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URAC Standards Objective (This is Department/Own

the "Why" as seen er (#1 Who)


in #5)

A. QM Objectives

Performance
metrics are utilized to
monitor and improve
the provision of
telehealth care to
consumers based on
identified
opportunities to
improve

CORE 35: 1) Complaint Health Services


Complaint Handling Resolution Process Clinical,
Health Services
a) All Complaints are Administrative,
resolved according Health Services
to the [insert name Operations
of policy].

b) Meet the specified


timeframe for
CORE 12: 2) Client Example [Quality
Client Satisfaction Satisfaction Management
Department/John
a) Client satisfaction Doe]
surveys are handled
according the the
[insert name of
policy]

b) Deliver the highest


quality of service to
our clients, It is the
organizations goal to
maintain a
Reporting on Goal Measurement Date (#3 Frequency
Performance Result When) (#3 When)
Indicator
Measurement/
Key Tasks/
Action Items
(#2 What--This is
the metric
developed based
on the Why in #5)

95% of all 95%


Complaints are
resolved within
(30) calendar days.

Data is
collected, analyzed
and reported for
the previous
month. 93% 4/1/2017 Quarterly
93% 7/1/2017 Quarterly
95% 10/1/2017 Quarterly
97% 01/01/2018 Quarterly
see annual 2/16/2018 Annually
work plan
evaluation.

Maintain a client 95%


satisfaction rate of
<95%

97% 4/1/2017 Quarterly


95% 7/1/2017 Quarterly
97% 10/1/2017 Quarterly
96% 01/01/2018 Quarterly
2/16/2018 Annually
Committee (#4 [BONUS TOOL]
Where) Don't re-create the wheel. Use this for
your annual evaluation.

Annual Work Plan Evaluation


Measurement / Outcome

[BONUS TIP: EXAMPLE]

2017 Annual Evaluation:

During the first two quarters of 2017, the


goal of 95% was not met. On 05/31/2017
a corrective action plan was developed
and initiated by the quality management
QMC department. Corrective actions included
QMC retraining staff on complaint handling
QMC processes and individual staff
counseling. Third quarter results
QMC
improved by 2% and we met our goal of
95%. The fourth quarter of the year
exceeded the established goal by 2%
with a 97% resolution time. The QM dept
will continue to monitor on an ongoing
basis.
retraining staff on complaint handling
processes and individual staff
counseling. Third quarter results
improved by 2% and we met our goal of
BOD 95%. The fourth quarter of the year
exceeded the established goal by 2%
with a 97% resolution time. The QM dept
will continue to monitor on an ongoing
basis.

[BONUS TIP: EXAMPLE]

2017 Annual Evaluation:

Client satisfaction survey results met or


exceeded the goal of 95% each quarter.
The Quality Management Departemen
will continue to measure and report on a
quarterly basis for 2018.

QMC
QMC
QMC
QMC
BOD