Quality Management
About QM
Program Description CoastalCare maintains a Quality Management Program which is a comprehensive, proactive program that provides the structure, process, resources, and expertise necessary to systematically define, evaluate, monitor and ensure that high-quality, cost-effective care and services are provided to consumers. The program is a commitment to continuous quality improvement principles and requires the participation of the Area Board, providers, and staff members. The Quality Management Program includes a continuous, objective, and systematic process for: monitoring and evaluation of key indicators of care and service; identification of opportunities for improvement; development and implementation of interventions to address the identified opportunities; and for re-measurement to demonstrate effectiveness of program interventions. Introduction CoastalCare statutorily defined as an Area Authority and functionally defined as a Local Management Entity (LME/MCO) is located in southeastern North Carolina. CoastalCare is responsible for managing, coordinating, facilitating, and monitoring the provision of mental health, intellectual/developmental disabilities and substance abuse services in Brunswick, Carteret, New Hanover, Onslow and Pender Counties. This includes: ensuring consumers 24/7 access to services, developing and monitoring providers, authorizing and managing service utilization for state funded services, handling consumer/provider complaints and quality management. In an era of increasing competition, decreasing resources, and healthcare reform, the Quality Management Plan will provide a framework for identifying service delivery system gaps, problems, and performance issues as well as increasing its own efficiencies and efficacies through the use of quality improvement strategies. The Area Authority’s goal is to strengthen the service delivery system and increase the quality of the services to meet the demands of an ever-changing behavioral healthcare environment that is increasingly demanding higher levels of quality, outcomes, and accountability. The Quality Management Plan identifies the quality assurance and quality improvement activities throughout this agency and the network of providers. The plan describes the structure and process by which the organization systematically measures, assesses and improves organizational and provider performance to facilitate positive outcomes on all levels, both external and internal. These outcomes include, but are not limited to: employee, provider, and consumer satisfaction, more effective and efficient operational processes, treatment outcomes, and more efficient use of resources. In order for Quality Improvement to be successful within the organization, it must be woven into all operational areas and supported by both leadership and systems. The most effective way to implement Quality Improvement is to align the QI objectives with the goals of the strategic plan. As the strategic plan should reflect the mission, vision, and values of the organization, then QI initiatives become the thread that creates the fabric of the organization. The CQI structure is integrated when quality assurance provides the foundation, quality planning identifies the performance expectations, and leadership and staff understand that continuous quality improvement means never stopping the efforts to raise the level of quality and/or performance. As part of its network management function, the objectives stem from a central mission to assess, monitor, and improve the quality of care in the service delivery system. The overall objectives of the quality management program are:
CoastalCare believes in a Quality Improvement philosophy (QI). Quality Improvement is the planned, systematic approach for monitoring, analyzing, and improving the organization and service delivery network. Employing QI tools and techniques that focus on meeting the expectations of the “voice of the customer” will result in increased operational efficiencies as well as better outcomes for our members, providers, community partners, colleagues, families, and other stakeholders. Finally, QI provides a vital way to assess and monitor the delivery of services to ensure that they are consistent with CoastalCare's Mission, Vision, Values, and Best Business Practices. Participation in QI is everyone’s responsibility: board members, management, employees, and providers. |
COASTALCARE QI PROJECT FOR STATE FUNDED RECIPIENTS: Reducing Cardiovascular Risk Slide Show Presentation Record of Indicators spreadsheet |
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| QM Team |
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