Quality Improvement in the Health Care Organization Accreditation

The health care industry is guided by-laws, standards, and regulations that will help in ensuring privacy, safety, accessibility, and quality. This paper aims at evaluating quality improvement and accrediting agencies plans which can be utilized in a magnet hospital’s forthcoming revenue cycle. This will focus on three accrediting programs that will replace the joint commission. Relatively, the benefits and costs of each program will be highlighted and rank the programs.

The Joint Commission

The Joint Commission is a nonprofit, non-governmental, and largest accrediting and standard-setting body within healthcare. It was established to carry on the study as well as improve health results. An onsite survey is conducted within the healthcare organization after every three years to ensure that the hospital stays in regulation with the joint commission. The appropriate health information expertise has to be in place to aid the gathering of data that enables in refining health care quality.

Healthcare Facilities Accreditation Program

Healthcare Facilities Accreditation Program (HFAP) is a non-profit organization that is aimed at helping healthcare establishments to uphold their standards, improve healthcare quality and conform with the healthcare environment and regulations (Araujo, Siqueira, and Malik, 2020). HFAP has offered accreditation to hospitals and has grown out of the former approval process of the American Osteopathic Association. The program has aimed to improve high-quality care for patients and safety through acknowledged standards. HFAP has been a non-profit program that enables healthcare organizations to maintain a high level of principles in patient care beside compliance with the state principles. When HFAP was first established in 1943 the certification was only offered to osteopathic hospitals and ensured that individuals acquired adequate training. Over the years, there have been more than 200 hospitals and healthcare facilities that have been listed under the HFAP program.

The average cost of the program is $25,000 for three years for a healthcare facility to be under the program. However, the cost varies on the volume and size of the organization. The program has been carried out various states, federal, and local support programs that help in the advancement of safety and quality. The mission of the program has been to advance the safety and quality of patient care by applying the recognized standards. The standards exceed or meet the CMS conditions of participation. HFAP surveys are conducted and announced after every three years as demanded by the CMS rules. The length of the survey varies depending on the hospital size as well as the complexity of services offered, off-site locations, and the presence of swing beds and excluded units.

The American Medical Accreditation Program

The American Medical Accreditation Program provides certification to distinct physician based on 12 core criterions in licensure, education, practice operations, and ethics. The program was established by the American Medical Association and is based in Chicago. The program evaluates the physicians alongside their peer performance and national standards in personal experiences, credentialing, clinical performance, the setting of care, and outcomes of patient care (Bahadori, Teymourzadeh, Ravangard, and Saadati, 2018). Relatively, the program has been responsible for verifying, collecting, and consolidating the portfolio of physicians into a single file.

AMAP costs $50 for the members and $150 for non-members. Most of the healthcare organizations have paid for the fees to be part of the program along with gaining continuous education. Under the American Medical Accreditation program, the care providers are credentialed in many managed care plans, Medicaid, and Medicare. AMA has been important in informing physicians about various advancements in a variety of medical fields, delivery of healthcare, and enhance prevention of disease to build a healthier population (Mosadeghrad, Akbari Sari and Yousefinezhadi, 2019). For instance, the AMA members have been given free access to AMA publications such as peer-reviewed journals. The educational tools have helped them in answering questions and offered resources to improve their understanding to work in a new healthcare environment. Therefore, the AMA program has offered enterprise solutions that have equipped the healthcare teams with resources that have boosted outcomes and driven value.

The National Committee for Quality Assurance

The national committee for quality assurance is a non-governmental nonprofit body developed in 1990. NCQA aimed at boosting healthcare quality by measures, values, accreditation, and plans. NCQA is a major symbol in boosting quality and enhancement in the healthcare organizations enabling elevation of issues linked to healthcare quality (Desveaux, Mitchell, Shaw and Ivers, 2017). NCQA has been recognized widely as a symbol of quality since it has enabled build agreement about essential health care quality concerns through operating with huge numbers of legislators, patients, employers, and doctors to determine what’s vital and how to evaluate it and how to stimulate development. The program controls the certification for health programs and physicians. NCQA is the only certification program which utilizes wide-ranging assessment of health plans. Its certification scores grounded on authentic outcomes attained on a set of clinical evaluations and knowledge.

Considerably, insurance firms have to attain the five necessities under the national committee of quality assurance which comprise quality management and improvement, credentialing and re-credentialing, utilization management, members’ responsibilities and rights, and member connections. The national committee of quality assurance works under all state regulations and laws. It’s acknowledged by forty-two states in the United States. It achieves the prerequisites for Medicaid commercial strategies. Since it is essential to align with the marketplace requirements the national committee of quality assurance accepts the outcomes that follow the CMS reporting conditions.

Through the utilization of NCQA in the healthcare system, healthcare protocols have been redefined (Poku, Hellmann, and Sharfstein, 2017). For instance, doctors have continued to learn new ways of practice while the patients have learned to get more engaged in their care. Due to this, lives have been saved, healthcare cost has continued to reduce and illnesses avoided. The national committee of quality assurance has consistently raised its bar. Accredited health programs today encounter a rigorous set of more than sixty standards and have to report their performance to more than 40 areas to gain the national committee of quality assurance seal of approval. These standards have promoted the adoption of approaches that they believe will boost healthcare, reduce costs, and enhance services such as disease management, reduce costs, and enhance service.

Conclusion

In summation, the accreditation programs play significant roles with regards to safety and quality standards along with the healthcare services revenue cycle. Ranking the programs concerning the data collected, the hospital should choose the Health Facilities Accreditation Program due to its accreditation with CMS. The aim of this program is not only to ensure that the hospitals offer quality healthcare services but also give importance to affordability, access, effectiveness, efficiency, and quality of healthcare. Next would be the NCQA due to its ability to track healthcare quality and redefining the healthcare protocols through the collected statistics. Lastly, AMA offers healthcare organizations unique resources that boost health outcomes and drive value. Research has shown that accreditation boosts the overall quality of care in healthcare organizations and patient results.

 

References

Araujo, C. A., Siqueira, M. M., & Malik, A. M. (2020). Hospital accreditation impact on healthcare quality dimensions: a systematic review. International Journal for Quality in Health Care32(8), 531-544.

Bahadori, M., Teymourzadeh, E., Ravangard, R., & Saadati, M. (2018). Accreditation effects on health service quality: nurse viewpoints. International journal of health care quality assurance.

Desveaux, L., Mitchell, J. I., Shaw, J., & Ivers, N. M. (2017). Understanding the impact of accreditation on quality in healthcare: a grounded theory approach. International Journal for Quality in Health Care29(7), 941-947.

Melo, S. (2016). The impact of accreditation on healthcare quality improvement: a qualitative case study. Journal of Health Organization and Management.

Mosadeghrad, A. M., Akbari Sari, A., & Yousefinezhadi, T. (2019). Evaluation of accreditation effects in hospitals. Tehran University Medical Journal TUMS Publications76(12), 804-812.

Poku, M. K., Hellmann, D. B., & Sharfstein, J. M. (2017). Hospital Accreditation and Community Health. The American journal of medicine130(2), 117-118.

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