To meet the growing demand for quality assurance in healthcare, many hospitals, nursing homes, medical equipment suppliers and other healthcare businesses are enlisting the help of a healthcare compliance consultant. A consultant for healthcare compliance assists the facility in the process of obtaining healthcare quality assurance and accreditation certification.

A healthcare accreditation consultant needs to be trained and certified in healthcare quality assurance. This training includes learning about billing, coding, supplier regulations and standards in addition to safety and privacy regulations. A consultant getting healthcare quality assurance and accreditation education and training should:

1. Become certified as a healthcare permit consultant.

2. Learn the process of healthcare accreditation.

3. Be trained in healthcare compliance consulting.

Action Steps
The best contacts and resources to help you get it done

Become certified as a consultant for healthcare accreditation

Healthcare accreditation consultants must be trained and receive certification to legally qualify as consultants for healthcare accreditation. Consultants must complete a certification program and learn about many aspects of healthcare quality assurance. Complete your certification to become a qualified healthcare compliance consultant.

I recommend: Earn certification from Healthcare Compliance Resources to become a certified healthcare compliance officer or a certified healthcare compliance consultant. Either title will allow you to legally serve as a healthcare accreditation consultant. Become credentialed as a certified health education specialist through the National Commission for Health Education Credentialing.

Get training in the process of healthcare accreditation

Healthcare accreditation consultants are responsible for working with healthcare facilities and training their staff to be compliant with industry guidelines and regulations. It's important as a healthcare accreditation consultant to be well trained and educated in all areas of compliance. Get training and education in the healthcare accreditation process to better serve your healthcare industry clients.

I recommend: Attend on-site or online seminars offered by Healthcare IT Certification to get training in many healthcare compliance issues. Get training and become a certified health care compliance officer with the program provided by the Health Care Compliance Association.

Get certified training in healthcare compliance consulting

Healthcare quality assurance training encompasses a variety of topics including billing, Medicaid and Medicare guidelines, equipment regulations, and facility standards. You will be responsible for assisting your clients in passing all these criteria for their accreditation. Get training in all aspects of healthcare quality assurance consulting to be a certified healthcare compliance consultant and be an asset to your clients.

I recommend: Earn certification as a healthcare compliance officer through the training program at Hamline University. The program teaches you everything you need to qualify as a legal healthcare compliance officer. You can also complete the "Compliance with Specific Laws and Regulation" course online at George Washington University.

Tips & Tactics

Helpful advice for making the most of this Guide

• •  Continue learning after you become a healthcare compliance consultant by attending continuing education seminars to stay informed about new healthcare regulations.

Healthcare quality assurance means measuring, improving and implementing the quality of care in your facility. It's a continual process not only to keep the confidence of the public, but to meet requirements for accreditation.

These QA requirements are complicated and require the help of a consultant for a healthcare quality assurance. To put a good Healthcare Quality Assurance and Accreditation program for your facility into place you must:

1. Measure the quality of your facility's care, according to expected standards for the industry.

2. Apply the appropriate techniques and systems to improve the levels of quality in your facility.

3. Use the recommendations made by healthcare accreditation consultants to meet Joint Commission requirements for accreditation.

Action Steps
The best contacts and resources to help you get it done

Hire a consultant for healthcare quality assurance to evaluate your facility

An independent consultant has up-to-date information about quality assurance issues and accreditation requirements. The QA assessment they conduct includes an evaluation of the quality of care and a plan for improving weak points.

I recommend: Zynx Health provides concise summaries of relevant performance. The company also measures performance once a facility completes recommendations. Thomson Reuters can help you look at relevant information about patient safety, delivery of care and patient flow. They provide a view of clinical performance to help your team detect inefficiencies, prioritize opportunities and set improvement goals. Bryant Statistical Consulting offers healthcare facilities quality improvement tools such as Six Sigma and Lean.

Employ the right methods to improve quality assurance in healthcare

In many cases, increasing resources doesn't necessarily ensure quality or efficiency, but improving the processes themselves can create better outcomes and reduce costs. Consultants for quality assurance in healthcare can propose a plan for corrective steps, implement improvements and conduct a follow-up monitoring. Still, you may want to supplement that effort.

