Training pack remuneration - pilot practices final v0.2

This document summarizes the learning from pilot projects aimed at improving phlebotomy services using Lean methodology. Key findings include: understanding patient data is important to improve performance; observing processes from the patient perspective reveals opportunities; establishing clear standards helps focus improvement efforts; and fixing phlebotomy in isolation may not impact broader patient pathways. Common themes across sites included managing services with data, training staff in Lean tools, improving communication, and reducing waste.

This document provides a directory of diagnostic services for commissioning organizations in the NHS. It includes descriptions and links to resources on several diagnostic modalities including endoscopy, pathology, genetics, and cross-diagnostics. The resources were developed by National Clinical Directors to inform decisions about commissioning diagnostic services and ensure patients have access to the best care.

This document outlines the clinical audit process. It defines audit as reviewing, monitoring, and evaluating care against agreed standards to improve patient outcomes, use of resources, education, and staff reflection. Research aims to discover new information rather than evaluate existing care. The audit cycle involves identifying issues, setting criteria, measuring current practice, analyzing data against criteria, implementing changes, and re-auditing. Types of audits include structure, process, and outcome audits. Steps of the audit cycle are also demonstrated through an example audit on postoperative wound infections.

This document discusses clinical audit and statistics. It begins by defining audit and its importance in clinical practice. The document outlines the types of audit and how statistics are used in clinical practice. It discusses the components of a clinical audit and defines key statistical terms like population, sample, and descriptive statistics. The document provides examples to illustrate statistical concepts and calculations like descriptive statistics and the area under the curve of a normal distribution. It emphasizes that the goal of statistics is to summarize data in a way that is understandable for non-statisticians.

The document outlines the process for conducting a medical audit including: 1) Medical audits systematically analyze the quality of medical care including diagnosis, treatment, resource use, and patient outcomes and quality of life. 2) Audits evaluate the structure, process, and outcomes of patient care and aim to identify how current care compares to standards to plan improvements. 3) Audits should be transparent, non-judgmental, and involve taking part in quality improvement activities as required by the General Medical Council.

The examples here showcase just some of the innovations that have enabled thousands of patients to enjoy better health and well-being thanks to practicalservice improvements implemented on various clinical pathways

This document discusses clinical audits, which systematically review patient care against criteria to improve outcomes. Clinical audits compare current practices to standards to identify any gaps and drive improvements. They have been incorporated worldwide as part of clinical governance efforts since the 1990s. Some key points made include: - Clinical audits can reduce risks, ensure cost-effectiveness, and improve patient care and outcomes. - One of the earliest clinical audits was conducted by Florence Nightingale during the Crimean War, which significantly reduced mortality rates. - Audits ask if standards are being followed correctly, while research asks if the right approach is being taken. - Successful audits include clear, measurable criteria; objective data collection; analysis

The document summarizes the Kayakalp initiative launched by the Indian government to promote cleanliness and hygiene in public health facilities. The initiative recognizes and rewards facilities that achieve high scores on criteria assessing cleanliness, sanitation, waste management, and infection control. Facilities are evaluated through internal and peer assessments as well as external assessments by trained teams. Cash awards are given to the top performing facilities at the state and national level to invest in improving amenities and services. The document outlines the goals of Kayakalp and provides details on the assessment process, criteria, and cash prizes awarded to winning facilities in 2015-2016, 2016-2017.

This document discusses strategies for cost containment and reduction in hospitals. It identifies the key challenges hospitals face like rising costs, staffing issues, and reduced reimbursement rates. It then provides recommendations in several areas: focusing on efficient processes and standardized operations; developing optimized workforce, technology, and infrastructure models; and creating systems for continuous cost management and improvement. Specific strategies addressed include inventory management, revenue cycle optimization, rational workforce planning, and marketing. The overall aim is for hospitals to contain costs while maintaining quality in the face of economic pressures.

