Reform and the bigger picture of quality
As we move toward myriad changes in the way health care is paid for and move toward a system that becomes increasingly tied in to value-based purchasing, Cheryl Wagonhurst, partner with Folley & Lardner LLP, suggests quality managers look at the big picture and create strategic plans to address quality as a broader, holistic objective.
Wagonhurst says quality improvement directors should be "focusing on building their internal structures to meet the changes in reimbursement, as well as, more importantly, the changes in compliance. I think this is going to be very, very difficult for the compliance officers to get their arms around how quality care is becoming one of the top compliance risk areas and the much bigger of the Obama administration's goal of eliminating waste in health care."
In the face of this, she says it is important to address "the issues in a very comprehensive way and developing an overall strategy so you can deal not only with what it is today but what it's going to be tomorrow." The heart of the readmission problem she says is structural weaknesses, in areas such as utilization review, peer review, and quality assurance.
She recommends taking a broader, big-picture view in adjusting to the changes in the health care scenery. "It kills me when I see how much time The Joint Commission has wasted in having providers focus on the wrong stuff. Is that cart on the right or left side of the hallway? It's sickening. And then the corrective action plans to deal with things that are just so miniscule and meaningless in the overall scheme... [Heath care staff] need to focus on the big picture stuff to make sure their basic systems are working. And that's not what The Joint Commission looks at."
To get the attention of the C-suite in making the broader changes needed to address the bigger picture problems Wagonhurst sees in hospitals, she recommends having a compliance committee. "I would say the focus on quality metrics alone is not enough to deal with the big picture." She says too many organizations are under the impression that if they're doing a good job on quality metrics and if they're in compliance with The Joint Commission, they're doing OK.
But it's much more than that Wagonhurst says, and it's much bigger. And with the OIG identifying quality of care as the No. 1 broad area it's going to be looking at, she says hospitals are going to be hurting themselves if they don't see the whole landscape through the trees.
As we move toward myriad changes in the way health care is paid for and move toward a system that becomes increasingly tied in to value-based purchasing, Cheryl Wagonhurst, partner with Folley & Lardner LLP, suggests quality managers look at the big picture and create strategic plans to address quality as a broader, holistic objective.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content. TESTING
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