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Enhancing Healthcare Quality: Balancing Care and Costs

Learn about the challenges of balancing high-quality patient care with cost control, the role of CMS, ways to decrease costs while maintaining quality, customer service strategies, and the importance of customer satisfaction in healthcare. Discover tips for quality improvement, patient advocacy, and handling customer feedback effectively to achieve better healthcare outcomes.

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Enhancing Healthcare Quality: Balancing Care and Costs

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  1. Chapter 23 Performance Improvement and Customer Service

  2. Quality of Care • Major challenge • Balance between high-quality patient care and controlling costs • Patient satisfaction not correlated to amount spent • Difficult to measure

  3. Quality Improvement • Role of Centers for Medicare and Medicaid Services (CMS) • Decrease costs while maintaining quality • Quality Assessment and Performance Improvement (QAPI)

  4. Question • True or False: • The U.S. ranks highest in quality of health care.

  5. Answer • False • U.S. ranks highest in health care costs • But not in quality of care

  6. Evaluation for Quality Improvement • Organizational structure • Health care professionals • Patient outcomes • Utilization review

  7. Customer Service • Essential to success • Internal customers • External customers

  8. Customer Service • Customers evaluate entire experience • Avoid slipping into automatic mode • Focus on patient • Lawsuits most commonly related to whether patient likes health care workers • Fewer long-term relationships in health care

  9. Lawsuits • May be frivolous • Time and money spent • Stress • Many can be avoided by working to ensure customer satisfaction

  10. Question • True or False: • Whether a lawsuit is filed or not is frequently based on whether the patient liked the health care professional.

  11. Answer • True • Lawsuits brought by patients more closely related to whether patient does or does not like health care professional than any other factor

  12. Taking Responsibility for Quality • Relationship to supervisor • Patient advocacy

  13. Good Quality Health Care • Doing the right thing • At the right time • In the right way • For the right person • Getting the best possible results

  14. Customer Satisfaction • Methods to assess: • Mail questionnaires • Call customers • Maintain log of complaints • Satisfaction subjective

  15. Customer Satisfaction • When working with unhappy customer: • Identify problem • Seek resolution • Verify satisfaction

  16. Internal Customers • Those working in health care industry • Areas of focus: • Good relationships with coworkers • Job satisfaction and pride in work • Constructive criticism • Destructive criticism

  17. Question • True or False: • Destructive criticism is never a positive event.

  18. Answer • False • Destructive criticism is hard to receive, but looking for “kernel of truth” can be beneficial

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