COLLEGE OF HEALTH AND HUMAN SERVICES
California State University, Long Beach
Health Care Administration Program
HCA 450-02 - Quality Management/Improvement in Health Care Delivery
Semester FALL 2015
Instructor: Rus Billimoria, MD, MPH, CPHQ
E-mail: rus.billimoria@csulb.edu
Office Hours: Tuesdays 6 - 7 pm
(Please call for appointments.
Telephonic appointments also available
at other prearranged days and times)
Phone: (818) 844 8003
Cell: (310) 508 1472
Class Number: Section 02, 6062 (HCA 450)
Class Location: SPA, Room-105
Class Meets: – August 24, 2015
Tuesdays from 7 PM to 9:45 PM
Additional Contact Information:
HCA Program Administrative Coordinator:
Deby McGill, dmcgill@csulb.edu
Tel. 562/985-5694; fax 562/985-5886
Catalog Description
Prerequisites: HCA 300. (Please refer to details below) and HCA 465 (Preferred)
Basic elements of quality improvement and organizational responsibilities related to quality
improvement in health care delivery. Data analysis for quality improvement, clinical practice
guidelines, and future of healthcare quality improvement strategies.
Letter grade only (A-F). (Lecture)
ADA Accommodation will be provided to any student who requests such, as defined by the ADA act
and CSU-LB. Please contact Dr. Billimoria or refer to your student handbook for further information.
Note: This syllabus is subject to change. Should there be any changes; students will be notified in
class of the amendments.
COURSE PREREQUISITES:
For HCA 450 students: Prior to attending this course students are required to complete the following courses:
 HCA 300 (Health Care System) and
 HCA 465 (Analysis and Evaluation)
Quality Management In Health Care Delivery HCA 450- Course Syllabus
COURSE OBJECTIVES
The purpose of this course is to familiarize the student with the concept of Quality and the process of Quality
Improvement across the Health Care continuum. This course focuses on the history and evolution of quality,
its terms, principles, theories, and practices. The student is introduced to a diverse collection of methods of
improving quality, including but not limited to continuous Quality Improvement and Total Quality
Management, and to the guidelines for implementing quality management and the continuous quality
improvement processes. Additionally , the students will be asked to review the changes that a selected
number of health care systems from across America have implemented in order to achieve the Institute of
Medicine’s goals to make quality health care more safe, timely, effective, equitable, efficient, and patientcentered. Students will also be exposed to new cutting edge technologies that impact the quality
improvement efforts/interventions in health care delivery.
Learning Objectives, Domain and Competency Table
Learning Objective
Domain
Competency
Understand and evaluate
the implications and effects
of regulation, legislation
and accreditation to Health
Care Quality Improvement
Knowledge of
the Healthcare
Environment
Understand and discuss
Quality, Efficiency, Return
on Investment, Access to
health care and Quality
implications
Discuss, Understand
Customer Satisfaction- Six
Sigma, Lean Sigma,
Taguchi Loss function
theories
Understand, discuss
Incentive payments for
Quality Health Care
Knowledge of
the Healthcare
Environment
Regulatory and
administrative environment
in which the organization
functions (e.g., antitrust;
Stark I and II;
accreditation; organized
labor)
The interrelationships
among access, quality,
cost, resource allocation,
accountability, and
community
The patient perspective
Knowledge of
the Healthcare
Environment
Funding and payment
mechanisms of the
healthcare system
Understand the need for
Accreditation, accreditation
standards, and impact of
Accreditation to Quality
Knowledge of
the Healthcare
Environment
Governmental, regulatory,
professional, and
accreditation agencies
(e.g., CMS; JC; NCQA)
related to healthcare
delivery
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Knowledge of
the Healthcare
Environment
Activity (A1),
Assignment (A2) or
Assessment (A3)
Lecture, Short
Essay
And Class
Discussion
Lecture,
Discussions, Project
& Paper
Lecture,
Discussions, Project
and Case studies
Lecture,
Discussions, Paper
or classroom
projects
Lecture, Discussion
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
Learning Objective
Domain
Competency
Understand and analyze
New Technologies and
Quality Implications
Understand and Discuss
Quality Improvement in
various delivery systems
Knowledge of
the Healthcare
Environment
Knowledge of
the Healthcare
Environment
Use Statistical Tools and
Analysis for Quality
Improvement
Use Clinical Guidelines,
Benchmarks in Quality
Improvement
Use Predictive Modeling
for Decision Support
Business
Knowledge
and Skills
Business
Knowledge
and Skills
Business
Knowledge
and Skills: D.