This document provides an outline and overview of clinical pathways. It begins with the history and origins of clinical pathways in the 1980s. It then defines clinical pathways as multidisciplinary tools to standardize and optimize care for specific patients based on evidence. The document discusses why pathways are used, including to improve quality of care, maximize efficiency, reduce variability, and support clinical effectiveness. It also covers potential issues, benefits, components of pathways, and how pathways are developed through a multidisciplinary process.

Clinical Practice Guidelines / Pathways as a Strategy / Tool for Hospital Quality Service Improvement

Nursing audit is a systematic evaluation of nursing care quality and outcomes. It involves comparing nursing services to established standards through record review. Nursing audit aims to ensure quality nursing care, stimulate better record-keeping, and contribute to research. It can evaluate care in all nursing areas. The audit process involves setting standards, implementing changes, observing practice, and comparing to standards in a continuous cycle. While time-consuming, nursing audit is a tool for quality assurance and improvement.

Importance of Medical Audit Don't let COVID - 19 impact your practice. Get Free Practice Analysis and be financially healthy. Call Now - 888-357-3226 Click Here For More Information: https://bit.ly/3kw4rka Get a Free Quote: https://bit.ly/30DFr2z #texasmedicalbillingandcodingservices #medicalbillingauditing #medicare #medicalbillingandcoding #MBC #importanceofmedicalaudit #medicalaudit #medicalbillingguideline

This document outlines the agenda and content for a clinical audit workshop. The workshop covers the principles of clinical audit including defining clinical audit, designing an audit, collecting and analyzing data, developing action plans for change, and re-auditing. Participants will learn about the clinical audit cycle and process through presentations, group exercises, and discussion. The goal is for participants to understand clinical audit and have basic skills to design and conduct their own clinical audits.

Presentation describing the DMA INSIGHT programme and its use in collaboration with St Andrews Hospital Charity to develop person centred integrated care pathways - presented at International Forensic Conference - UCLAN

This training pack provides guidance for dental practices participating in a contract reform programme as prototypes. It outlines the principles for calculating prototype remuneration, which will be split between a capitation element and an activity element. The expected patient list and minimum activity levels will be calculated based on historical data with adjustments. Practices can be allocated to Blend A or Blend B, which determine whether capitation covers bands 1 and 2 or bands 1 and 3, and which activity is counted. Worked examples are provided to demonstrate how the capitation and activity elements are calculated for each blend.

This document provides an introduction to dental contract reform prototypes in the UK. The objectives of the reform are to maintain or improve access to dental care, improve oral health, do so within the current financial envelope, and in a way that is financially sustainable. The prototypes test two blended remuneration models - blend A and blend B - which split the contract value between capitation and activity payments. The prototypes have been running since early 2016 to test the reformed contract's ability to achieve its goals before a potential national rollout.

