 |
 |
PHCS recognizes the importance and value of quality management and quality improvement.
We demonstrate our commitment to quality with our quality management program, a
company-wide program of continuous quality improvement.
We support the quality management program by: maintaining a cross-functional Quality
Management Committee that is accountable to the PHCS Executive Committee and ultimately
to the Board of Directors, performing critical quality management functions, such as
provider credentialing and re-credentialing and investigating quality of service or care
complaints about network providers, and undertaking projects each year that are designed
to improve the quality of our services.
An essential component of continuous quality improvement is our integrated quality
assurance oversight with aggregate reporting that enables us to identify opportunities
for enhanced performance. Centralized oversight enables us to apply consistent quality
standards and measures across the organization, resulting in more favorable outcomes.
This approach also contributes to our ability to obtain and retain national accreditation
of our Care Management and Network services. Further, it enables us to monitor our
compliance with the extensive state and federal statutes and regulations governing
businesses in our industry.
Employees from across the company participate in and contribute to the quality management
program through the Quality Management Committee. The committee is formed by liaisons from
each of the functional areas throughout the organization. Within their roles, they are
able to increase awareness of the ongoing importance of quality performance, both at the
organizational and departmental levels. Integrated quality oversight enhances our ability
to benefit from:
- a consistent, structured, and broadly representative approach toward quality management and process improvement;
- confirmation that quality improvement and quality management activities throughout the company align with the PHCS stated business strategies;
- dedicated support for compliance with state/federal mandates and national accreditation standards;
- opportunities to improve customer satisfaction by encouraging improvements in customer service; and
- employee involvement in process improvements and ongoing quality initiatives.
In addition to centralized quality assurance oversight, we also maintain several specific
quality assurance and management functions within operational and administrative areas.
While decentralized, these functions achieve coordination through established reporting
lines or committee representation, including participation on the Quality Management
Committee.
Annual quality improvement plans identify and report on those projects implemented over
the course of the PHCS business year that demonstrate the potential to achieve performance
improvements in clinical and/or non-clinical areas. The plan also documents specific
activities of the Quality Management Committee in selecting and overseeing the process of
quality improvement projects.
The PHCS Quality Improvement Plan is available to providers who participate in the PHCS
Provider Network. If you would like to obtain a copy of the 2003 Plan, please contact our
Member and Provider Services Department at (800) 950-7040.
|