Strategic
Planning and
Marketing
Business
Knowledge
and Skills: D.
Strategic
Planning and
Marketing
Healthcare technological
research and
advancements
Organization and delivery
of healthcare (e.g., acute
care, ambulatory care,
medical practice, ancillary
services)
Basic statistical analysis
Developing a Quality
Imrovement ProgramMission,Vision,Goals,
Objectives. Aligning
Quality Improvement with
organizational strategic
plan
Evaluate the benefits of
Electronic Health Records,
E-Prescribing and
improvement of safety and
quality-Regional Extension
Centers and the Federal
Stimulus for HIT
Discuss Credentialing
Requirements as a
structural component for
Quality Improvement
Discuss and Analyze
Detailed Theories,
Principles of TQM, CQI,
Deming, Juran, Crosby
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Business
Knowledge
and Skills: E.
Information
Management
Business
Knowledge
and Skills: F.
Risk
Management
Business
Knowledge
and Skills: G.
Quality
Activity (A1),
Assignment (A2) or
Assessment (A3)
Lecture, Discussion
Lecture, Discussion,
Project
Lecture, Classroom
project
Evidence-based practice
Lecture and
Discussion
Characteristics of strategic
decision support (e.g.,
planning; marketing;
modeling; forecasting)
Lecture, Discussion
Organizational mission,
vision, objectives and
priorities
Lecture, Discussion
and Project
Physician practice
management IT systems
(e.g., billing;
referral/authorization;
claims processing;
electronic medical records;
prescription writing;
productivity; transcription)
Credentialing, medical
malpractice, and
professional liability
Guest Lecture,
Discussions,
Position Paper
Optional
Quality improvement
theories and frameworks
Lecture, Discussion,
Paper, Project
Lecture, Discussion
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
Learning Objective
Domain
etcDiscuss, analyze concepts
and applications of Six
Sigma and Lean (Industry
Model and Relevance to
Healthcare)
Develop strategy for
Quality Planning and
management
Improvement
Business
Knowledge
and Skills: G.
Quality
Improvement
Business
Knowledge
and Skills: G.
Quality
Improvement
Business
Knowledge
and Skills: G.
Quality
Improvement
Calculate Utilization
Metrics and Relative
Resource Use. Understand
Quality Implications of
Under Over Utilization and
Medical Loss Ratio (MLR)
Competency
Activity (A1),
Assignment (A2) or
Assessment (A3)
Quality improvement
theories and frameworks
Lecture, Discussion,
Paper, Project
Quality planning and
management
Lecture and
Classroom Project
Utilization review and
management regulations
Lecture, Discussion,
Classroom Project
EXPECTED STUDENT LEARNING OUTCOMES
Upon completion of this course, the student will be able to:
1. Describe the evolution of the health care systems and Quality Management/Improvement Programs
and reflect on its future.
2. Understand the reasoning and the importance of the requirements for Health Care Quality
Management/Improvement Programs.
3. Describe the most current Quality Management/Improvement Program principles and techniques for
health care in general. This includes the principles of Continuous Quality Improvement, Total Quality
Management, and proactive versus reactive Quality Management programs.
4. Understand use of Quality Improvement Tools and Strategies including Kaizen, Lean and Six Sigma.
5. Understand the impact of federal and state legislation on Quality Management/Improvement
Programs in Health care.
6. Understand the need for and development of standards for accreditation of health care entities.
7. Describe the recent impact of consumers on health care Quality Management/Improvement
Programs and the development of health plan Report Cards (HEDIS etc.).
8. Understand the use of data and statistics for an effective Quality Management/Improvement
Program.
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
9. Understand basic elements of provider credentialing, physician profiling and report cards, risk
management and liability issues as they relate to Quality Management/Improvement Programs.
10. Understand the effect of Patient Safety issues on Quality Management/Improvement systems.
11. Understand the recent trends in Quality Management/Improvement and Continuous Quality and
Continuity of Care issues in Assisted Living, Skilled Nursing, and Long Term Care.
12. Health Care Report Cards, Pay For Performance and other strategies used for improving the quality
of health care
13. Demonstrate understanding of the principles in the development of a Quality
Management/Improvement Program/Project and Strategies for a health care entity via successful
completion of class project.
REQUIRED TEXTS AND ANY OTHER REQUIRED MATERIALS AND INFORMATION.