I recommend: Brown-Spath Associates offers training programs on performance improvement topics for health care facilities. The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) provides valuable health care programs and education for health care professionals. Provide senior heath care workers with continuing medical education with programs like those offered at The International Council for Quality Care, Inc.

Help meet Joint Commission standards by hiring a consultant for healthcare accreditation

The Centers for Medicare and Medicaid Services have given authority to The Joint Commission as an accrediting body. There are other US-based alternatives to the Joint Commission including: Community Health Accreditation Program (CHAP), DNV, Accreditation Commission for Health Care (ACHC), The Compliance Team, Inc. and Healthcare Quality Association on Accreditation (HQAA). You may want to hire a healthcare accreditation consultant or a healthcare compliance consultant to assure that your facility meets requirements.

I recommend: The Joint Commission standards can be purchased from Joint Commission Resources. Healthcare Compliance Strategies (HCCS) provides online compliance training and healthcare quality assurance training to hospitals, teaching facilities and other health care entities. Their online courses provide real-life scenarios and interactive questions and answers. DecisionHealth also offers tools for accreditation, compliance and safety/security.

Tips & Tactics

Helpful advice for making the most of this Guide

• •  If you're a smaller provider, don't use a healthcare quality assurance consulting firm that is big and expensive. You don't want to get lost, but you do want to to respond quickly and efficiently.
• •  Let staff members know that they must understand key hospital accreditation standards and give appropriate feedback to improve procedures.

Healthcare quality assurance and accreditation focuses on activities that contribute to defining, assessing, monitoring, and ultimately improving the overall quality of healthcare delivery. Many of these activities are done when facilities are applying for accreditation, which helps to focus the provider on delivering high quality healthcare.

This process includes the evaluation and assessment of the quality of care given; identification of any types of breakdowns in the process of delivering healthcare; the process of preventing any types of adverse event; and the correction and follow up monitoring. To better understand this process, become familiar with the common terms used in this type of evaluation.

Action Steps
The best contacts and resources to help you get it done

Accreditation

Accreditation is the processes utilized by various healthcare organizations to concisely assess the organization's level of healthcare performance according to established guidelines and standards and how they work to improve that level to the highest goals possible. This is done with the ultimate goal being high level quality care and optimal patient safety.

I recommend: An independent, not-for-profit organization called The Joint Commission certifies and accredits health care organizations and programs in the United States and is seen as the foremost leader in performance of this process.

Pay-for-Performance

Pay-for-Performance is a process for paying physicians and hospitals based on the demonstrated achievements of each, in meeting specific measures of health care quality objectives. It can be view as a way to reward healthcare providers who deliver good quality healthcare based on specific measures.

I recommend: Medicare has many different types of initiatives to increase improved quality of healthcare in all types of health care settings. To see the many types of incentives offered, including pay for performance, you can log onto the Center for Medicare and Medicaid Services website for complete details.

Quality medical care

Quality medical care is the measure of the ability of a healthcare provider to provide healthcare services which produce desired health outcomes by doing things the right way, in the right time for the right patient to get a positive outcome.

I recommend: The Journal of the American Medical Association has extensive information on what Quality medical care is and how it is delivered.

Agency for Healthcare Research and Quality (AHRQ)

The Agency for Healthcare Research and Quality (AHRQ) is the primary federal agency for the process of research regarding health care quality, outcomes, costs and patient safety and is under the U.S. Department of Health and Human Services.

I recommend: There are a multitude of initiatives that are sponsored by the AHRQ that examine the many aspects of providing quality patient care, as well as a huge database of practice guidelines.

Benchmarking

Benchmarking is a process that allows doctors and hospitals to analyze and compare quality data against other practitioners and facilities to better identify best types of practices to improve the overall quality.

I recommend: The Association for Benchmarking Health Care assesses and examines the needs of the health care management in relation to techniques and processes which can help to identify leading industry clinical practices.

Clinical practice guidelines

Clinical practice guidelines are sets of statements and ideas which are developed and based on many different sources of scientific based evidence. They help the healthcare provider their patients to make informed and appropriate healthcare decisions. These guidelines evaluate and identify the most current data and information about diagnosis therapy, effectiveness, risk, benefits and prevention.

I recommend: The National Heart, Lung and Blood Institute has a reference site that is solely devoted to the concept of clinical practice guidelines and is considered to be a leader in educating and evaluating healthcare providers in the use of these guidelines.