Course Code: REL-ACU-0-UTMQI
Hours: 0.5
Type: Online Course
Content Expiration Date: 12/31/2029
Learning Objectives:
Identify the role of quality indicators in healthcare and utilization management.
Recall agencies and programs that incorporate quality indicators into healthcare reporting.
Outline:
Section 1: Quality Indicators
Overview of Quality Indicators
Quality Indicators Defined
Applying Quality Indicators
Value-Based Programs
CMS Quality Measures
Hospital-Acquired Condition (HAC) Reduction Program
Hospital Readmission Reduction Program (HRRP)
National Quality Forum (NQF)
The Joint Commission (TJC) and ORYX®
Agency for Healthcare Research and Quality (AHRQ)
Consumer Assessment of Providers and Systems (CAHPS)
Healthcare Effectiveness Data and Information Set (HEDIS®)
Using Quality Indicators in UM
Length of Stay (LOS)
Denials
Data Submission
Knowledge Check
Key Takeaways
Section 2: Conclusion
Course Summary
Course Contributor
Resources
References
Centers for Medicare and Medicaid Services (CMS)
Subject Matter Expert: Sarah Hunter RN, SCRN, CNRN, CMSRN
Ms. Hunter is a SME writer at Relias. Her area of expertise is neuroscience nursing, medical-surgical nursing, and thoracic surgery. Ms. Hunter has worked at the bedside for 9 years in acute care and intermediate care at a large community hospital in North Carolina. She also served as chair of the hospital's shared governance council for Nursing Quality Improvement. She has a Bachelor of Arts and an Associate Degree in Nursing. Ms. Hunter is a Stroke Certified RN, Certified Neuroscience RN and a Certified Medical-Surgical RN.
Target Audience:
The target audience for this course is: Care and Case Managers; Nursing Personnel; in the following settings: Ambulatory Care, Hospitals: Acute, Hospitals: Critical Access (CAHs).
Relias Learning will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Relias Learning has a grievance policy in place to facilitate reports of dissatisfaction. Relias Learning will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias Learning at support@reliaslearning.com.
All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.