Quality Management In Health Care Delivery HCA 550 - Course Syllabus
CaliforniaStateUniversity at Long Beach - College of Health and Human Services
Department of Health Science - Health Care Administration Program
Course:Quality Management/Improvement In Health Care Delivery
HCA 550
Instructor’s Name: Rus Billimoria, M.D., MPH, CPHQ
Office Number(562) 985-5694 (Department Office for Information only)
Office Telephone Number or an E-Mail Address(213) 694-1250 or
Office Hours: By appointment only on day of the class.
Term:
Class Meeting Times: Hours: 7:00 p.m. to 9:45 p.
Class Location: ET 105
ADA Accommodation will be provided to any student who requests such, as defined by the ADA act and CSU-LB. Please contact Dr. Billimoria or refer to your student handbook for further information.
Note: This syllabus is subject to change. Should there be any changes, students will be notified in class of the amendments.
COURSE PREREQUISITES:
Prior to attending this course students are required to complete the following courses:
- HCA 402 or 502 and
- HCA 465 –or-
- HCA 450
Exemptions for the prerequisites are generally not entertained. However these may be considered on a case-by-case basis.
COURSE OBJECTIVES
The purpose of this course is to expand on the student’s knowledge of Quality and the process of Quality Improvement across the Health Care continuum. This course focuses on Quality in Healthcare Delivery, its terms, principles, theories, and practices. The student’s knowledge of the methods of improving quality, including but not limited to continuous Quality Improvement and Total Quality Management, and to the guidelines for implementing quality management and the continuous quality improvement processes will be expanded. Additionally , the students will be asked to review the changes that a selected number of health care systems from across America have implemented in order to achieve the Institute of Medicine’s goals to make quality health care more safe, timely, effective, equitable, efficient, and patient-centered.
EXPECTED STUDENT LEARNING OUTCOMES
On completion of this course, the student will be able to:
- Describe the various health care delivery systems and Quality Management/Improvement Programs presently used and reflect on their future.
- Explain the reasoning and the importance behind the requirements for Quality
Management/Improvement Programs in the health care environment today.
- Describe the current state-of-the-art Quality Management/Improvement Program principles, implementation strategies, and techniques for health care in general. This includes the principles of Continuous Quality Improvement, Total Quality Management, and proactive versus reactive Quality Management programs.
- Understand the impact of historical and current federal and state legislation on Quality Management/Improvement Programs in Health care.
- Understand and explain the need for and development of standards for accreditation of health care entities.
- Describe the recent impact of consumers on health care Quality Management/Improvement Programs and the development of health plan Report Cards (HEDIS etc.).
- Be adept at using data and statistics to build an effective, hypothetical Quality Management/Improvement Program.
- Understand and explain the elements and importance of provider credentialing, risk management and liability issues as they relate to Quality Management/Improvement Programs.
- Understand and explain the effect of Patient Safety issues on Quality Management/Improvement systems.
- Explain and discuss the recent trends in and the need for Quality Management/Improvement and Continuous Quality and Continuity of Care issues in Assisted Living, Skilled Nursing, and Long Term Care.
- Demonstrate understanding of the principles behind development of a Quality Management/Improvement Program for a health care entity via successful completion of class project.
REQUIRED TEXTS AND ANY OTHER REQUIRED MATERIALS AND INFORMATION.
This course does not prescribe a specific text, since no single text would cover the broad scope of this course. However, the following books and materials are strongly recommended for review:
- Continuous Quality Improvement in Healthcare, Curtis McLaughlin and Arnold Kaluzy, 3rd Edition, 2006, Jones and Bartlett Publishers, Inc.Sudbury, Massachusetts
- Lecture notes and handout materials
TYPES OF ASSIGNMENTS
Papers (25% of overall class Grade for 3 short essays over the course of the semester)
To understand the latest trends in Quality Management/Improvement Program it is necessary to review articles related to health care quality from professional medical or health care journals. All class sessions incorporate discussions on the latest trends presented in these journal articles. Students will be expected to read, summarize, and offer an opinion on the assigned articles or readings in the form of short papers (a maximum of two, doubled spaced and typed pages).
