you should be familiar with quality improvement initiatives including NCQA’s HEDIS® measures. Health plans and physicians must ensure they are meeting standards set by the accreditation agencies, such as NCQA. As a physician practice manager for Dr. Jones, you have just conducted a mock survey of the patient chart data. The data shows that your physician practice is not meeting standards for two HEDIS® measures.
Choose two HEDIS® measures (from the list below either a, b, c, d, e or f) that must be implemented in a physician practice to improve patient outcomes.
Describe the sources of data needed to conduct the two measures.
Using one of the quality improvement models (Lean, PDSA, or Six Sigma), explain how you would use the model to implement the two chosen HEDIS® Measures.
e. Women age 50-74 years, who have had a mammogram during the preceding 24 months. Exclusion of those women who have undergone bilateral mastectomy.
f. Male 50 years and greater who have received an annual PSA and/or Digital Rectal Exam.
Moin, T., Scales, C., & Sinay, T. (2014). Principles of healthcare quality management: Tools and applications.San Diego, CA: Bridgepoint Education, Inc.