baseline assessments helen burch8!12!03
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Presentation Overview
Process Assessment
Assessment Criteria Business Process Mapping
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Process Assessment
Research environment
Interview stakeholders
Collect documents
Review data sources
Verify information systems capabilities
Document existing processes swimlanes
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Assessment Criteria Core Measures
Case Management Measures
Data Measures
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Core MeasuresAccountability & Structure
Regulatory Compliance
Documentation Compliance
Stakeholder Communication
Clinical Services
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Accountability & Structure Philosophy, goals, objectives
Organizational structure
Committees
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Regulatory Compliance Reporting
File maintenance
Staff responsibilities
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Documentation ComplianceAccuracy
Completeness
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Civilian Communications Documents
Correspondence
Forms
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Clinical Services Installation services
Community services
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Case Management Measures Information Systems Staffing
Patient Protections
Client Choice Identification & Assignment
Client Disclosure
Client Assessment
Case Management Plan Requirements Complaints
Discharge & Termination
Return to Work
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Information Systems Systems integration
Access
Tools
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Staffing Job descriptions
Credentials
Caseloads
Performance standards
Physician expertise
Staff development and management
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Patient
Protections
Confidentiality
Security
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Client Choice Client rights
Provider selection
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Identification & Assignment Selection
Case Manager assignment
Integration with third parties
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Client Disclosure Communications to client
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Client Assessment Evaluation
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Case ManagementP
lan Plan development
Review and updating
Decision making
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Complaints Management and referral
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Discharge & Termination Case closure
Discharge and termination
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Return to Work Vocational rehabilitation
Modified and restricted duty
Independent Medical Examinations (IMEs)
Transition to work
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Data Measures - Metrics Program outcomes - frequency and cost
Case Manager performance
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BusinessP
rocess Mapping Swim Lane Diagram
Technique for mapping organizational
structure to processes
Delineates ownership of all activities and
processes within swim lanes
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Swim Lane ExampleSwimlane Process Mapping of Initial Stages of Non-Emergent Employee Injury
Employee
Supervisor
HealthP
rovider
Sustains
injuryReports
injury to
supervisor
Provide Form
CA-16 to
employee
Determine
appropriate site
for care
Provide initial
evaluation andtreatment
Access care
Determine
work status
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Now What?Assimilate and record all information
Review with stakeholders
Identify leakage points
Design and implement strategies for
improvement
Monitor progress