Examples of Journal materials that may be the subject of your reviews are as follows:
a)Journal of the American Medical Association (JAMA) -
b)New England Journal of Medicine -
c)Annals of Internal Medicine -
d)Journal of Health Politics, Policy and Law -
e)Journal of HealthCare Quality -
f)Med Bio World - Hospital & Healthcare Management Journals -
The summaries should be well thought out. The following is a suggested format for your papers.
1)Introduction – Reason for selecting the article.
2)Ideas or thoughts presented by the article.
3)Your analysis of the article and a critique.
4)Conclusions and opinions that may be derived from the article.
The summary papers will be graded on a scale of zero – 10 points. Grading will be based on the following criteria:
1)Selection and current relevance of the topic for review.
2)Clear presentation of the ideas and thoughts from the article.
3)Your analysis of how the article corresponds to current issues and trends in Health Care Quality.
4)Writing style.
5)Clarity of presentation, grammar and spelling.
Three shortessayswill be due on the weeks assigned. Please see agenda on the following pages. The papers must be well presented. Submit one copy to the instructor. The copy will be returned.
Class Participation (15% of Overall Class Grade)
Active classroom participation is encouraged. Each student will have adequate opportunities to participate in classroom discussions and two small classroom projects. Level of participation will contribute towards the overall course grade. A small proportion of the grade is assigned to classroom attendance.
PROJECT: Quality Management/Improvement Program Development
A major classroom project will be the development of a Quality Management/Improvement Program for a health care entity, to be assigned during the course.
Students will form teams and develop a Quality Management/Improvement Program for their assigned entity. The program development will make use of principles and standards presented during the course.
Each student within a team must make specific contributions to the program development. The programs developed will be presented to the class by a representative from each team with a written copy submitted to the instructor noting each participant’s contributions. Please see course agenda below for timelines. Guest speakers may be present during presentations and will contribute to the discussions.
Grading For “The Quality Management/Improvement Program Development Project": (Constitutes 30% of the overall class grade)
Each student’s contribution towards the team project will be presented in form of a paper not less than three double-spaced type written pages. The paper shall comprise of the following elements:
a)Introduction to the portion being contributed by the student. (10% of Mid term Grade)
b)Presentation of the ideas and components the student is responsible for(10% of Mid term Grade)
c)Discussion on the importance of the student’s contribution towards the team project using the principles and theories discussed in class as well as pertinent literature reviewed by the student. (40% of Mid Term Grade)
d)Class Presentation by Team (40% of the Mid Term Grade)
Position Paper:This constitutes 30% of the overall class grade)
Development of a Quality Management/Improvement Program may present organizational and process problems or issues that need to be reviewed and resolved if possible. The position paper will use the Quality Management/Improvement Program development exercise as its base. Develop your view of an idea or a problem related to the program development using professional literature and other resources from within or without the course materials. This position paper is expected to be formulated on the increased graduate level knowledge base and must have four major components.
a)Description of the problem or idea. (20% of the Final Exam Grade)
b)Description of the significance of the problem or issue arising out of the Quality Management/Improvement Program development. (30% of the Final Exam Grade)
c)Your position, analysis and proposed solution if applicable. (40% of the Final Exam Grade)
d)Literature support for your position and analysis. (10% of the Final Exam Grade)
The position paper will need to be written on a maximum of 10 double spaced pages. Your position paper must be presented to the class. Arrangements for your presentation are to be made at least a week prior to the desired date. The oral class presentation of your position paper should be 15 minutes in length, followed by a question & answer session. Grading will be based mainly on the written paper. Oral presentations will only help enhance the overall final class grade for 550. Please note: student’s grades will not be affected adversely if oral presentations are not made. No presentations will be allowed after week 14.
For the short notes topic the student will be expected to write a short paragraph on each of the topics.
Please see agenda for timelines.Agenda is subject to change.
