How are Quality Management Systems Impacting the Healthcare environment?

Mary Van de Kamp, SVP, Quality & Clinical Operations, Kindred Rehabilitation Services and Tammy Graham, MBA, Director Product Management, Kindred Rehabilitation Services
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Mary Van de Kamp, SVP, Quality & Clinical Operations, Kindred Rehabilitation Services

Mary Van de Kamp, SVP, Quality & Clinical Operations, Kindred Rehabilitation Services

Having served over two and a half decades in the healthcare sector, Van de Kamp, has experienced a great deal of changes throughout her experience as a leader in healthcare that directly (and indirectly) impact the healthcare environment.

 The patient experience has always been so critically important to each of us, but now it is taking a broader role in determining value and how we are engaging our patients in the care as well as helping us to define the quality of the care they want to receive 

In her role as an organizational leader of quality, Van de Kamp carries a wide array of responsibilities. However, “the most critically important primary task is establishing a safe, no harm, high quality consistent program (or culture) in an environment that is challenged by workforce and caregiver stress. We have the opportunity to listen to our patients and have them define quality for us; to listen to our staff and how we can improve their workflow allowing them to be in front of the patients,” explains Van de Kamp. With this, recent technology developments and transformations in the Quality Management Systems (QMS) area are the top factors today, impacting the way the business and organizational quality leaders approach meeting the needs of their patients.

Historically, behaviors in healthcare were driven primarily by what was measureable at the patient bedside. Today, I believe data is driving behavior; there is a major shift from (data) only at the patient bedside to aggregate data that assesses payment in rural and urban areas, looking at hospital and nursing home compare, driving five-star measurement.

While having such great depths of data provides a broader perspective of measures, it is not without its challenges. Data is giving a picture of what some have decided is the scorecard for quality therefore, we need to be much more diligent around identifying the key data points that actually reflect the quality. The patient experience has always been so critically important to each of us, but now it is taking a broader role in determining value and how we are engaging our patients in the care as well as helping us to define the quality of the care they want to receive.

Quality measures are not clearly defined. While we are working very closely with the Centers for Medicare and Medicaid Services (CMS) and others to define the quality measures of which we will be held accountable, as we do this, it is critically important to continue to analyze the measurements for which we are being judged. If we aren’t measuring the correct pieces of the pie to improve quality, then we may have strong scores without strong quality.

Another important transformation in the QMS area is the concept of replacing ad hoc work practices with consistent practices so as to aid in knowledge transfer.

Standardization of quality process is key. While in the hospital sector, the business has lived under Joint Commission and CARF Accreditation criteria, we, as a company, have decided we want to take it to a new level on the Baldridge journey. With this, we must have a strong and sustainable process without dependency on individual caregivers. Because of the draconian results, a mistake can have in every sector of healthcare; it is paramount that we build into our workflow, the kinds of consistency that drive safe quality care in our settings.

A couple of major changes posing a challenge in the QMS space, which must be addressed by the organization per Van de Kampare, “workforce shortage and an increase in the frail and/ or increasing elderly population of baby boomers.”

With the developments in technology, it is important to understand that while technology can help provide the data and the risks which can aid in the development of quality measures and patient care, it is critically important that the actual hands on (remains) the focus. The whole face of healthcare accessibility will fade if we don’t have strong caregivers in our facilities or in our homes. With the developments in technology and transformations in QMS, how companies manage that is critically important.

In addition, we are caught between a generation that isn’t as technologically savvy with a generation that is incredibly savvy; (therefore, we must determine) how we in quality and technology bridge that gap. The focus for solving this gap is “patient engagement.”

If a patient is engaged in their care, the outcome and stability of the outcome is much better. As we looked at that as a company, we recognized that we wanted technology to be a component of our patient engagement. As the focus for meeting this need gap, we developed a tool to help bring the patients and therapists together. The tool allows the patient to help determine their goal and the therapist to communicate and measure that goal, thereby engaging the patient through both their own goal-setting and our therapists’ ability to help that patient restore function. In addition, it also allows for family members to be part of the encouragement of that care.

In considering the increased need for quality in every sector and where such is headed within the next decade, the advice Van de Kamp gives for budding technologists in the QMS space is, “understanding how critically important technology is as a tool for which quality and patient experience can improve” and to “keep the focus on the outcome. We should not be in a rush to automate or transform into a technological advancement without first ensuring what quality is truly needed.”

While disruptions in the QMS space will evolve, and some challenges are likely to remain for some time such as the gap in sharing of key information electronically across settings and across sites of service, Van de Kamp is confident that “we have technology with end sights of service that measure the great care and that we can begin to use to drive the right outcome.”

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