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ProgenyHealth’s Quality Focus Delivers Results

October 2017 Blog, The Business of Health Care Comments Off on ProgenyHealth’s Quality Focus Delivers Results

In business, engineering and manufacturing, quality has a pragmatic interpretation as the non-inferiority or superiority of something; it’s also defined as fitness for purpose. Quality is a perceptual, conditional, and somewhat subjective attribute and may be understood differently by different people. In healthcare, we deal with people’s lives, not tangible things so the definition changes. The Institute of Medicine defines health care quality as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”

ProgenyHealth has a quality management (QM) program, the purpose of which is to ensure that our team, interacting with clients and our client’s members uses a coordinated, integrated and comprehensive approach to address preventive and clinical care, while ensuring safety and access to services for all client’s members.

The ProgenyHealth QM Program is designed to integrate all levels of staff and departments to participate in QM/Quality Improvement (QI) activities. Having the participation of various departments at ProgenyHealth, including its leadership, demonstrates the company’s commitment to a successful and effective QM Program.

Examples of activities ProgenyHealth has undertaken under its QM umbrella include:

  • Quality Improvement Projects addressing such topics as:
    • Improving care transitions through increasing receipt of discharge summaries
    • Increasing successful contact rates by case managers
  • Assessment of client and member satisfaction;
  • Analysis of length of stay and readmission rate data to identify possible over or under utilization of services; and
  • Identification and elimination of risks identified during regular vulnerability scans of our information systems network.

Outcomes we are proud of:

  • Publication of four clinical practice guidelines with two more in development;
  • We have been URAC Accredited for UM since 2007 and CM since 2011;
  • With one client, we reduced the readmission rate during the first year of life by 50%;
  • In another targeted population, we exceeded Healthy People 2020 Breastfeeding goals for both “Ever Breastfed” and “Still Breastfeeding at 6 Months,” and
  • For the past 4 years, our overall client satisfaction has averaged above 90%.

Phil Crosby, an American businessman and author who contributed to management theory and quality management practices, said “Quality is the result of a carefully constructed cultural environment. It has to be the fabric of the organization, not part of the fabric”.

At ProgenyHealth quality is our culture. It is the responsibility of every employee at ProgenyHealth, from the newest hire to the one who has been with the company the longest, from the CEO to our interns. It is this commitment that has driven ProgenyHealth to be the leader in NICU management.

 

About Our Author:

Debbie Sweeney, RN, MSN, MBA, is Vice President of Quality, Compliance and Network Expansion at ProgenyHealth. She is accountable for all aspects of both the Quality Management and Corporate Compliance programs, and is responsible for the successful integration of new client business. Debbie has more than twenty-five years of experience in the managed care sector, including commercial and government-sponsored programs..