Quality Management In Health Care Delivery HCA 450/550 - 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 450/550 - Fall Semester 2007
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 ext 4274 or
Office Hours: By appointment only on day of the class.
Term:Thursdays, September6 – December 20, 2007
Class Meeting Times: Hours: 7:00 p.m. to 9:45 p.
Class LocationET 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
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 familiarize the student with the concept of Quality and the process of Quality Improvement across the Health Care continuum. This course focuses on the history and evolution of quality, its terms, principles, theories, and practices. The student is introduced to a diverse collection of 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. 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 evolution of the health care systems and Quality Management/Improvement Programs up to the present and reflect on its future.
- Understand the reasoning and the importance behind the requirements for Quality
Management/Improvement Programs in the health care environment.
- Describe the current state-of-the-art Quality Management/Improvement Program principles 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 federal and state legislation on Quality Management/Improvement Programs in Health care.
- Understand 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.).
- Understand the use of data and statistics for an effective Quality Management/Improvement Program.
- Understand basic elements of provider credentialing, risk management and liability issues as they relate to Quality Management/Improvement Programs.
- Understand the effect of Patient Safety issues on Quality Management/Improvement systems.
- Understand the recent trends in 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 (20% of overall class Grade)
To understand the latest trends in Quality Management/Improvement, 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 and summarize assigned articles or readings in the form of short papers (a minimum of two amd maximum of three, 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 papers should be well thought out. 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 that may be derived from the article.
The summary papers will be graded on a scale of zero – 10 points (Total of 30 Points for 3 papers which is 20% of the overall class Grade). 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 summary papers will 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 (20% of Overall Class Grade, which is 30 Points)
Active classroom participation is encouraged. Each student will have adequate opportunities to participate in classroom discussions and two small class room projects. Level of participation will contribute towards the overall course grade. A small proportion of the grade is assigned to class room attendance.
PROJECT: Quality Management/Improvement Program Development (Project in Fall Semester only for HCA 450 and HCA 550)
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 Quality Improvement principles and guidance providedin the course. Each student within a team will make specific contributions to program development. Programs developed will be presented to the class by representative(s) from each team. 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 or a total of 45 Points)
Each student’s contribution towards the team project will be presented in form of a paper not less than two or maximum of three double-spaced type written pages. The paper shall comprise of the following elements:
a)Introduction to the portion being contributed by the student. (20% of Mid term Grade)
b)Presentation of the ideas and components the student is responsible for(40% 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)
Position Paper (HCA 550): Position Paper (For Graduate HCA 550 Students only. This constitutes 30% of the overall class grade or 45 Points)
The position paper may use the Quality Management/Improvement Program development exercise as its base. Development of a Quality Management/Improvement Program may present organizational and process problems or issues that need to be reviewed and resolved if possible. However student is free to select a different Quality Improvement topic. The topic for position paper needs approval by the lecturer. Develop your view of an idea or a problem related to the topic selected, using professional literature and other resources from within or without the course materials. This position paper must have four major components.
a)Description of the problem or idea. (Approx. 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. (Approx.30% of the Final Exam Grade)
c)Your position, analysis and proposed solution if applicable. (Approx.40% of the Final Exam Grade)
d)Literature support for your position and analysis. (Approx.10% of the Final Exam Grade)
The position paper will need to be written on a minimum of 10 or maximum of about 18 double spaced pages. Your position paper may 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.
Final Exam for HCA 450 (Constitutes 30% of the Overall Class Grade or 45 Points)
HCA 450 students will be administered a final exam equivalent to 30% of the overall class grade.
Then exam may be a multiple choice exam or an essay exam ( series essay questions). Exam format will be selected by the lecturer.
1)Multiple Choice Exam: A set number of questions (Approximately 40 to 50) will be provided to students through Beach Board. Students would have a fixed amount of time (2 Hours to answer all questions). The exam will be scored by the computer.
2)The essay exam: Exam comprises four questions. Three questions are discussions from the topics reviewed in class during the semester. These may be in form of problems built around specific health Care Quality Improvement scenariosThe fourth question is a series of short notes on specific topics discussed during the course.
For each essay question, the student will be required to use the following format:
a)Introduction (20% of the question grade)
b)Factual presentation of the areas asked for in the question. (40% of the question grade)
c)Brief Discussion of the topic (30% of the question grade)
d)Conclusion. (10% of the question grade)
Length of the written answer is left to the discretion of the student. It is important to ensure that the above four points be taken into consideration for the answer.
For the short notes, students will be expected to write a short paragraph on each of the topics.
The Class agenda is presented below:
SEQUENCE OF ASSIGNMENTS
WeekObjective
Week 1 – September 6, 2007a) Introduction to the course.
b)Literature Review Guidelines.
c)Introduction to Terminologies.
d)Introduction to Health Care Systems.
Week 2 – September 13, 2007 a)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 – September 20, 2007 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 needed of Quality
Readings: Chapter 2 & 3; (Prescribed Text Book)
Week 4 – September 27, 2007a)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 – October 4, 2007Paper # 1 Due in Class– Why Quality Improvement Program in Health Care?
a)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 – October 11, 2007 a) Use of Data for Quality Improvement.
- Data for Structure, Process and Outcomes Measures.
- Data for service measures.
b)Tools for CQI/TQM
Review: Chapter 9 (Prescribed Text Book)
Week 7 – October 18, 2007Paper # 2 Due in class- Report Cards in Health Care and their implications to quality of care
a) Progress Report and Updates on the Quality Improvement
Program development by each team.
b) Statistical Analysis in Quality Management
Review: Chapter 4 (Prescribed Text Book) & Lecture Notes
Week 8 – October 25, 2007a) Health Plan Report Cards.
b)Health Employer Data Information Set -2007 (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 – November 1, 2007MID-TERM EXAM / PRESENTATIONS
Week 10 – November 8, 2007a)Guest Lecturer: Topic to be announced
b) Class Room Project
c)Suggested Readings.
Week 11 – November 15, 2007a)Introduction To Government Legislation (Guest Lecturer)
b) Class Room Project
Review: Chapter 13 (Prescribed Text Book)
Week 12 – November29, 2007 Paper # 3 Due in class- Impact of legislation on Quality of care
a) Use of Clinical Practice Guidelines.
b)Disease Management Programs.
c)Provider Credentialing and Quality Implications.
Review: Appendix A (Prescribed Text Book)
Week 13 – December 6, 2007a)Incentive Programs and improving Health Care Quality
b)Perceptions of Quality
Leap Frog and IHA.
c)Safety
Week 14 – December 13, 2007a)Accreditation and Accreditation Organizations.
b)Selecting Quality Organizations
c)Course Summary.
d)The future of Healthcare Quality
e)Opportunities in Health Care.
Week 15 – December 20, 2007HCA 550Graduate Students – Submission of Position Papers
FINAL EXAMINATION FOR HCA 450
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, classwork 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 450HCA 550
Discussion Papers20%20%
Development of a Quality30%30%
Management Program Project (Mid Term Exam for both 450 and 550)
Final Exam (Position Paper for 550 only)30%30%
Class Participation20%20%
(Includes Attendance)
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 /
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. By the same token, 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.