specialized experience and expertise
  • Reduced startup time and transition
  • Proof of performance
  • Ongoing technical support and access to upgrades
  • Reduced stress on the agency’s IT department

Foundational to using an exception-based review process is trust that the electronic medical record solution includes reliable functionality, standard language, evidence-based clinical content and support for regulatory compliance. Establish these areas with the vendor before moving forward and then look to its guidance to assist with transitioning the process into the agency.

Research has shown that once an exception-based quality process is automated within a user friendly system, work can be dramatically streamlined. To fully realize the benefits of these streamlined processes, clearly identify increased efficiency and cost savings as compared to current methods. Additionally, it’s important to understand the overall benefits and costs for the agency.

It’s not always necessary to eliminate staff to realize the benefits of efficiency improvements. Quality reviewers are an experienced and valuable asset to the agency; however, you haven’t had the opportunity to fully use their expertise if they’re “heads down” with tedious chart reviews every day. Here are a few suggested strategies for using these clinicians for a “higher purpose”:

  • Dig deeper into the patient records that need the most attention
  • Develop data-driven reports for your agency’s planning with other providers
  • Collaborate with clinical managers and education staff to identify and create content for problematic areas
  • Become the chair or member on new and ongoing committees
  • Assist as preceptor for new clinicians
  • Mentor experienced clinicians who need review and reinforcement

Adopting exception-based quality review can provide changes that positively affect the entire organization. Understanding the approach, the organizational benefits and the strategies for success significantly contribute to reaching the Triple Aim of improving quality, assuring continuing care management and improving cost effectiveness.

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