Continuous Quality Improvement
PLAN
ACT
DO
STUDY
Continuous Quality Improvement (CQI) is at the core of successful claims denial strategies. CQI is a structured and ongoing process that helps identify problems, implement changes to resolve them, monitor the effectiveness of the changes, and make adjustments to ensure better outcomes in the future. It is recommended that readers examine various CQI models to determine the most suitable one for their organization. This can be time-consuming, consulting with organizations with CQI expertise can be beneficial. One such model is PDSA (Plan-Do-Study-Act), or the Deming Cycle. It is a four-stage problem-solving approach that is particularly useful for claims denials.
What are you trying to accomplish? How will you know that a change is an improvement? What changes can you make that will result in an improvement? In applying PDSA, ask these questions:
After each complete PDSA cycle, the effectiveness of the change is evaluated, and necessary adjustments are made before repeating the next cycle to ensure the change is successful and sustainable. Organizations naturally become more efficient and successful as they integrate CQI into their culture.
CLICK HERE
To learn more about the PDSA cycle as it relates to claims denials,
© AMN Healthcare 2024
AMNHealthcare.com | 3
Made with FlippingBook. PDF to flipbook with ease