MR 107 - Health Information Assessment and Reporting Principles

• Quality Management:
  • differentiate between quality management, quality assurance, quality assessment and quality improvement;
  • define quality as per Joint Commission definition;
  • describe the evolution of quality assurance in health care;
  • identify management information standards per the current JC Accreditation Manual for Health Care Organizations;
  • state the components of a hospital-wide QA plan per JC standards;
  • identify the tools used in the quality management process and know how to utilize them;
  • describe the role of the health information professional in quality health care data collection, analysis and display and reporting; and
  • conduct clinical pertinence review based on established criteria.
• Risk Management:
  • describe the evolution of risk management in health care;
  • identify legal imperatives and accrediting organization requirement for risk management;
  • define the fundamental concepts of risk management;
  • identify the role of the medical staff in risk management; and
  • define outcome in relation to risk and interpret risk data.
• Utilization Review:
  • define and know the purpose of utilization review in the health care setting;
  • describe the external influences that have a significant impact on the development of UR programs;
  • describe the current process of utilization monitoring and review programs; and
  • evaluate and assess the implementation and effectiveness of a utilization review program.
• Statistical Reporting Principles:
  • define health statistics and identify their sources and uses;
  • calculate basic mathematical measures of rounding, metric conversion, percentage, measure of central tendencies, and measures of variability;
  • define and compute common health rates and percentages;
  • distinguish between raw and display data, and prepare various types of data displays;
  • compile and retrieve complete and accurate clinical information using a variety of methodologies;
  • accurately report vital statistics information using both manual and computerized processes;
  • generate statistical reports and display statistical data through manual and computer means; and
  • accurately abstract health records for generation of meaningful statistical data.