Why a Clinical Quality Management Program?

Learn how to implement a quality management program as part of accreditation preparation.

Put simply, a quality management program allows you to monitor the care your crews are providing. It then yields feedback on improvements made through your associated education and training programs. This form of loop closure provides invaluable data not only to you and your organization, but clients and insurers alike.

Nearly every aspect of care can be monitored and transformed into valuable metrics. This is accomplished primarily with chart audits. However, additional data sources can be utilized. With this information, you can visualize, track and identify trends in compliance with medical protocols as well as other program defined markers.

A side note regarding chart audits: the question always is, “What percentage should we be auditing?” There is no black & white answer. A minimum of 25% of random charts is safe, plus for-cause reviews. This is all determined by your call volume, company policies, medical director and accrediting body (if any).

There are many methods used to monitor quality. When talking about accreditation, the most important aspect is documenting chart audits. Depending on the clinical documentation system that is in place, medical records will be manually read by an individual. Data is then entered into a spreadsheet (or other tracking tool) to allow for calculation and tracking of metrics. There are commercially available (and customizable) quality management software systems that tie in to charting software with reporting mechanisms built in. Additionally, “ad-hoc” report options are available so specific data can be gathered.

Companies seeking accreditation should develop and implement a quality management program far before beginning the application process. Establishing a robust quality management program that works hand in hand with your educational systems will most certainly ease the process.