The Quality Metrics Tracking Improvement Program (QTIP-R) is a targeted initiative specifically tailored to Psychiatric Residential Treatment Facilities (PRTFs) within Empower Health Plan. Its primary objective is to elevate the quality of care provided to Empower members receiving psychiatric services at these facilities. By utilizing data extracted from paid claims, the program’s approach is data-driven and allows for a focused evaluation of key quality metrics.
Key Components of the QTIP-R:
- Data-Driven Evaluation: The QTIP-R relies on data derived from paid claims to assess the performance of PRTFs regarding various quality metrics. These metrics may include readmission rates, follow-up rates after discharge, medication adherence, length of stay, and other relevant indicators of patient outcomes and care effectiveness.
- Quality Improvement Senior Analyst: A dedicated Quality Improvement Senior Analyst takes charge of the program’s implementation. This analyst works closely with the PRTFs to comprehensively review and analyze the collected data, identifying areas that require improvement.
- Collaborative Discussions with Providers: The program emphasizes collaborative engagement with the PRTFs. The Quality Improvement Senior Analyst meets with the providers to discuss the identified quality metrics, share insights from the data analysis, and collectively explore potential areas for improvement.
- Strategic Plan Development: Based on the discussions with providers and the insights from the data analysis, a strategic plan is formulated. This plan outlines specific objectives, actions, and timelines to enhance the identified quality metric(s).
- Empower and PRTF Collaboration: The QTIP-R fosters a close working relationship between Empower Health Plan and the PRTFs. Empower actively supports the PRTFs in implementing the strategic plan, providing resources, expertise, and guidance as needed.
- Targeted Improvement: The QTIP-R focuses on enhancing one or more identified quality metrics at a time. This targeted approach allows the PRTFs to concentrate their efforts on areas that have the most significant impact on patient care and outcomes.
- Ongoing Review and Monitoring: The program’s success is not measured solely by the implementation of the strategic plan but also by ongoing review and monitoring of the improvements achieved. The Quality Improvement Senior Analyst tracks progress, identifies successes, and addresses any challenges that may arise.
- Continuous Collaboration: Collaboration is a key aspect of the program’s design. Regular meetings, open communication channels, and a willingness to adapt and learn from the process facilitate a culture of continuous improvement.
By adopting a collaborative and data-driven approach, the QTIP-R empowers PRTFs to make informed decisions, address care gaps, and implement meaningful changes in the quality of care they provide to Empower members. This program ultimately contributes to improved patient outcomes, increased patient satisfaction, and a more efficient and effective healthcare system within the psychiatric residential treatment setting.