Course Description
This course focuses on the role of the health information manager in meeting the information requirements of quality review programs. Students are introduced to the terminology, rationale, and current models, methodologies, tools and techniques associated with quality, utilization, and risk management. This course also provides the student with additional opportunities to practice reporting of health data/information.
Course Content
- Quality Management
- Define quality within the context of health care
- characteristics
- terminology
- Identify internal and external influencing factors on quality
- Identify the key contributions of select quality leaders: Shewhart, Deming, Juran, Crosby, Kaizen, and others
- Explain the evolution and development of quality management programs
- Apply quality planning models to facilitate improvements in key issues and processes impacting health care and service delivery:
- DAT
- PDCA
- Six Sigma
- Pier
- Other
- Standards
- characteristics
- types
- how to set standards
- advantages/disadvantages
- measurement of standards
- MIS
- Performance Indicators
- definition
- types
- development of
- characteristics
- uses
- benchmarks
- measurement and monitoring
- Customers
- internal/external
- needs/expectations
- satisfaction survey
- Tools for
- data collection (brainstorming, checksheets, boarding, affinity diagram, multivoting, decision matrix)
- displaying data (cause and effect, histogram, run chart, pie chart)
- analyzing data (scatter plot, Pareto chart, control chart, force field analysis, flow chart)
- Accreditation Canada
- evolution of
- process
- terminology
- relationship to quality, RM and UM
- role of HIM
- Utilization Management (UM)
- definitions and purpose
- rationale
- terminology
- data collection/sources of data
- UM methodologies
- prospective, concurrent, retrospective reviews
- AEP, MCAP, InterQual, and others
- Clinical UM tools
- clinical practice guidelines, protocols, and critical pathways
- discharge planning
- case management
- managed care
- disease management
- clinical audits
- Outcome Management
- Donabedian’s Model
- UM Committee
- Role of health information management
- data collection/sources of data
- documentation requirements
- analyzing data (admission, LOS, balanced scorecards)
- selection and application of appropriate quality management tools and methodologies
- Risk Management (RM)
- definition and purpose
- rationale
- terminology
- role of health information management
- processes (identification, analysis, control, evaluation)
- tools
- incident reporting
- occurrence screening
- occurrence reporting
- infection control reporting
- safety (patient/employees)
- other
Learning Activities
1. Lecture/Practice
2. Group discussion
3. Guest lecturers
4. Application case studies/health records
5. Application software
6. Independent study of courseware and specified topics
Means of Assessment
Typical evaluations would include:
- Final Exam
- Midterm Exam
- Learning Activities
- Assignments
Course evaluation is based on course objectives and is consistent with the ÁñÁ«ÊÓƵ Curriculum Development and Approval policy.
A detailed evaluation schedule is presented to the student at the beginning of the course.
Outline of evaluation may be subject to change.
This is a graded course.
Learning Outcomes
In this course participants have opportunities to:
- describe the need for and the components of a quality improvement program
- describe current methodologies and models used to assess and improve the quality of care and services provided within the health care system
- describe the current and future role of health information management services in supporting quality assessment initiatives for quality improvement, accreditation, performance improvement, benchmarking, workload measurement, outcomes management, utilization management, and risk management within the health care system.
- develop performance indicators and standards for the primary activities within the health information department
- apply a variety of quality improvement tools and techniques to collect, display, and analyze data for problem identification, problem solving, and decision making
- assess, design, collect, organize, analyze, and present demographic, clinical and financial statistical information using a variety of data sources to meet the information needs of quality, accreditation, risk, and utilization programs
- have knowledge of and use a variety of utilization review and analysis methodologies
- describe the components of a risk management program including risk identification, assessment, treatment and evaluation
Textbook Materials
Textbooks and Materials to be Purchased by Students:
A list of mandatory and optional textbooks and materials is provided for students at the beginning of the course.