STANDARD COMPETENCIES

 

 1. Define key quality management and patient safety terminology.

 2. Identify major societal and regulatory drivers for quality and safety initiatives in healthcare organizations.

 3. Identify key risk management and utilization management activities in health care organizations

 4. Analyze policies and procedures to ensure organizational compliance with regulations and standards

    (HIPAA, ARRA, The Joint Commission, QIO, Meaningful Use, Risk Management and Patient Safety)

 5. Adhere to the legal and regulatory requirements related to health information management i.e. coding quality monitoring,

    compliance strategies and reporting.

 6. Utilize data that has been abstracted and reported for facility-wide quality management and performance improvement programs;

    structure and use of health information and health outcomes, i.e. shared governance

 7. Analyze data to identify trends, with regard to quality, safety, healthcare outcomes.

 8. Apply graphical tools for data presentations

 9. Utilize software in the completion of HIM processes, i.e. quality improvement

 10. Utilize tools and techniques to monitor, report and improve processes, such as Gantt chart, benchmarking, Lean and Six Sigma.

 11. Identify cost-saving and efficient means of achieving work processes and goals, i.e. Incident Response, Sentinel Event

 12. Analyze current regulations and established guidelines in clinical classification systems, i.e. Severity of Illness, UHDDS guidelines

 13. Identify potential abuse or fraudulent trends through data analysis, i.e. unbundling, upcoding, etc.

 14. Utilize basic descriptive, institutional, and healthcare statistics, i.e. mean, standard deviation, LOS, death, autopsy, infection rate, etc.

 

 

 

 TOPICAL OUTLINE

 

 I. Introduction to Quality Management

 II. Performance Measurement

 III. Performance Assessment

 IV. Performance Improvement

 V. Managing Risk and Patient Safety

 VI. Resource Management, Utilization Management, and Case Management;

        Assuring Individual Professional Competence (Medical Staff, HIM professionals)