Question

Explain the process used by managed care plans for "quality management."

the research paper is about Quality management.

Answer 1

" People forget how fast you did a job, but they remember how well you did it."

- Howard Newton.

Quality management- by the word itself its understood that it is all about management of quality. Quality is the major requirement in todays scenario where every customer heir only those goods and services which is of good quality or which can meet the required standards. Quality management ensures that an organizations services or products are consistent. The quality management include four main components. They are:

• Quality planning
• Quality assurance
• Quality control
• Quality improvement.

The concept of quality management was first proposed in the year 1924 by Walter A. Shewhart. This concept of quality management is adopted internationally and it the primary goal of evey organization to achieve quality. The international standards for quality management adopts a number of quality principles which guides the institutions towards improvement.

• Customer focus: The primary focus of quality management is to meet customer requirements and to exceed customer expectations.
• Leadership : It is important that the quality management activities are supervised by a good leader so that the outcome of the activities is always towards the goal achievement.
• Engagement of people: Quality of a service depands greatly on the competency and efficient effots of its staffs.
• Improvement: The quality improvement is a continous process that increases the level of performance and provides new opportunity for development.
• Evidenced based decision making: In order to achieve quality in every activity, the actions implemented should be evidenced based. It provides the basis for every activity.
• Relationship management: Quality management often is an interdepartment process which requires maintaining a good work relationship with its customers, retailers, and suppliers.

In order to measure the quality standards, the International organization for Standardization (ISO) created the Quality Management System(QMS) standards in 1987. These standards are applicable to different industries depending on the activity or process. It offers guidelines for the performance improvement. There are seven tools for quality assessment and management. They are:

• Cause and effect diagrams
• Sheet Chart
• Control Chart
• Histogram
• Pareto chart
• Scatter diagram
• Stratification.

The rapid expansion of Medicaid managed care has raised certain questions the ability and willingness of health plans that promises Medicaid beneficiaries to provide high quality care to their patients. The success of the health care delivery depands on the intergration of the total quality management and managed care. The nursing faculty play a key role in the integration of these two concepts. Like the above mentioned quality management principles and and tool, the quality management is practiced in manage care.