Quality Control and Accreditation
Core Competencies and Functions
Following the proposals for the Community Clinic and the GAH as well as their structure, there are various functions and competencies that relate to their mandate. They are defined as follows.
The design, development and implementation of an integrated care that is centered on the patient. The main goal for this core competency is to build the capacity for the measurement, management and improvement of the quality of care and the efficiency in the delivery of care across the continuum of care (American Hospital Association, 2011).
The continued organizational-wide collection and use of data to aid in the improvement of the performance. The goal for this core competency is to implement an informatics system that not only delivers the patient information at the point of care but also facilitates the review of performance during the team meetings at the clinical and administrative level (American Hospital Association, 2011).
The development and implementation of a leadership and governance system that is transparent and accountable. The objective of the organization is to engage the stakeholders in the management and governance activities in light of their role as organizational partners (American Hospital Association, 2011).
Engage in the strategic planning to ensure the future viability of the organization despite the dynamic environment in which it operates. The organizational goal for this core competency is to develop a time-bound strategic plan for a value-based delivery of care (American Hospital Association, 2011).
Ensuring collaboration both internally and externally. The organizational goal for this core competency is to create partnerships with other health institutions within the community (American Hospital Association, 2011).
Control Methods
It is important for the organization to measure the rate at which the goals and objectives attached to each of the core competencies are being achieved.
Competencies for JCAHO Accreditation
The management and the staff at the hospital will require exhibiting certain major competencies. The accreditation process is aimed at ensuring that the hospitals employ standardized indicators that measure that both the performance and the competency of the practitioners and the demand for higher quality care by the consumers (Smallwood, 2016). There are six competencies that the staff and the management at the hospital should exhibit.
Patient care: this competency requires that the practitioners offer appropriate, compassionate and effective care to the patients. The competency applies to the health promotion activities, prevention services, and the treatment of illnesses and during palliative care (Smallwood, 2016).
Clinical and medical knowledge: this is a requirement for the practitioners to not only possess but also demonstrate knowledge in clinical, social, and biomedical sciences during the delivery of care and the education of other professionals (Smallwood, 2016).
Practice-based improvement and learning: this competency is a requirement to demonstrate that the practitioners in the hospital utilize both scientific methods and evidence during investigations, evaluation, and the improvement of the practices that characterize patient care (Smallwood, 2016).
Communication and Interpersonal Skills: This entails the demonstration of the ability to establish and sustain a professional relationship with other colleagues in the medical and nonmedical staff, the patients, the family members of the patients and the other employees in the hospital (Smallwood, 2016).
Professionalism: This requirement is a prerequisite for JCAHO accreditation as it requires the management and the practitioners at the hospital to embody a commitment to ethics, responsibility, continuous professional development, sensitivity to diversity, and a positive attitude towards the medical profession, the patients, and the community as a whole as demonstrated through their behavior (Smallwood, 2016).
Systems-based practice: this major competency is a requirement on the practitioners and the management at the hospital to demonstrate the knowledge of the systems and contexts that characterize the delivery of health care and the application of the said knowledge in the improvement of healthcare (Smallwood, 2016).
Information Technology Systems
Component Recommendations
Communication within an organization is vital for its performance. This is more the case in health care where the practitioners rely on the input of their colleagues during decision-making. The incorporation of information technology systems helps reduce the costs of healthcare as well as enhance the speedy transmission of information to the point of need. To enable these benefits, and in consideration of the organization structure of the proposed project, the following are the major components of an information technology system that enables the communication within the organization and between the various units in the organization.
One of the components is a patient management system in which patient management activities such as appointment and scheduling, the registration of patients, information on admission, discharge, and the transfer of patients from one ward to another or to other hospitals. Another component is the patient billing and account receivable. This component deals with the generation and management of patient bills, the payment of bills, management of collection and refunds, the reconciliation of accounts, and generation of billing reports (Wager, Lee & Glaser, 2013). A component that is even more important is the clinical information system; a system that contains information on physician and nurse documentation (Wager, Lee & Glaser, 2013). Information on this system should be provided on all points of use in the delivery of care to aid in medical decision-making. Other major components include the laboratory information system, pharmacy information system, and executive information system (Wager, Lee & Glaser, 2013).
System Requirements
The use of electronic system in the storage and transfer of information in healthcare organizations is subject to breaches that could reveal confidential patient information (Centers for Medicare and Medicaid Services, 2013). The HIPAA Act of 1996 places standards regarding the use of electronic systems in the transfer and storage of healthcare data (Centers for Medicare and Medicaid Services, 2013). These standards have been reinforced by the Affordable Care Act of 2010 because of the increased reliance on electronic exchange of data (Centers for Medicare and Medicaid Services, 2013). Some of the system requirements to enable the compliance with the ethical requirements outlined under HIPAA include a standard Health Plan Identifier, the implementation of standard operating procedures for the electronic transfer of funds (Centers for Medicare and Medicaid Services, 2013).
References
American Hospital Association. (2011). Hospitals and care systems of the future. Retrieved from http://www.aha.org/content/11/hospitals-care-systems-of-future.pdf
Centers for Medicare and Medicaid Services. (2013). HIPAA – General Information. Retrieved from https://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative- Simplification/HIPAAGenInfo/index.html?redirect=/HIPAAGenInfo/
Ho, K. and Pakes, A. (2014). Physician incentives introduced by the new Accountable Care Organizations could reduce costs of care by 5 percent. Retrieved from http://eprints.lse.ac.uk/58952/1/__lse.ac.uk_storage_LIBRARY_Secondary_libfile_share d_repository_Content_American%20Politics%20and%20Policy_2014_June_blogs.lse.ac. uk- Physician_incentives_introduced_by_the_new_Accountable_Care_Organizations_could_ reduce_costs_of_care_.pdf
Smallwood, P. (2016). Using the JCAHO's six competencies to evaluate MD performance. Retrieved from http://www.hcpro.com/HOM-62362-3615/Using-the-JCAHOs-six- competencies-to-evaluate-MD-performance.html
Wager, K. A., Lee, F. W., & Glaser, J. P. (2013). Health care information systems: A practical approach for health care management. San Francisco. Jossey-Bass..