SEQUENCE OF ASSIGNMENTS
WeekObjective
Week 1 – January 29a) Introduction to the course.
b)Literature Review Guidelines.
c)Introduction to Terminologies.
d)Introduction to Health Care Systems.
Week 2 – February 5a)The evolution of Health Care Quality Management with a
historic perspective.
b)Basic Elements of Quality Improvement
Readings: Review Chapter 1(Prescribed Text Book)
Week 3 – February 12Essay # 1 Announced
a)Basic Elements of Quality Improvement continued.
b)The Deming approach to Quality Improvement.
c)Principles of Continuous Quality Improvement (CQI) and
Total Quality Management (TQM).
d)Outcomes in Quality
Readings: Chapter 2 & 3; (Prescribed Text Book)
Week 4 – February 19a)Principles in developing a Quality Improvement Program
in health care (Part 1).
b)Quality Improvement and the Physician Factor.
c) Organizational Responsibilities in development of a
Quality Improvement Program.
d)Selection of Team Leaders for the project.
Review: Chapter 11 (Prescribed Text Book)
Week 5 – February 26a)Development of a Quality Improvement Program ( Part 2).
b)Strategic Planning and Quality Improvement.
c)Project on Quality Improvement Program development.
d)Suggested Readings and literature search discussions.
Review: Chapter 6 (Prescribed Text Book)
Week 6 – March 5Essay # 2 Announced
a) Use of Data for Quality Improvement.
- Data for Structure, Process and Outcomes Measures.
- Data for service measures.
Review: Chapter 9 (Prescribed Text Book)
Week 7 – March 12a) Progress Report and Updates on the Quality Improvement
Program development by each team.
b)TeamBuilding
c) Statistical Analysis in Quality Management
Review: Chapter 4 (Prescribed Text Book) & Lecture Notes
Week 8 – March 19a) Health Plan Report Cards.
b)Health Employer Data Information Set -2007/2008 (HEDIS).
c)Member Satisfaction as data used for Quality Improvement.
d) Group Presentations of Quality Improvement Program.
Review: Chapter 5 (Prescribed Text Book)
Week 9 – March 26MID-TERM EXAM / PRESENTATIONS
April 2ndSPRINGBREAK
Week 10 – April 9Essay # 3 Announced
a)Guest Lecturer: Topic to be announced
Suggested Readings.
b) Class Room Project
Week 11 –April 16a) Introduction To Government Legislation And Health Care &
Understanding Regulatory Requirements (Guest Lecturer)
b) Class Room Project
Week 12 – April 23a)Paper # 3 ---- Topic to be announced in class
b) Use of Clinical Practice Guidelines.
c) Disease Management Programs.
d)Provider Credentialing and Quality Implications.
Review: Appendix A (Prescribed Text Book)
Week 13 – April 30a)Incentive Programs and improving Health Care Quality
b)Perceptions of Quality
c)Leap Frog and IHA.
d)Safety
Review: Chapter 13 (Prescribed Text Book)
Week 14 – May 7a)Accreditation and Accreditation Organizations.
b) Selecting Quality Organizations
Week 15 – May 14HCA 550Graduate Students –
Presentation & Submission of Position Papers
a) Course Summary
b)The future of Healthcare Quality
c)Opportunities in Health Care.
Week 16 – May 21Finals
BASIS FOR ASSIGNING THE COURSE GRADE
This being a double numbered course, university policy requires greater expectations, additional work and different grading scales for graduate students. Due importance will be given to student participation in projects, papers, class work and exams. Letter Grades are assigned from A-F for level of achievement in the course. For final computation of the letter grades, following weights for each course component will be used:
ComponentHCA 550
Discussion Papers25%
Development of a Quality30%
Management Program Project
Final Exam (Position Paper for 550 only)30%
Class Participation15%
(Includes two small practical projects)
STUDENT RESPONSIBILITIES AND EVALUATION
Attendance
Students are required to attend and to be prepared for each session by reading any assigned or referenced materials. Attendance is expected at each class session. However, if there are compelling circumstances, an absence may be excused. It then becomes the responsibility of the student to bring her/himself up to date in the class material.
