QAPI Program Utilization_Manual

 Staff orientation, inservice and continuing education records  Inter/Intradepartmental committee meeting minutes  Patient case conferences  Utilization Review reports  Structure, process and outcome study data  Accreditation/licensure/certification survey requirements • Patient classification data • Patient care standards • Personnel records • Financial reports • Other data relating directly/indirectly to client care External Data sources include, but are not limited to, the following: • Professional organizations • Regulatory agencies • Review agencies • Cost review agencies third party payers • PRO profiles • Continuing education conferences • Professional conferences • Professional literature Valid and relevant structures, processes and outcomes of patient care and/or clinical practice criteria that: • Are developed to define the focus for monitoring and assessing quality of healthcare services. • Are appropriately implemented to monitor and assess quality of healthcare services. Corrective action plans are developed and implemented. Developed corrective action plans describe: All corrective actions required to resolve knowledge, performance and systems areas of concern. Measurable objectives for each corrective action, including degree of expected change in patient care and/or clinical practices. Person(s) responsible for implementing, monitoring, evaluating and reassessing corrective actions. Date corrective action is to be implemented. Date corrective action is to be evaluated for effectiveness. Names/titles of personnel responsible for overseeing implementation of the outlined corrective actions. 80