Section 1: Introduction A. About This Course B. Learning Objectives Section 2: Quality Improvement Infrastructure A. John’s Phone Message B. QI Infrastructure C. QI Coordinator D. QI Committee E. QI Principles F. Identify & Analyze G. Proactive & Reactive Strategies H. Develop & Implement I. Evaluate J. Data Collection and Tracking K. Data Display: The Dashboard Format L. Data Reporting M. The Role of Leadership N. Review O. Summary Section 3: Proactive Strategies A. Peer Review B. Peer Review Goal #1: Answering Clinical Questions C. Peer Review Goal #2: Comparing Your Data to Benchmarks D. Peer Review Audit Questions E. Examples F. Audit Types G. Aggregating and Analyzing Your Peer Review Data H. Responding to Peer Review Findings I. HRSA Core Clinical Measures J. Integration of CPM with QI Systems K. Patient Satisfaction Surveys L. Ideal Survey Topic Areas M. Patient Satisfaction Survey Tips N. Patient Satisfaction Survey Response and Follow-Up O. Other Patient Satisfaction Strategies P. Review Q. Summary Section 4: Reactive Strategies A. Documenting Patient Complaints B. Resolving Patient Complaints C. Patient Complaint Tracking, Types and Trending D. Incident Response and Tracking E. Types of Incidents F. Incident Response G. Case Study: Medication-Related Incidents H. What is a Sentinel Event? I. Examples of Sentinel Events J. Incidents vs. Sentinel Events K. Root Cause Analysis L. Review M. Summary Section 5: Putting QI into Action A. QI Models B. FOCUS C. PDSA D. Case Study: FOCUS E. Case Study: PDSA F. Review G. Summary Section 6: Conclusion A. Summary B. Congratulations
Jennifer Moore, RN-BC, DNS-CT, CDP started working in the senior care industry in 2000. She is a certified Gerontological Nurse, a Director of Nursing Services – Certified, and a Certified Dementia Practitioner. She has held positions including MDS Coordinator, Director of Nursing, Medicare Nurse Coordinator, Nurse Consultant, Area Manager, and Director of Quality Assurance. Her overall responsibility within each of these positions was to ensure residents received the highest quality of care. This included active participation in quality improvement initiatives, review of clinical records to identify areas of weakness, corroboration with the medical director to institute policies and procedures for resident care, and staff education/training. Additionally, she was responsible for maintaining an effective compliance program under a Quality of Care Corporate Integrity Agreement with the Office of Inspector General for a period of five years. She currently serves as the manager of curriculum design for post-acute care for Relias. Within this position, her responsibility is to oversee the development of online training modules for the post-acute care industry. She has served as the subject matter expert for courses on re-hospitalization, clinical skill reviews, and various OSHA and regulatory compliance topics. In addition, she has presented at various state conferences on mandatory compliance, quality assessment and assurance (QA&A), and quality assurance and performance improvement (QAPI). Disclosure: Jennifer Moore, RN-BC, DNS-CT, CDP has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.