Part II: Record Financial Operations CHAPTER 5: EXPENSES: (OUTFLOW) Overview: The Distinction Between Expense and Cost • Expenses are expired costs that have been used up, or consumed, while carrying on business. • Expense in the broadest sense includes every expired (used up) cost that is deductible from revenue. Overview: The Distinction Between Expense and Cost • “Cost” is the amount of cash expended* in consideration of goods or services received (or to be received). *(or property transferred, services performed, or liability incurred) • Costs can either be expired or unexpired. • Expired costs are used up in the current period and are matched against current revenues. • Unexpired costs are not yet used up and will be matched against future revenues. Overview: The Distinction Between Expense and Cost • Confusion also exists over the term “cost” versus the term “charges”. • Charges are revenue, or inflow • Costs are expenses, or outflows • Charges add; costs take away. Overview: Confusion Over Other Terminology Disbursements for Services • Disbursements for services represent an expense stream (an outflow) • Disbursements for services can trigger payment either: – when the expense is incurred; or – after the expense is incurred. Disbursements for Services • Payment when the expense is incurred does not require the expense to enter the Accounts Payable account. • Payment after the expense is incurred requires the expense to be recorded in the Accounts Payable account. • It is then cleared from Accounts Payable when payment is made. Grouping Expenses for Planning and Control • Grouping by Cost Center • One form of responsibility center. • Study examples in Exhibits 5-1 and 5-2. Exhibit 5–2 General Services and Support Services Cost Centers Grouping by Diagnoses and Procedure • Beneficial because is matched costs and common classifications of revenues • Study examples in Exhibits 5-3, 5-4, 5-5 & Table 5-1 Exhibit 5–5 Example of Hospital Departmental Costs Classified by Diagnoses, MDC, and DRG Table 5–1 Example of Radiology Department Costs Classified by Procedure Code • By care settings recognizes different sites where service is delivered • Care settings were discussed in the previous chapter. Grouping by Care Settings • By service lines would be used for grouping costs if revenues were divided by service line. • Service lines were discussed in the previous chapter. Grouping by Service Lines • Distinguishes projects that posses their own objectives, funding, and indicators. • Study the example in Exhibit 5-6. Grouping by Programs Exhibit 5–6 Program Cost Center: Southside Homeless Intake Center Cost Reports As Influencers Of Expense Formats • Since the mid-1960s Annual Cost Reports are required by the Medicare Program and the Medicaid Program. Cost Reports As Influencers Of Expense Formats • The arrangement of c ...

This document provides an overview and agenda for an open forum on the Independence at Home demonstration. It summarizes the legislation mandating the demonstration to test home-based primary care and outlines the goals of reducing costs and improving outcomes. It describes requirements for medical practices participating in the demonstration, including providing 24/7 care and meeting quality measures. Payment methodology incentives are based on spending targets and quality performance. The demonstration is seeking stakeholder input on design and will cover 10,000 beneficiaries over 3 years starting January 2012.

The CMS Innovation Center held the fourth in a series of webinars for potential applicants interested in applying to Health Care Innovation Awards Round Two. The webinar held on Thursday, June 20, 2013 from 1:00–2:00pm EDT, focused on how to achieve lower costs through improvement. This webinar also reviewed the components of the Financial Plan. - - - CMS Innovations http://innovations.cms.gov We accept comments in the spirit of our comment policy: http://newmedia.hhs.gov/standards/comment_policy.html CMS Privacy Policy http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html

The Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted an introduction webinar about the Oncology Care Model (OCM) on Thursday, February 19, 2015 from 12:00pm – 1:00pm EST. The webinar focused on introducing core concepts of OCM and application instructions. Advance registration was not required. - - - CMS Innovation Center http://innovation.cms.gov We accept comments in the spirit of our comment policy: http://newmedia.hhs.gov/standards/comment_policy.html CMS Privacy Policy http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html

ICAR-IFPRI: Methodologies in Agricultural Extension Research capacity development program from September 21-24, 2015 in New Delhi

This document summarizes the key points from a document about patient safety goals for 2010. It discusses goals around improving patient identification, communication among caregivers, medication safety, reducing healthcare associated infections, medication reconciliation, and identifying patients at risk for suicide. The goals cover topics like using two patient identifiers, reporting critical test results in a timely manner, properly labeling medications, implementing best practices to prevent infections from multi-drug resistant organisms and central lines, and reconciling medications when patients transfer between care settings.

