Kaiser Permanente: Inpatient Quality Management
Inpatient Quality Management
Marian R. Eckardt
September 2, 2014
MGMT 570- Organizational Performance Improvement
Steven Gabriel
TABLE OF CONTENTS
•
•
•
•
•
•
•
•
•
Kaiser Permanente Baldwin Park……………………………3
Functional Scope………………………………………………4
Process of care measures…………………………………….5
Inpatient Quality Management Philosophy………………….6
Data Collection and Analyses…………………………….7-12
Inpatient Quality Management Flow Chart……………..13-15
Performance Scorecard………………………………………16
Observations and Recommendations…………………..17-18
References…………………………………………………….19
•
•
Kaiser Permanente is an integrated managed care group based in Oakland, California.
It provides care throughout eight regions in the United States and is the single largest provider of managed health care in the country (Kaiser Permanente). In Southern …show more content…
California alone, there are 14 medical centers and approximately 143 medical offices
(Physician Careers, 2010).
Health plan membership in the area reached up to 3,594,848 according to the research conducted in 2012 (Fast Facts about Kaiser Permanente, 2013).
One of the medical centers is the Baldwin Park Medical Center. Baldwin Park Medical
Center is part of an integrated health care delivery system serving the community and over
244,000 Health Plan members in the San Gabriel Valley. In keeping with the company program of providing safe, accessible, high-quality, and culturally sensitive health care to all members, the hospital provides a full array of health care services, including
primary, specialty, surgical, obstetrical, and emergency services (Baldwin Park, 2010).
Approved by:
Nantiya Chandravirojkul, Director
Functional Scope
•
•
•
•
Inpatient Quality Management Focus
Inpatient Quality Management functional scope
Inpatient Quality Management Concerns
Inpatient Quality Management Implementation
Process
Care Measures
Kaiser Permanente prides itself in delivering care that that demonstrates empathy and genuine concern along with quality and patient safety. These 3 core measures are followed on a daily basis:
• Competence
• Courtesy
• Compassion
"The very first requirement in a hospital is that it should do the sick no harm.“
- Florence Nightingale
What is Inpatient Quality Management?
The Kaiser Permanente Baldwin Park medical center prides itself in the ethics of quality and a functioning medical center.
Maintaining a patient centric care builds upon the following core principles to provide the best patient care for our members and the community:
•
•
•
•
Timeliness of care
Long view of care
Appropriateness of care
Communication and collaboration
Data Collection
Several accredited organizations are involved in providing score cards and reports for health care organizations. Part of the data collection processes will greatly involve the following:
• National Committee for Quality Assurance (NCQA) – focuses on improving and measuring the quality of health care • Joint Commission – accredits and certifies that an organization meets quality standards
• Hospital Consumer Assessment of HealthCare Providers and Systems (HCAHPS) – measures quality
Data Collection for Quality
•
For quality and patient satisfaction, the best resources is the Hospital Consumer Assessment of
HealthCare Providers and Systems (HCAHPS). Based on the chart shown below, Kaiser Permanente
Baldwin Park has repeatedly exceeded the California overall hospital rating in in different areas of patient’s perspectives in their hospital care. This was from the latest survey results that were taken from October 2012 to September 2013.
Data Collection cont.…
• For employees , Kaiser Permanente created a yearly survey to score specific departments in the hospitals. This is administered by a third party to perform metrics results for several key areas in the department involving workplace injury, cultural diversity, quality, attendance, work/life balance and workforce effectiveness. Based on the results, management is able to view areas of improvements as well as the department’s strength and weaknesses. High Performance Questionnaire
A department survey similar to Likert was handed out to 6 employees on a scale from 0-5 ranging from not applicable, strongly disagree, disagree, partly agree, agree and strongly agree based on the following categories:
• Clinical Quality (Reduce readmission rates)
• Inpatient Care Experience (Overall rating of hospital)
SURVEY RESULTS
•
Discharge Phone Calls Completed Performance Year-to-Date 89.1%
•
Minimum Target: 60% | Maximum Target: 80%
•
Follow up Visits Scheduled Performance Year-to-Date 78.6%
•
Minimum Target: 60% | Maximum Target: 80%
CLINICAL QUALITY
R
E
S
U
L
T
S
YTD
Maximum
Minimum
72
73
74
75
76
PERCENTAGE
77
78
79
80
81
82
INPATIENT CARE EXPERIENCE
Inpatient Care Experience
YTD: 78.2%
Minimum Target: 75% | Maximum Target: 81%
Inpatient Care Experience p e r c e n t a g e
82
80
Inpatient Care Experience
78
76
74
72
TARGET
Inpatient Quality Management flowchart (Full process)
Admit to Inpatient workflow
(current process)
Admit to Inpatient (suggested process)
PERFORMANCE SCORE CARD
• The chart shown below is a scorecard based on Emergency
Room to Inpatient performance on complete and accurate admissions Scorecard
P
e r f o r m a n c e 100
99
98
97
EMERGENCY
INPATIENT
96
95
94
93
92
20-Sep
27-Sep
TARGET
Results per week
YTD
OBSERVATIONS
• Majority of the patient’s complaints are the wait times in the
ER, this should be addressed by either informing the patient upon check-in or having a board visible to patients in the waiting room on approximate wait times.
