Quality Improvement Program Annual Report and Evaluation …
Quality Improvement Program Annual Report and Evaluation
2014
Quality Oversight Committee approval on Compliance and Quality Committee approval on
2/23/15 3/19/15
Table of Contents ?2014QI Program and Work Plan Evaluation
L.A. Care's Vision, Mission and Values
4
Executive Summary
5
QI Committee Summary including Policy and Procedure review
23
A. Clinical Care and Safety
A.1 Preventive Services/Well Care Visits
27
A.2 Perinatal Services
42
A.3 Women's Health Initiatives
48
A.4 Older Adults and Chronic Condition Management
A.4.a Improving Rates of Care for Older Adults (Medication Review, Functional Status, and Pain Screening)
57
A.4.b Annual Monitoring of Patients on Persistent Medication
60
A.5 Disease Management
A.5.a Asthma Management
65
A.5.b Diabetes Management
80
A.5.c Reducing Cardiovascular Risk
90
A.6 Clinical Practice Guidelines
97
A.7 Continuity and Coordination of Medical Care
135
A.8 Continuity and Coordination of Medical and Behavioral Healthcare
161
A.9 Evaluation of Effectiveness of Model of Care
183
A.10 Quality Improvement Projects
A.10.a Reducing Readmissions
191
A.10.b Improving Diabetes Screenings
197
A.11 Potential Quality Issues
202
A.12 Facility Site Review/Medical Records Initiatives
204
2|2014 QI Program Annual Evaluation
B. Service Improvements
B.1 Member Satisfaction (CAHPS) and Grievances and Appeals
212
B.2 Access to Care
235
B.3 Network Adequacy
258
C. Systems of Care, Administrative and Other QI Activities
C.1 Pharmacy Initiatives and Management
270
C.2 Delegated Oversight
293
C.3 Credentialing
295
Conclusion
297
Attachments
#1 ? 2014 Completed QI Work Plan
3|2014 QI Program Annual Evaluation
Mission To provide access to quality health care for Los Angeles County's vulnerable and low income
communities and residents and to support the safety net required to achieve that purpose. Vision
A healthy community in which all have access to the health care they need.
Values We are committed to the promotion of accessible, high quality health care that:
Is accountable and responsive to the communities we serve and focuses on making a difference; Fosters and honors strong relationships with our health care providers and the safety net; Is driven by continuous improvement and innovation and aims for excellence and integrity; Reflects a commitment to cultural diversity and the knowledge necessary to serve our members
with respect and competence; Empowers our members, by providing health care choices and education and by encouraging
their input as partners in improving their health; Demonstrates L.A. Care's leadership by active engagement in community, statewide and national
collaborations and initiatives aimed at improving the lives of vulnerable low income individuals and families; and Puts people first, recognizing the centrality of our members and the staff who serve them.
4|2014 QI Program Annual Evaluation
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