Quality Improvement Plan Components Sample Clauses

Quality Improvement Plan Components. Contractor shall implement and maintain a written description of its QIP which shall include the following: a) Organizational commitment to deliver quality health care services, goals, and objectives, including accreditation of its QIP, which are evaluated and updated annually and include a time table for implementation and accomplishment; b) Organizational chart showing the key persons, committees and groups responsible for Quality Improvement, reporting relationships of QIP committees within Contractor’s organization, and provisions for support staff including reporting relationships; c) Qualifications of staff responsible for Quality Improvement studies and activities including appropriate education, experience and training; d) The QIP scope of review, which must include: i) quality of clinical care services including, but not limited to, preventive services, prenatal care, and family planning services; ii) quality of non-clinical services including, but not limited to, availability, accessibility, coordination and continuity of care, Grievance process, and, marketing and information standards; and iii) representation of the entire range of care provided by Contractor including all demographic groups, care settings (e.g. Emergency Services, inpatient, ambulatory, and home health care) and types of services (e.g. preventive, primary, specialty and ancillary). e) A description of specific Quality of Care studies and other activities to be undertaken over a prescribed period of time, the responsible individuals, organizational resources utilized to accomplish them, methodologies to be used, including but not limited to process measurements and health outcome and mechanisms for tracking issues over time; f) A description of a system for provider review of the QIP which at a minimum demonstrates physicians’ and other professionals’ involvement and provisions for feedback to staff and Contracting Providers regarding performance and outcomes; and g) A description of the annual QIP report shall include a summary of all QIP studies and other activities completed; trending of clinical and service indicators and other performance data; areas of deficiency and Corrective Actions undertaken; an evaluation of the overall effectiveness of the QIP and evidence that activities have contributed to significant improvements in care delivered to Members.