• Many of the patients are unprepared to pay larger amounts of co-pays hospitals should set up some time of payment plan to make ER visit affordable. This also applies to a daily inpatient day rate. Many do not go to the ER for lack of funds. • Staffing during holidays is also important. Leadership should make sure there are adequate staff members to treat the influx of patients.
RECOMMENDATIONS
• Triage wait time should be less than 2 hours even during peak times
• Explain to irate patients that staff is doing the best they can to accommodate patients and that the more emergent ones are being treated first
• Inform patients of approximate wait time so the non-emergent patients can decide if they want to wait in the ER or make an appointment for follow-up the next day
• Money (copays) should be the least of worries when seeing patients in the ER
• Customer service is still #1
• Always follow-up with a phone call or survey after ER or Inpatient visit
References
•
•
•
•
•
•
•
Fast Facts about Kaiser Permanente. (2013). Retrieved from kaiserpermanente.org: http://share.kaiserpermanente.org/article/fast-facts-about-kaiser-permanente/ Baldwin Park. (2010). Retrieved 2013, from physiciancareers.kp.org: http:// physiciancareers.kp.org/scal/location-baldwin-park.html Kaiser Permanente Nursing Pathways. (2014). Retrieved from http://kpnursing.org/quality/index.html
MEASURING CARE QUALITY IN OUR HOSPITALS. (). Retrieved from https://healthy.kaiserpermanente.org/static/health/pdfs/quality_and_safety/sca/sca_quality_BaldwinPar k.pdf
About NCQA. (2014). Retrieved from http://www.ncqa.org/HomePage.aspx
The Joint Commission. (2014). Retrieved from http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx Towers Watson. (2013). Explore the Possibilities [PowerPoint slides]. Retrieved from
http://www.towerswatson.com/assets/17748/Linking-Employee-Survey-Results-to-Key-Business.pdf.
Marian R. Eckardt
September 2, 2014
MGMT 570- Organizational Performance Improvement
Steven Gabriel
TABLE OF CONTENTS
•
•
•
•
•
•
•
•
•
Kaiser Permanente Baldwin Park……………………………3
Functional Scope………………………………………………4
Process of care measures…………………………………….5
Inpatient Quality Management Philosophy………………….6
Data Collection and Analyses…………………………….7-12
Inpatient Quality Management Flow Chart……………..13-15
Performance Scorecard………………………………………16
Observations and Recommendations…………………..17-18
References…………………………………………………….19
•
•
Kaiser Permanente is an integrated managed care group based in Oakland, California.
It provides care throughout eight regions in the United States and is the single largest provider of managed health care in the country (Kaiser Permanente). In Southern …show more content…
California alone, there are 14 medical centers and approximately 143 medical offices
(Physician Careers, 2010).
Health plan membership in the area reached up to 3,594,848 according to the research conducted in 2012 (Fast Facts about Kaiser Permanente, 2013).
One of the medical centers is the Baldwin Park Medical Center. Baldwin Park Medical
Center is part of an integrated health care delivery system serving the community and over
244,000 Health Plan members in the San Gabriel Valley. In keeping with the company program of providing safe, accessible, high-quality, and culturally sensitive health care to all members, the hospital provides a full array of health care services, including
primary, specialty, surgical, obstetrical, and emergency services (Baldwin Park, 2010).
Approved by:
Nantiya Chandravirojkul, Director
Functional Scope
•
•
•
•
Inpatient Quality Management Focus
Inpatient Quality Management functional scope
Inpatient Quality Management Concerns
Inpatient Quality Management Implementation
Process
Care Measures
Kaiser Permanente prides itself in delivering care that that demonstrates empathy and genuine concern along with quality and patient safety. These 3 core measures are followed on a daily basis:
• Competence
• Courtesy
• Compassion
"The very first requirement in a hospital is that it should do the sick no harm.“
- Florence Nightingale
What is Inpatient Quality Management?
The Kaiser Permanente Baldwin Park medical center prides itself in the ethics of quality and a functioning medical center.