This course does not prescribe a specific text, since no single text would cover the broad scope of this
course. However, the following books and materials are strongly recommended for review:
1. Introduction to Quality Health Care Management, Patrice Spath, 2013, 2nd Edition, AUPHA,
Health Administration Press, Chicago, Illinois
Lecture notes and handout materials. All lecture notes will be posted on Beach Board. Students need to print
these. Some copies may be available for distribution by the instructor.
TYPES OF ASSIGNMENTS
I
Short Essays (Approx. 10% of overall class Grade for each one of 2 essays over the course of
the semester. Total Percentage of overall class grade for these 2 essays is 20)
To understand the latest trends around Quality Management/Improvement Programs it is necessary to
review articles related to health care quality from various sources including professional medical or health
care journals. Students will be expected to write short essays on specific prescribed topics (a maximum of
two, doubled spaced typed pages with a reasonable font size 11 or 12 ). The students will be provided
with a relevant topic for each essay. Students will then research and select one or more published articles
pertaining to the topic and complete the short essay as follows:
1)
2)
3)
4)
Introduction – Introduce the topic with a brief reason for selecting the article(s) or sources
used for the essay. Students must make special mention in support for selecting their articles.
Summary-Summarize the contents of the article(s) as they relate to the topic.
Discussion-Provide your analysis and discussion pertaining the topic being discussed.
Conclusions – Conclusion regarding the topic derived from the article(s).
The essays will be graded on a scale of (0 – 20 points). Grading will be based on the contents of
sections addressed above.
Examples of Journals that may be used for writing your essays are as follows:
a)
b)
c)
Journal of the American Medical Association (JAMA) - http://jama.ama-assn.org/
New England Journal of Medicine - http://content.nejm.org/
Annals of Internal Medicine - http://www.annals.org/
HCA 450 SPRING 2015
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
d)
e)
f)
Journal of Health Politics, Policy and Law - http://www.jhppl.org/
Journal of HealthCare Quality - http://www.allenpress.com/jhq/
Med Bio World - Hospital & Healthcare Management Journals - http://www.medbioworld.com/
The two short essays will be due in the weeks assigned. Please see agenda on the following pages for due
dates.
On the due date, submit one copy to the instructor. The essay will be returned after review and scoring.
II
Class Participation (Approx. 10% of Overall Class Grade)
Active classroom participation is encouraged. Each student will have adequate opportunities to participate in
classroom discussions. Students will be provided the opportunity to participate in small projects and pop
quizzes to assess participation. Level of participation will contribute towards the overall course grade.
III
Mid Term Exam for HCA 450 (Constitutes approx. 30% of the Overall Class Grade)
HCA 450 students will be administered a midterm exam worth approximately 30% of the overall class grade.
The exam will comprise of multiple questions. Questions will be a mix of essay type discussions and short
problems based on case studies using the knowledge from topics discussed in class and the prescribed text
book during the semester and a series of short case studies or notes on specific issues or topics.
For each essay question, the student will be required to use the following format:
a) An Introduction to address the case or problem presented
b) Presentation of the ideas in addressing the issue or case using information from the course.
c) Brief Discussion of the interventions or direction suggested by the student for addressing the case
or issue
d) Conclusion- Summary of thoughts
Length of the written answer is left to the discretion of the student. It is important to ensure that the above
four points be taken into consideration for a complete answer. In general two type written pages with a
reasonable font size (11 or 12) would be adequate.
IV
PROJECT: Quality Management/Improvement Project or Program Development (Approx. 30%
of the overall Grade)
A major classroom project will be the development of a Quality Management/Improvement Program
or Quality Improvement Project or Process/strategy pertaining to a health care entity. This project will
be assigned during the course and will be completed as part of your final exam. Students will select a
topic for the project and discuss with instructor before starting.
Students will form teams and develop a Quality Management/Improvement Program or Process
Improvement strategy based topic pertaining to improvement of care and/or services for their
selected entity. The project will make use of quality improvement principles and information
presented during the course. Each student within a team must make specific contributions to
the program or project development and discussions.
The projects developed will be presented to the class by all members of each team. Each team
member presents their specific contributions to the project. Please see course agenda below for day
of presentation. Guest speakers may be present during presentations and will contribute to the
discussions and grading.
