In acute care hospitals today, the safety and quality officers are likely to be very well versed in the recently enacted Patient Protection and Affordable Care Act (PPACA). In fact, some who are newly appointed in this role may very well owe their job to it. That is because this is the law which sets forth the requirement that Medicare and Medicaid care providers have a corporate compliance program in place. The idea is to help raise the bar when it comes to the transparency and quality of care that both groups get from their caregivers. In support of this consideration, a recent editorial from the New England Journal of Medicine, included the Economist Paul Ginsburg, president of the Center for Studying Health System Change, who said that the CMS did right to “set the bar relatively high” for Medicare accountable care.
As part of this discussion, you tend to see the word “quality” a lot. In order to qualify as an ACO and get reimbursed, organizations will need to improve it and then prove it. The only concern here is what does the word “quality” actually mean and what kind of reporting will they expect in order to be reimbursed? Recently, Patient Safety and Quality Healthcare published an article which offers a little more detail on the topic. As you might guess, the quality equation has a lot to do with the 28 “never” events established by the National Quality Forum (NQF) back in 2002. A list that most hospital executives are likely to have indelibly committed to their memory, these are all of things that should never be allowed to happen in a hospital. Infections, falls, incorrect delivery of care and medication related errors are a few of the core issues that the CMS expects hospitals to reduce. The question is, how? Establishing the guidelines for what it takes to be an ACO and holding back related reimbursements and are good incentives, but offer no prescription as to how to head off never events in the first place.
Hospitals need to have a clear competency management strategy in place that considers the education, demonstration and evaluation of all of their healthcare staff. This involves not only the use of an LMS to deliver compliance courses, but also electronic checklists to make sure that the education can be applied in practice. In addition, people managers should be able to call up the competency picture of any of their staff members at a moments notice with an electronic portfolio. This information will help them to form actionable tasks so they may stay ahead of any potential safety or compliance issues before they happen.
If you are considering being part of an ACO, have a careful look at your competency plan. If you are challenged when it comes to finding a competency tool which can manage it all from one place, contact Decision Critical and ask about our electronic portfolio and reporting tools.