Quality improvement should be a system-wide initiative. Many healthcare facilities
think of quality only as it applies to the clinical side. They concentrate on outcomes
defined by accrediting bodies such as JHACO. Many businesses are like this
too. However, the best organizations use quality tools throughout their
organization. I want to show you the benefits of doing so.

As a healthcare professional would you even think of just treating one part of the
body to keep a patient healthy? For instance, do you think that just by concentrating
on the heart that you can keep the rest of the body healthy? Certainly
not! Healthcare professionals know that to keep a body and mind healthy they must
concentrate on the whole body. That’s why we give patients regular physicals.

A healthcare facility or site is much like a human body. All parts much function well
to insure positive outcomespatient health, a good bottom line, and time and staff
to get things done. A hospital is more than just the doctors and nurses. The
administrative staff and all other supporting staff are important too. For instance, in
a recent issue of Quality Progress an article highlighted a change in food delivery
which greatly impacted profit and patient satisfaction. The hospital decided to let
patients order food from a menu much like any commercial restaurant at any time
convenient to the patient and not too unreasonable for the hospital. They
responded to patient needs and wants and saved money doing so.

If your site is a family doctors office, do you think that the only important functions
are those provided by the doctors and nurses? What do you think a patient would do
if he or she got excellent delivery of primary health treatment and prevention but
had a horrible experience with billing? That patient might very well end the
relationship with your facility.

Research has shown that the key to profits is customer loyalty. One of the key
ingredients of customer loyalty is quality of service and product delivered by
satisfied employees. That means that every facet of an organization is important in
delivering a service or product.

So how do you get started?

–Leadership is a key ingredient. Leaders at all levels must support system-wide
quality.

–Gather information on quality improvement ideas from all areas and staff. No
one’s ideas are unimportant.

–Form cross-sectional teams to solve the important problems that you have
identified.

–Gather baseline data about the process as it exits now so you know when you are
improving and by how much. Monetary measures are important.

–Make a detailed plan that all team members can agree upon and educate the staff
about the tools needed to implement the changes.

–Implement the changes and measure your success.

–Make the new, improved methods standard operating procedures.

Many of the ideas above come from Lean Healthcare ideas and other quality
improvement initiatives, such as Baldrige and Six Sigma. The CFO of one local
hospital with whom I spokeMetro Hospital of Grand Rapids, MIstated that Lean
was one their primary tools and that it had made an enormous impact at their
sites. Metro was even recognized recently in a national publication of The Institute
for Healthcare Improvement as a leader in quality.

Implementing quality improvement throughout an organization is a difficult task.
For many, this approach is a radical cultural change. Such changes fail without
commitment from leadership and steady and firm hand guiding the changes. I
suggest that you start small and spread the initiatives methodically throughout your
organization. At each step demonstrate to all the benefits for the organization and
to the individuals. Doing so will ensure that many will buy into the changes and
commit to continuing quality improvement. I know of some organizations, which
have gone through several Lean training initiatives but have failed to maintain it
system-wide for a variety of reasons. They end up losing many opportunities to
improve the bottom line, increase client loyalty, and improve employee satisfaction
in a job well done.

Donald Bryant helps healthcare providers meet their challenges and writes
“Making Good Healthcare Better” a free monthly ezine for healthcare
providers who want to dramatically improve patient health, improve the
bottom line, and make work more rewarding, guaranteed. Go now to
http://www.bryantsstatisticalconsulting.com to get a free article with tips you can
use to start making improvements immediately and to learn more about Lean Healthcare.

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Q. What is credentialing?

A. It is a process by which insurance carriers and hospitals verify the credentials of the medical provider. This includes verification of licenses, verification of malpractice insurance, verification of college degrees and background checks to disclose any felonies or criminal activity.

Q. Why is credentialing important? Who is it important to?

A. It is important to the provider to maintain his credibility with the insurance carriers and to hopefully receive a contract to participate in an insurance companies various programs. This is critical to a medical provider due to the fact that most of us want to see a doctor in our network as it creates a savings for us with our medical expenses. Most out of network benefits require us, the patient, to meet a deductible before any payments to the provider of services are made.

Q. How does credentialing help the medical provider?

A. Once a medical provider is credentialed and accepted into an insurance plan, their information is then posted in the provider directory. If a patient is looking for a medical provider in their network, they usually search by zip code. If a medical provider is not listed in that directory, the medical provider has missed the opportunity to get a new patient. Therefore, credentialing in a sense is a marketing tool as well.

Q. How does a medical provider go about the process of credentialing?

A. Credentialing is an extremely time consuming process and requires an individuals’ undivided attention. Current documents must be attached to a standard application which should be type written for legibility. Documents include licenses, diplomas, resumes, and declaration pages of the current malpractice. A cover letter should accompany the application and documents, introducing the provider to the carrier or hospital. Most providers use an outside service for this process.

