Quality Assurance Interview

Quality Assurance Interview

Question One: Regulations and Quality Standards a Healthcare Manager Must Maintain and the Importance of the CQI/Process Improvement

As the health care manager, I will adopt regulations and quality standards as outlined by the CMS, NCQA, AHRQ, and The Joint Commission. Centers for Medicare and Medicaid Services (CMS) established standards and regulations that guide healthcare organizations to qualify for CMS-related programs. Maintaining the CMS regulations will enable the facility to meet the standards required to qualify for Medicaid, Medicare, and other programs provided by CMS. Further, the National Committee for Quality Assurance (NCQA) sets up accreditation standards for performance and quality, and the Agency for Healthcare Research and Quality (AHRQ) is a federal agency responsible for the maintenance of safety, quality, and the effectiveness of care services provided to United States citizens. The AHRQ also provides guidelines based on research evidence to help healthcare organizations improve the quality of care. Finally, the Joint Commission provides accreditation and certification based on set standards for the use of digital systems. Continuous quality improvement (CQI)/process improvement is important in a healthcare workplace as it is closely associated with improved efficiency in the provision of quality and safe healthcare services and improves patient outcomes (Hill et al., 2020). CQI can also help healthcare organizations to remain up-to-date with federal regulations.

Question Two: The Impacts of External Regulations and Quality Standards

External regulations and quality standards act as a framework for a healthcare facility such as a hospital to achieve the expected service standards as well as deliver high-quality healthcare services. These external standards and regulations are also necessary for accreditation. Achieving such accreditations on quality and safety standards from external regulators protects the facility against fines related to a lack of meeting the safety and quality standards. The provision of quality and safe healthcare services, abiding by external regulations and quality standards, and achieving external accreditation build trust in the facility’s services. External accreditation improves the hospital’s reputation. This, in turn, gives the hospital a competitive advantage within the healthcare market. Being highly competitive positively impacts the hospital’s performance, including financial performance. As the facility’s manager, I will ensure that my department remains compliant with external regulations and quality standards by organizing training exercises for the staff within the department on the requirements and expectations of the external regulations and quality standards.

Question Three: The CQI Process

CQI is important for the quality of direct patient care for several reasons. Firstly, CQI supports the implementation of evidence-based patient care plans with defined monitoring and evaluation criteria. Through such monitoring and evaluation measures, healthcare professionals can identify the achievements made through the current treatment plan for the direct client and the opportunities available for further care and recovery. CQI can also help identify the sources of delays or errors during the delivery of care to the direct client. A good CQI process can help the healthcare organization continuously improve the quality of services delivered. It also helps the organization to take advantage of current research evidence to improve its operations. Therefore, it is an important tool for ensuring patient safety, quality care, and improving patient health outcomes (Elbeddini et al., 2021). As the healthcare manager, I will ensure continual improvements in quality are being made by setting up quality goals per the existing regulations and standards and adopting the Plan-Do-Study-Act (PDSA) cycle within the facility and department.

Question Four: Approaches for Ensuring the Aptitude and Competency of Clinical and Non-Clinical Staff Members and Ensuring the Team has Proper Resources to Deliver High-Quality Care

Health facilities and agencies ensure the aptitude and competency of their clinical and non-clinical staff members by ensuring that each staff member clearly understands their roles within the organization. They provide clear role descriptions and the competency requirements for each role. Health facilities and agencies also ensure the aptitude and competency of their clinical and non-clinical staff members through continuous and regular evaluation of the staff’s performance against set measures and indicators. The health facilities also continuously train their staff as needed to update their skills and knowledge. Additionally, health facilities and agencies employ various tactics to motivate the staff to develop professionally, such as providing career development sponsorships and implementing quality and safety standards within the workplace. As the manager, I will ensure that my team has the proper resources to consistently deliver high-quality care by first ensuring the facility is sufficiently staffed. The next thing is to implement an electronic resource management system, partner with dependable suppliers, and create an environment where the staff can deliver quality care.

Question Five: Technology’s Role in Direct Patient Care Quality and Safety

Technology plays a critical role in delivering quality and safe care in direct patient care. Technologies such as Electronic Health Records (EHRs) can help health providers access, share, and review patient information, including current medications, health history, and lab results, to provide timely and safe care (Dubovitskaya et al., 2020).  EHRs also enhance the efficiency of the medication process, therefore, reducing and preventing errors, especially medication errors during care delivery, which improves the safety and quality of care. Healthcare professionals can also use technologies such as telehealth to provide timely patient care remotely and collaboratively and support continuous monitoring of the patient. As the manager, I would apply both Excel and Tableau as tools for analyzing data and creating visualizations of achievements and expected goals to be achieved. The visualizations will motivate the staff to either maintain the progress achieved so far or attempt to achieve the projected achievements as per the visualizations.

