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Applying total quality management to the medical practice.

Total quality management (TQM) has the potential to help medical practices in the transition to a healthcare system that is more demanding in terms of both higher quality and lower cost. Incorporation of TQM principles, however, must be based on creating skills in the areas of teamwork, communication, and problem solving. The potential gain will be seen in improved patient satisfaction, increased revenue as a result of more accurate billing, clearer understanding of costs and outcomes, better clinical documentation, and enhanced staff productivity.

Documentation↗

A study of patients receiving no billed nursing care.

Although home health care traditionally is conceptualized as nursing care, in today's environment care at home may be delivered by a myriad of professional and nonprofessional practitioners. In fact, many patients who receive home care do not receive billed nursing visits. We studied a group of patients (n = 200) who received no billed nursing care, but rather received billed care from therapists, social workers and home health aides. This cohort of patients differed from patients who received billed nursing care in several ways: they were more frequently referred to home care from the community, their prognoses on admission to home care were significantly better, and their outcomes from home care services were considerably more favorable. Clearly patients not receiving billed nursing care have service and resource needs different from those of the population receiving billed nursing care. Therefore, new perspectives must be used when considering how to assess, deliver and perhaps pay for the requirements of these patients.

Home Care Services↗

When patient meets provider--opportunities lost.

Healthcare customers demand the highest levels of service in all aspects of their healthcare experience. Sometimes, though, they do not receive the expected level of service. What are some of the critical customer service failures identified by patients, and what can health-care facility staff members do to rectify those failures? The following article presents passages (in italics) from one patient's recent experiences at a hospital. After each passage, the author analyzes the patient's encounters with failures in customer service.

Financial Management, Hospital↗

The impact of managed care contracts on the admission and registration process.

With increasing demand placed on the admission and registration process, hospitals are undergoing dramatic operational changes. These changes are necessary to maintain the vital cash flow of the hospitals. A major factor forcing hospitals to rethink the front line process in the admission and registration area is the impact of managed care.

Admitting Department, Hospital↗

Patient accounts and CQI--one department's experiences.

When people think of the quality revolution in health care, most probably will not consider the patient accounts area as the leader. Patient accounts professionals seeking to rectify this reputation need to encourage healthcare facility management staff to pay more attention to the monthly volume of patient complaints. Customer satisfaction levels can be controlled by a CQI-invested patient accounts department that effectively manages the patient billing process.

Financial Management, Hospital↗

How healthcare access management can facilitate an organization's approach to managed care.

Healthcare Access Managers can positively influence the success of their facility's interaction with managed care and recipients of services by applying their knowledge of sound business practices. Most managed care companies are eager to build these positive working relationships in their respective market areas. A positive approach can result in a win/win situation for all parties involved in the delivery of services.

Managed Care Programs↗

Improving patient satisfaction at all points in the revenue cycle.

A common expectation among consumers, whether in the market for a new automobile, a new home, or healthcare services, is that a certain level of customer service will be provided along with the product or service. And the level of customer service provided substantially influences a consumer's satisfaction with the purchase of a product or service.

Patient Credit and Collection↗

Provider automation. The secret to better cash flow.

Morton Plant Hospital has a remarkable track record in applying automation in its business office. The provider cut its receivables in half while reducing patient complaints about billing.

Computer Communication Networks↗

Nursing process approach improves receivables management.

The "nursing process" is a systematic decision-making approach to problem solving based on open-system theory. This theory assumes that there is an on-going interchange between all system components. Components cannot be viewed in isolation, because decisions regarding one component will affect other components. Receivables management is similar to the nursing process, in that it involves constant diagnosis, assessment, and intervention in the work in process during all phases of the receivables cycle. In experiments that applied the nursing process concept to the management of accounts receivable in several hospitals, gross days in accounts receivable were reduced and cash flow was increased.

Accounts Payable and Receivable↗