Maintaining a patient centric care builds upon the following core principles to provide the best patient care for our members and the community:
•
•
•
•
Timeliness of care
Long view of care
Appropriateness of care
Communication and collaboration
Data Collection
Several accredited organizations are involved in providing score cards and reports for health care organizations. Part of the data collection processes will greatly involve the following:
• National Committee for Quality Assurance (NCQA) – focuses on improving and measuring the quality of health care • Joint Commission – accredits and certifies that an organization meets quality standards
• Hospital Consumer Assessment of HealthCare Providers and Systems (HCAHPS) – measures quality
Data Collection for Quality
•
For quality and patient satisfaction, the best resources is the Hospital Consumer Assessment of
HealthCare Providers and Systems (HCAHPS). Based on the chart shown below, Kaiser Permanente
Baldwin Park has repeatedly exceeded the California overall hospital rating in in different areas of patient’s perspectives in their hospital care. This was from the latest survey results that were taken from October 2012 to September 2013.
Data Collection cont.…
• For employees , Kaiser Permanente created a yearly survey to score specific departments in the hospitals. This is administered by a third party to perform metrics results for several key areas in the department involving workplace injury, cultural diversity, quality, attendance, work/life balance and workforce effectiveness. Based on the results, management is able to view areas of improvements as well as the department’s strength and weaknesses. High Performance Questionnaire
A department survey similar to Likert was handed out to 6 employees on a scale from 0-5 ranging from not applicable, strongly disagree, disagree, partly agree, agree and strongly agree based on the following categories:
• Clinical Quality (Reduce readmission rates)
• Inpatient Care Experience (Overall rating of hospital)
SURVEY RESULTS
•
Discharge Phone Calls Completed Performance Year-to-Date 89.1%
•
Minimum Target: 60% | Maximum Target: 80%
•
Follow up Visits Scheduled Performance Year-to-Date 78.6%
•
Minimum Target: 60% | Maximum Target: 80%
CLINICAL QUALITY
R
E
S
U
L
T
S
YTD
Maximum
Minimum
72
73
74
75
76
PERCENTAGE
77
78
79
80
81
82
INPATIENT CARE EXPERIENCE
Inpatient Care Experience
YTD: 78.2%
Minimum Target: 75% | Maximum Target: 81%
Inpatient Care Experience p e r c e n t a g e
82
80
Inpatient Care Experience
78
76
74
72
TARGET
Inpatient Quality Management flowchart (Full process)
Admit to Inpatient workflow
(current process)
Admit to Inpatient (suggested process)
PERFORMANCE SCORE CARD
• The chart shown below is a scorecard based on Emergency
Room to Inpatient performance on complete and accurate admissions Scorecard
P
e r f o r m a n c e 100
99
98
97
EMERGENCY
INPATIENT
96
95
94
93
92
20-Sep
27-Sep
TARGET
Results per week
YTD
OBSERVATIONS
• Majority of the patient’s complaints are the wait times in the
ER, this should be addressed by either informing the patient upon check-in or having a board visible to patients in the waiting room on approximate wait times.
• Many of the patients are unprepared to pay larger amounts of co-pays hospitals should set up some time of payment plan to make ER visit affordable. This also applies to a daily inpatient day rate. Many do not go to the ER for lack of funds. • Staffing during holidays is also important. Leadership should make sure there are adequate staff members to treat the influx of patients.
RECOMMENDATIONS
• Triage wait time should be less than 2 hours even during peak times
• Explain to irate patients that staff is doing the best they can to accommodate patients and that the more emergent ones are being treated first
• Inform patients of approximate wait time so the non-emergent patients can decide if they want to wait in the ER or make an appointment for follow-up the next day
• Money (copays) should be the least of worries when seeing patients in the ER
• Customer service is still #1
• Always follow-up with a phone call or survey after ER or Inpatient visit
References
•
•
•
•
•
•
•
Fast Facts about Kaiser Permanente. (2013). Retrieved from kaiserpermanente.org: http://share.kaiserpermanente.org/article/fast-facts-about-kaiser-permanente/ Baldwin Park. (2010). Retrieved 2013, from physiciancareers.kp.org: http:// physiciancareers.kp.org/scal/location-baldwin-park.html Kaiser Permanente Nursing Pathways. (2014). Retrieved from http://kpnursing.org/quality/index.html
MEASURING CARE QUALITY IN OUR HOSPITALS. (). Retrieved from https://healthy.kaiserpermanente.org/static/health/pdfs/quality_and_safety/sca/sca_quality_BaldwinPar k.pdf
About NCQA. (2014). Retrieved from http://www.ncqa.org/HomePage.aspx
The Joint Commission. (2014). Retrieved from http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx Towers Watson. (2013). Explore the Possibilities [PowerPoint slides]. Retrieved from
http://www.towerswatson.com/assets/17748/Linking-Employee-Survey-Results-to-Key-Business.pdf.