References

Dubovitskaya, A., Baig, F., Xu, Z., Shukla, R., Zambani, P. S., Swaminathan, A., Jahangir, M. M., Chowdhry, K., Lachhani, R., Idnani, N., Schumacher, M., Aberer, K., Stoller, S. D., Ryu, S., & Wang, F. (2020). ACTION-EHR: Patient-Centric Blockchain-Based Electronic Health Record Data Management for Cancer Care. Journal of Medical Internet Research, 22(8), e13598. https://doi.org/10.2196/13598

Elbeddini, A., Almasalkhi, S., Prabaharan, T., Tran, C., Gazarin, M., & Elshahawi, A. (2021). Avoiding a Med-Wreck: a structured medication reconciliation framework and standardized auditing tool utilized to optimize patient safety and reallocate hospital resources. Journal of Pharmaceutical Policy and Practice, 14(1), 1–10. https://doi.org/10.1186/S40545-021-00296-W/TABLES/4

Hill, J. E., Stephani, A. M., Sapple, P., & Clegg, A. J. (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: A systematic review. Implementation Science, 15(1), 1–14. https://doi.org/10.1186/S13012-020-0975-2/TABLES/5

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

Exam

Wk 4 Summative Assessment: Quality Assurance Interview (Due Monday)
Wk 4 Summative Assessment: Quality Assurance Interview (Due Monday)
Exam Content

Scenario
You are being considered for a healthcare manager position at a local healthcare facility. The job description for this position emphasizes the need for quality assurance and improvement through tracking outcomes and analyzing the data. The first step in the interview process is to provide written answers to a series of questions sent to you by the facility’s HR department. The questions focus primarily on describing the process of tracking outcomes and improving quality and safety.

Quality Assurance Interview

Preparation
Continuous quality improvement (CQI) is the idea of constantly improving performance and outcomes. CQI is a foundational principle in the delivery of health care. Having high quality and safety ratings is important to a healthcare organization for these reasons:

The organization’s success can be advertised to the public to gain the trust of the community.
Delivering consistent, high-quality care keeps the organization in compliance with regulations, which are Conditions for Coverage and Participation set forth by the Centers for Medicare/Medicaid (CMS) and state health departments.
Having high-quality ratings helps negotiate with payers to secure higher payments. Payers are increasingly tying payments to how the provider has performed with quality metrics, which are standards set forth by various agencies, including the National Council for Quality Assurance (NCQA) and the Agency for Healthcare Research & Quality (AHRQ).

Do the following as you prepare to answer the interview questions:

Review the Conditions for Coverage (CFCs) & Conditions of Participation (CoPs), a list of federal CMS regulations for health care facilities (e.g., nursing homes, surgical centers, etc.) and operations (e.g., home health agencies, hospice agencies, etc.).
Review “QI: Getting Inside Quality Improvement Mindset” from NCQA, which provides tips on how to gain a continuous quality improvement mindset.
Visit The Joint Commission, which accredits and certifies hospitals and health facilities, and read about their accreditation process and quality standards.
Many businesspeople use Microsoft Excel to plan, track, filter, and analyze data in their work environment. For an introduction or refresher on using Excel at work, consider watching the LinkedIn Learning videos located in this week’s Learning Activities folder: “Excel Essential Training” and “Excel Quick Tips.”

Assessment Deliverable
Write a response for the hiring department that addresses the following questions in 175–350 words for each question:

Describe some of the regulations and quality standards (e.g., CMS, NCQA, AHRQ, The Joint Commission) that you must maintain as a health care manager. Why is CQI/process improvement so important in a health care workplace?
What are the impacts on a health care facility (e.g., hospital, doctor’s office) of external regulations and quality standards (e.g., CMS regulations, state regulations, The Joint Commission)? As a manager, how would you ensure that your department is compliant with external regulations and quality standards?
Why is CQI process so important for quality of direct patient care? What are the outcomes on patient care if the health care organization does or does not have a good CQI process in place? As a health care manager, how would you ensure that continual improvements in quality are being made?
What are approaches that health facilities and agencies take to ensure the aptitude and competency of their clinical and non-clinical staff members? As a manager, what are some things you can do to ensure that your team has the proper resources to consistently deliver high quality care?
What is the role of technology in direct patient care quality and safety? As a manager, how could you use technology (e.g., Microsoft Excel, Tableu) to help your department stay on track?

Format your paper according to APA guidelines.