The Bundled Payments for Care Improvement (BPCI) Initiative began generating data in January of 2013. Dr. Iorio will outline the challenges and benefits of implementing BPCI for Total Joint Arthroplasty at an urban, tertiary, academic medical center with a hybrid compensation model. Early results from the implementation of a Medicare BPCI Model 2 primary TJA program demonstrate cost-savings with an improvement in quality of care metrics and continued cost savings through year 3 of our experience. Changes in patient optimization, care coordination, clinical care pathways, and evidence-based protocols are the key to improving the quality metrics and cost effectiveness within the implementation of the Bundled Payment for Care Initiative, thus bringing increased value to our TJA patients. Maximizing Value in a Bundled Environment – Keys to Success: • Evidence based, cost effectiveness analysis • Standardized protocol adoption • Transparent data • Perioperative Patient Optimization • Care management • Physician-hospital alignment with Gain sharing • Enhanced pain relief and rehabilitation protocols • Blood management and rational VTED prophylaxis About the Speaker: Richard Iorio, MD, is the William and Susan Jaffe Professor of Orthopaedic Surgery at New York University Langone Medical Center Hospital for Joint Diseases and Chief of Adult Reconstruction at NYU Langone HJD. He co-founded Labrador Healthcare Consulting Services, Responsive Risk Solutions, and the Value Based Healthcare Consortium in 2015. He is a member of the Board of Directors for LIMA, the Lifetime Initiative for the Management of Arthritis. Dr. Iorio is a national expert in physician and hospital quality and safety and a leader in the implementation of alternate payment paradigms in orthopaedic surgery.

The Center for Medicare and Medicaid Innovation hosted a series of two webinars on Wednesday, July 15 and Thursday, July 16, 2015. These webinars focused on providing an overview of the model and provided an opportunity for attendees to ask questions. - - - CMS Innovation Center http://innovation.cms.gov We accept comments in the spirit of our comment policy: http://newmedia.hhs.gov/standards/comment_policy.html CMS Privacy Policy http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html

PRIMARY CARE Scenario Type of care provided Scenario Question 1 Question 2 Care in this type of setting is delivered by physicians, physician assistants, nurse practitioners, and ad- vanced practice professionals. This area of health care is the most widely used, and it is a major focus of the Affordable Care Act of 2010, focusing on primary care providers and decreasing the focus on the utilization of specialty providers. As an administrator, you need to assess this situation: How would you determine if there was a true need for another receptionist? Do you need to reinstate the position or can you retrain the current number of employees? Why? As an administrator, describe the effects that labor shortages of key personnel and rising costs of labor have on profitability. How would you determine how to allocate your money? Be sure to think critically about the impact that quality outcomes and patient outcomes have on financial resources. A primary care clinic can be an individual-physician practice or a multiple-physician practice organized as a nonprofit or a for-profit facility. Multiple-physician practices generally specialize in cardiac, women’s health, pediatrics, or related services. You are the administrator of a local for-profit, multiple-physician community clinic owned by five local physicians, specializing in internal medicine, women’s health, pe- diatrics, orthopedics, and oncology. The clinic sees an average of 50 patients per day. Scheduling is centralized with two receptionists, and each specialty has four staff members to assist the physicians. All the physicians have visiting privileges at the area hospitals and frequently speak at local and national conferences on numerous preventative health care topics. The clinic is noted for its use of technology and has agreements in place with the local hospitals for web-based exchanges of health information on shared patients. Action Required: Your office just underwent an organizational change and one office receptionist was eliminated, saving the office $25, 000 per year in labor costs. However, there have been a number of complaints that all patients cannot be processed due to the increased flow of patients. Two weeks later you begin to hear that wait times for appointments have increased, and one specific patient was not able to be seen. That patient now has developed an infection and requires surgery. Question 3 Based on what you have learned so far in this course, what would be your plan of action for the next 30 days? What types of reports would you use to help support your decisions? Budget Considerations Operational Budget – This budget focuses on a broader view of the total operations of the organization in which all departments are reviewed for both their income potential and the costs associated with the work activities used to generate projected revenues. Each department will have its own budget for the managers to follow and on wh.

