Overview
SHP maintains an active Quality Improvement Program (QIP) that provides
structure and processes for our ongoing commitment to proved and continually
improve upon the care and services that are offered to our members. The QIP
goals are based upon our ongoing evaluation of programs and services offered;
regulatory, contractual and accreditation requirements; and strategic planning
initiatives.
Program Goals
The goals of the QIP include but are not limited to:
* Develop, implement and maintain systems and programs that monitor,
measure and improve the health care outcomes and service levels within
identified member populations
* Ensure access to qualified, competent providers
* Engage member/legal guardians in the education, managing and improving
their current health state
* Promote a safe, culturally-sensitive delivery of health care that
promotes appropriate, efficient and effective use of resources and supports the
physician-patient relationship
* Ensure the coordination of and transition of care needs are identified
and provided to our
members
* Ensure compliance with standards as required by contract, regulatory
statutes and accreditation agencies
* Encourage and use feedback from stakeholders to improve reporting
methods and information availability in relevant, timely manner
* Utilize a multidisciplinary committee approach to facilitate the
success of the QIP goals, improve organizational communication and ensure the
participation of contracted community providers in the development/review of
the clinical aspects of programs and services
The QIP works to achieve these goals through an evaluation process of clinical
and service outcomes by measuring the effectiveness of internal processes and
ongoing, active improvement interventions. Functional aspects of the QIP that
contributes to a high level of clinical and service outcomes include, but are
not limited to:
o Care Management Programs:
