Quality Improvement (QI) Program
The Quality Improvement (QI) program aims to continually improve the service and care provided to members by both PerformCare and the provider network. The QI program focuses on identifying measures and studies of many aspects of treatment. A QI committee meets quarterly to oversee the work of the QI program and annually adjusts its goals. The QI program focuses on 10 areas:
- Access — The degree to which appropriate care and services are accessible and obtainable to meet the member's needs.
- Appropriateness — The degree to which the care and services provided are relevant to the member's clinical needs, given the current state of knowledge and available resources.
- Competency — The degree to which providers and PerformCare staff adhere to professional and/or organizational standards of care and practice.
- Consumer and family involvement — The degree to which HealthChoices members and families of members have an active role in PerformCare.
- Continuity and care coordination — The degree to which needed health care services for a member or specified population are coordinated across levels of care, organizations, or care of physical health and behavioral health.
- Diversity and cultural competency — The degree to which providers and PerformCare staff understand and demonstrate respect for differences among groups.
- Outcomes and efficacy — The degree to which a treatment or service improves health status.
- Prevention and community outreach — The degree to which PerformCare services promote health, prevent deterioration of conditions, and educate the community.
- Safety — The degree to which risks of adverse outcome are reduced for the member and others, including the health care provider.
- Service excellence — The degree to which PerformCare meets established service standards and produces provider and member satisfaction.
If you would like more details about quality improvement activities, please contact the Quality Improvement department at 1-717-909-2102.