Monitor is conducting a review of general practice services in England to determine if commissioning and provision of GP services is operating in the best interests of patients. As part of this review, Monitor invited comments on patients' ability to access and switch GP services, providers' ability to develop new services and locations, and new models of primary care. Monitor has received written submissions, conducted stakeholder interviews and events, and will publish a statement on what they have heard and any next steps. They are interested in hearing from patients on topics such as the importance of seeing the same GP each time, ability to access a GP in a reasonable time frame, ability to see a GP or register at a convenient location, and ability to switch GP or practice

It compares an intervention to another intervention (or the status quo) by estimating how much it costs to gain a unit of a health outcome, outcomes by a measure of some health outcome unit, such as the number of malaria cases prevented or the number of lives saved. CEA is applied in the areas where effect or outcome is measured in non monetary terms (clinical areas as well as to evaluate health policies, programs, and interventions). It can be applied to both service providers and users. CEA is useful when the primary objective of the study is to identify the most cost-effective strategy from a group of alternatives that can effectively meet a common goal and are often competing for the same resources.

The document provides an agenda and information about an upcoming Meaningful Use Mini-Camp on October 21, 2015. The agenda includes introductions, an overview of the California Technical Assistance Program (CTAP), a review of the 2015-2017 Modification Final Rule, a discussion of challenging measures, and strategic planning for Meaningful Use. Additional details are then provided about CTAP funding, milestones, and payments. The document concludes with sections on enrollment in CTAP and an overview of some of the most challenging Meaningful Use measures.

CircleBath used PROMs data to identify areas for improvement in their hip and knee replacement procedures. They implemented changes such as enhanced recovery protocols and improved rehabilitation services. This contributed to CircleBath moving from below to above the England average for adjusted health gains on the Oxford Hip and Knee scores between 2011/12 and 2013/14, demonstrating improved patient outcomes.

This document discusses managed care and performance measurement in healthcare. It provides information on: - The differences between managed care reimbursement and fee-for-service, including incentives created by capitation payments. - Examples of managed care review mechanisms like preauthorization, concurrent review, and retrospective review that are intended to reduce unnecessary procedures and hospitalizations. - Utilization and financial measures used to evaluate providers and health plans, including member months, costs per member per month, and admission rates. - The similarities and differences between managed care organizations and accountable care organizations, including their reimbursement structures and emphasis on care coordination.

This document discusses cost-effectiveness analysis (CEA) and calculating the incremental cost-effectiveness ratio (ICER). There are 4 main types of CEA: cost-minimization analysis, CEA using natural units, cost-utility analysis using quality-adjusted life years (QALYs), and cost-benefit analysis using monetary units. The ICER is calculated as the incremental cost divided by the incremental effectiveness (e.g. cost per QALY gained) of a new intervention compared to the existing one. Key information needed includes outcomes and costs of both the existing and new interventions. An example ICER calculation for a new treatment for thingyitis is provided. Thresholds of willingness to pay per QAL

The document provides information on changes to the MDS (Minimum Data Set) for October 2019, including changes made to several sections and items. Chapter 2 was extensively revised and individual changes were not tracked. Cognition assessment is now required for all PPS assessments. For the Interim Payment Assessment, Section GG covers the last 3 days. The HIPPS code under PDPM includes classification codes for each component and an assessment indicator. Section K no longer includes mechanically altered diets, and respite care was removed from Section O.

PYA Consulting Manager Aaron Elias co-presented “Modern Relationships Between Physicians, Hospitals, and Long-Term Care Providers in a Time of Risk-Based Contracting,” along with Jeanna Palmer Gunville, a shareholder at Polsinelli.

The document provides survey results from NHS LEWISHAM CCG's GP Patient Survey. It includes: - An overview of patients' overall experience at their GP practice, with 80% reporting a good experience. Experience varied across practices from 55% to 97%. - Results on ease of getting through to practices by phone, with 61% finding it easy. Experience varied across practices from 30% to 95%. - Feedback on receptionist helpfulness, with 87% finding them helpful. Experience varied across practices from 66% to 99%.

The Health and Social Care Committee published a report on NHS dentistry identifying a crisis in access that is declining oral health. The report makes 16 recommendations to reform the dental contract system, improve workforce issues, and ensure the dental profession is represented in integrated care boards to better plan local dental services and commission flexible models using population need assessments.