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View Case Studies | Quality Improvement | Accreditation & Compliance | Utilization of Services Utilization of ServicesIn order to improve the results achieved in an organization, performance measures must be established, monitored regularly, and findings used to target areas needing improvement.MCPP consultants assist teams and organizations in understanding and establishing performance measures for specific programs or activities and for overall organizational performance. Tools and methods for regular monitoring of measures as part of ongoing operational functions are used to implement monitoring processes. Facilitation and consultation services to use performance results to target and achieve improvement are also available. Quality Tools and Methods Training and Education MCPP consultants are experts in training senior leaders, managers, and front line staff in the tools and methods for improving work processes. We encourage training efforts that builds expertise within the organization and encourages continuing improvement and integration of improvement philosophies into the organization's culture. All training activities are tailored to the size and needs of each organization. Facilitating Change and Improvement Projects MCPP Consultants have facilitated many QI, re-engineering, and large-scale change projects. Linking training sessions with actual QI projects is a good way to gain knowledge and practice skills, and to demonstrate the results that are possible by using QI tools and methods. We encourage senior management to be part of a QI project's steering committee to assist in the implementation phase and to provide leadership to the improvement effort. Identifying and Adopting Best Practices Why spend the time and resources to design something brand new when a proven, effective process is available to adapt to your organization? MCPP consultants have conducted successful, best practice projects in organizations of all sizes. We recommend searching within the organization, in non-competitor organizations of the same type, and in totally different industries for potential best practices. A best practice toolkit is a valuable mechanism for standardizing work and results across departments and saving the costs of "reinventing the wheel".  Accreditation and Compliance ConsultationTraining in Interpretation and Compliance with Quality and Performance StandardsSuccessful compliance with accreditation or quality standards requires knowledge of the intent of standards and the various ways in which standards can be met. MCPP consultants have presented local and national level courses to improve participants' abilities to achieve full compliance with various types of quality standards, including National Committee for Quality Assurance, CDC Standards for Public Health, and Baldridge Criteria. Offerings are tailored to the organization and to the size and expertise of the participants. Assessment and Mock Surveys One of the best ways to determine current levels of performance and compliance is to conduct a test against standards or requirements. Consultants can either evaluate the processes and documentation against a specific standard, or conduct a mock survey against a full set of standards. This evaluation gives the client an indication of the most critical areas needing attention and suggestions for activities that will bring the organization to a higher level of compliance. Compliance Program Development and Implementation Some organizations need assistance in the development and implementation of their compliance programs for meeting required quality and performance standards. Hiring additional FTEs to perform this function may not be cost effective or feasible. MCPP consultants work with operations staff to develop and implement compliance programs. The consultant provides the expertise in the standards and how to meet them, while the internal staff executes the implementation of the plans. Assessment Matrix Example from Mock Survey
Utilization of ServicesUtilization Management activities are often classified in three categories, prospective, concurrent and retrospective review of services. By addressing all three types of utilization, providers and health care organization can maximize its resources and reduce unnecessary costs. MCPP consultants assist in the development of UM plans and the collection of data to improve care and business results.Prospective Management of Services Through the use of clinical guidelines and protocols, health care organizations of all types can optimize the treatment and the utilization of services. MCPP consultants are experts in assisting clients in developing and implementing clinical practice guidelines. Prior-authorization processes are another mechanism for reviewing high-cost and high-risk services to assure appropriate utilization. Concurrent Management of Services Any provider who bears financial risk for utilization should consider concurrent review of services. Care management activities direct patients to appropriate settings for care, and to appropriate treatment. Coordination with inpatient discharge planning staff helps to address lengths of stay and assure patients have support for services after discharge. Retrospective Review of Services Using aggregate data to evaluate levels and types of services in individual practices, or for a specific population helps to identify under and over-utilization of services. By addressing inappropriate utilization, patients receive more appropriate care, and health care resources are maximized.
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