According to the National Association for Healthcare Quality (NAHQ), one of the core competencies of healthcare quality professionals is patient safety, which includes ensuring effective transitions of care and reducing preventable readmissions12.
One of the strategies to achieve this goal is to improve patient compliance with follow-up visits, which can help monitor patient outcomes, prevent complications, and provide continuity of care34. Among the four options given, the best way to improve patient compliance is to initiate a process where the discharge planners call patients prior to the follow-up visit. This is because:
A phone call can serve as a reminder for the patient to keep the appointment, as well as an opportunity to address any barriers or concerns that the patient may have34.
A phone call can also help establish rapport and trust between the patient and the discharge planner, which can increase patient satisfaction and adherence4.
A phone call can also allow the discharge planner to confirm the patient's understanding of the discharge instructions, medication regimen, and follow-up plan, and to provide any additional education or support that the patient may need34. The other options are less effective because:
Benchmarking with other facilities in the area to determine the rate of patient compliance may provide some insight into the current performance and best practices, but it does not directly address the specific needs and preferences of the individual patient5.
Including handouts in the discharge documents on the importance of keeping follow-up appointments may increase the patient's awareness and knowledge, but it may not be sufficient to motivate the patient to act on the information, especially if the patient has low health literacy, cognitive impairment, or mental health issues.
Communicating to noncompliant patients that appointments should be kept may sound authoritative and judgmental, which may alienate the patient and reduce their willingness to cooperate. Instead, a patient- centered and empathetic approach that acknowledges the patient's challenges and preferences may be more effective.
Reference: 1: [NAHQ Code of Ethics] 2: [NAHQ HQ Principles] 3: The Importance of Patient Follow-Up | MagMutual 4: The Importance of Patient Follow-Up and Service Recovery 5: [The Financial Case for Quality as a Business Strategy]: [Utilization of Improvement Methodologies by Healthcare Quality Professionals During the COVID-19 Pandemic]: [Understanding the Evolving Landscape of Healthcare Quality]: https://nahq.org/about-nahq/code-of-ethics/: https://nahq.org/products/hq-principles/:
https://nahq.org/resources/the-financial-case-for-quality-as-a-business-strategy-2/:
https://nahq.org/resources/journal-for-healthcare-quality/utilization-of-improvement-methodologies-by- healthcare-quality-professionals-during-the-covid-19-pandemic/: https://nahq.org/news- media/news/understanding-the-evolving-landscape-of-healthcare-quality/

Based on the provided Pareto chart of general surgery readmission causes, the most significant causes should be addressed first to have the greatest impact on reducing readmissions.
* Pareto Principle (80/20 Rule): The chart illustrates that a small number of causes contribute to the majority of the readmissions. The top three causes-pain, constipation, and PCP (Primary Care Provider) unavailable-account for the most significant portion of the readmissions.
* Prioritization of Interventions: By addressing these top three causes first, the healthcare team can potentially prevent the majority of readmissions, making the intervention more efficient and effective.
* Strategic Focus: Focusing on pain, constipation, and the unavailability of PCPs aligns with the principle of focusing on the "vital few" causes rather than spreading resources thinly across many less significant issues.
References: (Based on Healthcare Quality NAHQ documents and resources)
* NAHQ Quality Improvement and Data Analysis Modules.
* CPHQ Study Guide, Section on Pareto Analysis in Quality Improvement.
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When prioritizing quality improvement initiatives, the highest priority should be given to a process that needs to comply with a new regulatory requirement beginning in the next quarter. Regulatory compliance is crucial for maintaining the organization's accreditation, avoiding penalties, and ensuring patient safety.
Addressing this requirement promptly is essential to meet legal and accreditation standards and avoid potential risks.
A high-performing patient experience metric with one month of decreased performance (A): While important, this issue is less urgent compared to regulatory compliance.
A high-risk, low-volume process with common cause variation in the past quarter (C): Though important, common cause variation suggests the process is stable, making regulatory compliance a more pressing issue.
An outcome measure outperforming the benchmark for the past 12 months (D): This area is performing well, so it is not a priority compared to ensuring compliance with new regulations.
Reference
NAHQ Body of Knowledge: Prioritizing Quality Improvement Initiatives
NAHQ CPHQ Exam Preparation Materials: Regulatory Compliance and Quality Improvement