Introducing the Hospital-Based Healthcare QMS

Grace Landis Duffy, LSSMBB, President, Management and Performance Systems, Eustis, FL, USA

Keywords: Healthcare, QMS, Quality Management System

Industry: Healthcare

Level: Intermediate


A Hospital-based Healthcare Quality Management System Model must provide the CEO and CMO a model to improve: 

-Patient Outcomes, Safety, and Satisfaction

-Cost Savings, Risk Management, and Regulatory Compliance.

These imperatives are being driven within the United States in part by the 2016 Centers for Medicare and Medicaid Systems(CMS) Quality Strategy which ties reimbursement to quality and value metrics. Other country healthcare systems undoubtedly have equivalent regulations and measures that drive priorities and decision making. International readers are encouraged to read this document with local regulations and measures in mind.

The CMS Quality Strategy envisions healthcare provisions that are person-centered, provide incentives for the right outcomes, are sustainable, emphasize coordinated care and shared decision-making, and rely on transparency of quality and cost information. However, in order for providers to achieve these results, there must be an overarching program capable of enabling and maintaining the necessary operational and structural changes. In most industries, Quality Management Systems provide this structure by creating a framework for defining and delivering quality outcomes, managing risk and continually improving performance and processes.

A QMS is defined as a formalized system that documents the structure, responsibility and procedures required to achieve effective quality management focused on quality policy and quality objectives to meet customer requirements. In healthcare, a QMS would specifically describe the process for improving patient outcomes across the key components of care while improving operating performance through continuous quality improvement.

To help achieve the CMS Quality Strategy requirement and enable healthcare providers to meet the future demands of care delivery, the ASQ Healthcare Technical Committee has developed a model to describe and depict a healthcare-specific Quality Management System for hospital-based care.

The model described in this session offers a systemic structure focused on the patient and the patient experience, supported by four key Components of the Care Delivery and ten Quality System Elements. Fully integrated, this structure will enable hospitals to meet both the quality and value-based goals imposed by the CMS Quality Strategy.

By enacting this structure in hospitals of all sizes, hospital managers can create the operational environments to support and comply with CMS everexpanding demands. In a hospital with a properly functioning Quality Management System, there is no need to ramp up for an inspection because the requirements are so integrated into the organization s processes that compliance with requirements is the way the staff work all the time.

The audience will be introduced to the fully illustrated Hospital-based Healthcare QMS model as well as participate in a dialog exploring the integration of the components comprising the model into their own healthcare environment.