Q. How long does it take to be credentialed?

A. Most carriers take from 90-180 days to complete their credentialing process. Once the provider is credentialed, the applications goes before a committee for final acceptance into an insurance plan.

Q. How will the provider know if they are accepted into a plan?

A. Most carriers inform the provider via letter along with a welcome packet of some type. Another method is to track your application which requires someone to contact the carrier every couple of weeks to check the status of the application.

All in all, credentialing is a very important part of the medical providers’ business.

Michele Graham
CEO and Owner of Professional Healthcare Management
Billing and Credentialing Service
41 years in the healthcare industry

http://www.phmnetwork.com
http://phmnetwork.blogspot.com

http://www.healthcarenewsonline.com

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While the need for qualified nurses has always been a factor in the healthcare industry, the demand is greater now than in the past decade. Who will make the Nursing Choice?

Nursing is today a very bright career option given its wide application and multifaceted nature. Though nursing has always been to support health needs of the people, but being an inseparable part of doctor-patient relationship, it has undergone many alterations effected by the changing needs of the people and the society at large. Today nursing has assumed a colossal role, encompassing all aspects of healthcare provided to the society. The testimony to its value lies in the fact that nursing makes the largest component of healthcare profession with about 2.6 million registered nurses (RNs) in US. So then what does a nurse do? By tradition, a nurse’s unique function in health care is to assist the patient in regaining his or her normal health and activities within a reasonably short period of time. In other words, nursing caters to that function where a patient is helped to perform routine activities, which she or he would be in a position to do without aid under normal health conditions. Nursing differs from practicing medicine in that it aids in easing problems arising out of ailment rather than diagnosing and treatment of illness as is the case with medicine.

While this has been the traditional view, nursing today belongs to a wide gamut of healthcare activities. Thus, apart from catering to patients’ well-being in hospitals, community health clinics, nursing homes, long-term care centers and home-care agencies, nursing is also a sought-after profession as teachers in nursing schools, as research scholars engaged or helping in research activities, as hospital regulators, as professionals in insurance and healthcare companies, and above all as administrators in nursing related entities.

Even as nursing career has diversified into many disciplines, the principal requirement of nurses remains in hospitals and different healthcare centers. However, many nurses prefer to function independently as nurse practitioners, certified midwives, specialist nurses for clinics, certified nurses for anesthetists and so on. Many of these specialized jobs call for nursing education up to master’s level after having served as registered nurses that require bachelor’s degree.

Let us now look at what a student needs to know in order to become a practitioner in nursing.

Studying Nursing

You need to be a student of Science in high school with chemistry, biology, physics, psychology, algebra, English, and preferably computer application. In order to enroll into a nursing school, you may need to take NLN Pre-Admission Examination in addition to other tests, such as SATs. It is always a good idea to seek admission in state-approved accredited nursing schools. For good career prospects, studying 4-year Bachelor of Science in Nursing (BSN) program is preferable. Other common courses are 2-year Associate Degree in Nursing (ADN) program and 2 to 3-year Hospital Diploma in Nursing. A BSN degree will pave the way to study masters course in nursing, if later you so desire.

NCLEX Licensure Examinations

Assuming that you have already earned your bachelor degree in nursing, it is now time for you to pass one of the two licensure examinations conducted by the National Council of State Boards of Nursing (NCSBN). The examinations are meant to test your competence to effectively and safely serve as a newly licensed, entry-level registered nurse. The two examinations are the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and the National Council Licensure Examination for Practical Nurses (NCLEX-PN).

For more detail information about the tests and how you must prepare to perform well, consider visiting the website of NCSBN.

Nursing Opportunities

Career opportunities are aplenty in nursing as briefly elaborated above. There is indeed a varying choice of attractive careers available today for nursing graduates owing to several factors, the chief among which being huge shortfall of qualified nurses projected over the coming decade.

Earnings Potential

Upon becoming a registered nurse (RN) with 4-year BSN degree, entry-level nurses can expect yearly income of $31,000 to $41,000. That translates to $15 to $20 per hour of work. Salary increases with experience. If you opt to become a traveling nurse later in your career, you may make between $23 to $35 per hour plus free housing, free insurance, travel reimbursement and lots of fringe benefits.

As you can see, nursing is a good career option loaded with immense opportunities.

Copyright 2006 Linda Raye

Linda Raye is an accomplished author having a special interest in healthcare and nursing. You can contact her at LRaye@cinci.rr.com
For more information on nursing visit the website at: http://www.nursingchoice.com

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