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Quality Assurance Management System

This document outlines best practices for communication between Regional Provider Organizations (RPOs) and service providers regarding quality assurance measures. It emphasizes the importance of discussing questions, concerns, areas for growth, and training opportunities. The guide clarifies the processes for generating Quality Assurance Communications (QACs) during agency reviews, detailing types of QACs, required provider responses, and closure procedures. It also includes troubleshooting tips and encourages collaboration to improve service quality and compliance.

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Quality Assurance Management System

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  1. Quality Assurance Management System QAMS Provider Regional Meetings

  2. Quality Assurance Communication (pg 16-18) • Communication between the RPO and the provider that identifies: • Questions, concerns, and praise related to quality measures • Areas of growth • Areas of excellence • Training Opportunities • Provide RPO, providers, and case managers an opportunity to share information and communicate a plan to improve the quality of services • Think of it as a learning tool

  3. QAR QAC When an issue is identified during the agency quality assurance review • Reviewer generates a quality assurance communication (QAC) • Three types of QACs generated during a review • QAR • QAR Standard • QAR Consumer • QACs are submitted as a group

  4. QAR QACs Continued • QAR Standard • Connected to either a provider prepared standard or on-site standard • QAR Consumer • Connected to a consumer visit • QAR • A QAC generated during a review that is not associated with a standard or a consumer visit

  5. QAR QACs: Reviewer Info • Reviewer identifies the issue or best practice and how it was discovered • Reviewer references the review standard (when applicable) • Reviewer references the manual (when applicable)

  6. QAC Provider Response • You must enter information in the Provider Response boxes • QAC Cause: • Describe the cause • Be specific to individual circumstances • Think broadly about system issues that may have caused the issue

  7. QAC Provider Response Cont • QAC Action: • Describe the provider follow-up action • Address specific QAC issue • Address prevention of future issues and assurance of program compliance in the future • Remember: You must enter text in both of these boxes to submit the QAC to the RPO! • Feel free to submit additional documentation and material, i.e., in-service training, compliance tool, letter, updated service plan, etc.

  8. QAC Closure • *Closed Resolved – Provider response is adequate and provides necessary action, documentation or follow up. • *Closed Unresolved – Provider response does not meet expectation and agreement cannot be reached. • *Closed with Follow Up QAC – Provider response misses intent of request or partially meets the intent. Follow-up QAC provides more specifics of what is needed from the provider. QAC closure is required prior to review closure

  9. QAC Search (pg 18) • Use this screen to find a QAC that an RPO sends you • Search by QAC Number • Use this screen to search for QACs that are not closed • Search by Status • Use this screen to search for QACs generated during a quality review

  10. Trouble Shooting Tips (pg 19-20) • Navigating Drop-down lists • Required Fields • If you delete text accidentally • Use your submit buttons to finish your action • Use your scroll bar to see all the information in fields

  11. QAMS Questions? • Ask a co-worker • Call your RPO • Make sure to notify the RPO when a staff member who has access to QAMS leaves your agency so their system access can be blocked!

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