Healthcare Quality Management – Health System Example

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"Healthcare Quality Management" is a great example of a paper on the health system. According to the National Committee for Quality Assurance (2018), Healthcare Effectiveness Data and Information Set popularly known, as HEDIS is a program designed to handle a broad scope of customer service and health-related issues. It was developed as a scheme to compare and ameliorate the quality of the healthcare system. HEDIS is mostly helpful in admonishing and tracking diabetic patients between ages 18 and 75 years old. The information collected through the program is serviceable and valuable to the government, medical insurance companies, and employers to evaluate the prime and estimate relatively plan performance. In 1997, public and private groups came up with The Diabetes Quality Improvement Project aimed to exhibit evidence-based execution and upshot assessment precisely for diabetes care.

The National Committee for Quality Assurance currently owns the assessments developed because of this project characterized as part of the Healthcare Effectiveness Data and Information Set (HEDIS) measures. Every health care plan should take part in the HEDIS and its assessment to be commissioned by the National Committee for Quality Assurance (NCQA).

Following (National Committee for Quality Assurance, 2018), about nine out of ten of all US health plans take advantage of the HEDIS measures to keep a tab on the performance of volumes of care and services rendered. One of the projects being extensive diabetes care. Health care plans funded by the government, such as Medicaid in the US and the Indian Health Service, are expected to adhere to the HEDIS collective measures (Spath, 2013). As stipulated by the NCQA, patients aged 18 to 75 years old diagnosed with diabetes, are required to have measurements in the extensive diabetic care in the following areas: hemoglobin A1c (HbA1c) testing, a 9% more HbA1c poor control, a less 8% HbA1c control, a 7% HbA1C control preferred population, an eye examination retinal performance, a medical aid from the nephropathy and lastly a blood pressure control of less the 140/90 Hg. As a nurse in the primary care unit, I would be at the forefront to assist in how many diabetes patients are in practice and verify how many of those have met the criteria of the HEDIS extensive diabetes unit.

The comprehensive diabetic administration in our small organization would take all day and a lot of paperwork for anybody trying to solve and analyzing charts. Being a leader would necessitate assistance from fellow staff members. With my team, we would want to place every person with diabetes and tick off his or her chart for later inspection. A complete competency in computer literacy would be required to ensure proper use of the EHR. I would compile all the information and make sure every patient's EHR is up to date and recorded. The process in the initial stages will demand intensive hours as patient charts will require be cutting into and classifying them by quality control.

A time frame would also be necessary for the EHR modulation and should be adhered to. I would, in addition, address the manual files to point outpatients diagnosed and require more comprehensive testing to ascertain the level of care left out. Once all the data is collected, a chart audit would be drawn to gather a sample of about less than 60 patients to admonish.

The info collected will be added to a bar graph to show the eight HEDIS care measures and the population of diabetic personnel who received each screening. A bar chart is beneficial in the visual display by the doctors and keeps track of the improvement. The medical assistant and office personnel roles are essential in the EHR to ensure proper management of diabetic patients. Though the operation may consume time, the data gathered can be advantageous and used to decrease diabetes ramifications.

Moreover, this may ameliorate the lives of those living with the two types of diabetes, namely type 1 or type 2. However, it is probably the medical providers that do not cover some diabetic patients, which might be a challenge to them.


National Committee for Quality Assurance. (2018, April 18). Retrieved from Comprehensive diabetes care: htttp://

Spath. (2013). Introduction to healthcare quality management. Chicago, Illinois: Administration Press.

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