Drops
It is the responsibility of the student to file for a drop status if he or she desires. No drops will be signed by the instructor after the third week.
Exams
A traditional grading system is required for evaluation of student performance in this course. There will be one mid-term and one final exam. Exam formats will be developed and announced by the Instructor. No make-up exams will be offered unless the student has made specific arrangements with the instructor prior to the exam.
ADDITIONAL INTERNET RESOURCES:
America’s Health Insurance Plans /AmericanCollege of Medical Quality /
American Health Information Management Association /
American Health Information Management Association /
American Healthcare Association /
American Society for Healthcare Risk Management /
American Society For Healthcare Risk Management /
Association for Quality /
association for quality /
California Association for Healthcare Quality /
California Code of Regulations /
California Department of Corporations /
ADDITIONAL INTERNET RESOURCES(Con’t.):
California Medical Association /Joint Commission on Accreditation of Healthcare Organizations /
Medicare /
National Guideline Clearinghouse /
National Library of Medicine /
National Network of Libraries of Medicine /
Quality Indicator Project /
CHEATING AND PLAGIARISM
The following is excerpted from the CaliforniaStateUniversity, Long Beach Policy Statement85-19, dated December 13, 1985.
It is the policy of the faculty and administration to deal effectively with the student who practices cheating or plagiarism. These acts are fundamentally destructive of the process of education and the confident evaluation of a student's mastery over a subject. A University maintains respect and functions successfully within the larger community when its reputation is built on honesty. Similarly, each student benefits in helping to maintain the integrity of the University. This policy, therefore, provides for a variety of faculty actions including those, which may lead to the assignment of a failing grade for a course and for administrative actions, which may lead to dismissal from the University. It is the intent to support the traditional values that students are on their honor to perform their academic duties in an ethical manner.
GENERAL:
The following definitions of cheating and plagiarism shall apply to all work submitted by a student.
DEFINITION OF PLAGIARISM:
Plagiarism is defined as the act of using the ideas or work of another person or persons as if they were ones own, without giving credit to the source. Such an act is not plagiarism if it is ascertained that the ideas were arrived at through independent reasoning or logic or where the thought or idea is common knowledge.
Acknowledge of an original author or source must be made through appropriate references, i.e., quotation marks, footnotes, or commentary. Examples of plagiarism include, but are not limited to, the following: the submission of a work, either in part or in whole, completed by another; failure to give credit for ideas, statements, facts or conclusions with rightfully belong to another; in written work, failure to use quotation marks when quoting directly from another, whether it be a paragraph, a sentence, or even a part thereof; close and lengthy paraphrasing of another writing or paraphrasing should consult the instructor.
Students are cautioned that, in conducting their research, they should prepare their notes by (a) either quoting material exactly (using quotation marks) at the time they take notes from a source; or (b) departing completely from the language used in the source, putting the material into their own words. In this way, when the material is used in the paper or project, the student can avoid plagiarism resulting from verbatim use of notes. Both quoted and paraphrased materials must be given proper citations.
DEFINITION OF CHEATING:
Cheating is defined as the act of obtaining or attempting to obtain or aiding another to obtain academic credit for work by the use of any dishonest, deceptive or fraudulent means.
Examples of cheating during an examination would include, but not be limited to the following: copying, either in part or in wholes, from another test or examination; discussion of answers or ideas relating to the answers on an examination or test unless such discussion is specifically authorized by the instructor; giving or receiving copies of an exam without the permission of the instructor; using or displaying notes; "cheat sheets," or other information or devices inappropriate to the prescribed test conditions, as when the test of competence includes a test of unassisted recall of information, skill, or procedure; allowing someone other than the officially enrolled student to represent the same. Also included is plagiarism, which is defined as altering or interfering with the grading procedures.
It is often appropriate for students to study together or to work in teams on projects. However, such students should be careful to avoid use of unauthorized assistance, and to avoid any implication of cheating, by such means as sitting apart from one another in examinations, presenting the work in a manner, which clearly indicates the effort of each individual, or such other method as is appropriate to the particular course.