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
Grading Components For “The Quality Management/Improvement Program Strategy Project"
(Constitutes approximately 30% of the overall class grade):
I
Class Presentation by Team (The score achieved by the team will be applied to each team
member)
II
Short Project Paper by Each Student: In addition to the presentation, each student’s
contribution towards the team project will be presented in form of a paper not less than two
double-spaced type written pages. The paper shall comprise of the following elements:
a) Introduction: The importance of portion being contributed by the student.
b) Presentation of the ideas and components the student is responsible for developing as
part of the team effort
c) Discussion on the student’s contribution towards the team project using the principles
and theories discussed in class as well as pertinent literature reviewed by the student.
III
Presentation Scoring Rubric will consider the following:
All 7 Elements listed below must be covered in your Presentation
1. Outline the research documenting need for healthcare improvement (Background)
2. Define the system in which you are making improvements (Hospital, HMO,SNF or
other entity)
3. Identify key themes for improvement efforts (Which areas or items of the issue
were selected for improvement and why)
4. Use the improvement processes best suited for your project. (Six Sigma, Lean,
PDSA etc)
5. Develop and Describe the team meeting management skills used to accomplish
your project. (Includes Team Dynamics)
6. Describe basic steps used in managing change as you implemented your
improvement plan
7. Describe the value and context for the tools your team used and implemented in
settings you used. Examples include but are not limited to:




Fishbones
Process mapping
Flow charting
Run/control charts
The Final Exam Grade for each student includes a combination of the individual student
contribution paper and team presentation scores.
Instructor will always be available to all students for guidance during development of the project.
V
Comprehensive QUIZ (Approx. 10 % of overall grade): One Comprehensive Quiz will be offered
during the semester. This will be announced a week prior to each quiz giving adequate preparation
time to the students.
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
AGENDA AND SEQUENCE OF ASSIGNMENTS (The agenda is subject to change.)
Week
Objective
Week 1 – August 25
a)
b)
c)
d)
e)
Week 2 – September 1
a)
Week 3 – September 8
a)
b)
c)
Week 4 – September 15
Topic for Essay # 1 to be announced in class
Introduction to the course.
Literature Review Guidelines.
Introduction to Terminologies.
Introduction to Health Care Systems
Selection of Teams (8) & Team Leaders for projects.
Evolution of Health Care Quality Management with a
historic perspective.
b)
Introduction to Quality Improvement (Lecture Notes)
c)
Discuss Quality Improvement Project
Readings:
Review Chapters 1 (Prescribed Text Book)- Defining
Quality, What is Quality?
Business Case for Quality – Reading for class project
Basic Elements of Quality Improvement (Lecture Notes)
The Deming approach to Quality Improvement.
Continuous Quality Improvement (CQI) and
Total Quality Management (TQM) (Thoughts, Lecture notes)
d)
Classroom Project-Business case for Quality
Readings:
Chapter 2 (Prescribed), Quality Building Blocks
a)
b)
c)
Continuous Quality Improvement –Thoughts (Lecture Notes)
Beyond Ishikawa (Lecture Notes)
Data and Measuring Performance
Review:
Week 5 – September 22
Week 6 – September 29
HCA 450 SPRING 2015
Chapter 3 (Measuring Performance)
Essay # 1 to be submitted in class
a) Performance Improvement Tools for Quality- Introduction with
Fishbone Diagram (Lecture Notes)
b) Discuss FOCUS and Pareto Charts (Lecture notes)
c) Leadership and Quality Improvement Teams (Lecture notes)
d) Draw Fishbone- in class exercise
Review: Chapter 6 (Performance Improvement Tools) and
Chapter 7 (Improvement Project Teams)
a)
Progress Report and Updates on the Quality Improvement
project by each team.
b) Variations (Lecture Notes)
c) Plan Do Study Act (Using more Tools)
Review: Chapters 4 (Page 100) and Chapter 5 (Continuous
improvement)
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
:
Topic for Essay # 2 to be announced in class
Week 7 –October 6
a)
b)
c)
Principles and Tools for Quality Part I (Lecture Notes)
Control Charts
Using Quality Improvement Tools- Small Classroom Project
Review: Chapter 6 (Performance improvement Tools)
Week 8 – October 13
a)
b)
Principles and Tools for Quality Part II (Lecture Notes)
Using Quality Improvement Tools- Small Classroom Project
Review: Chapter 6 (Performance improvement Tools)
Essay # 2 to be submitted in class
MID TERM EXAM PAPER
Week 9 – October 20
a) Six Sigma and Lean
b) Small Classroom Project Presentations by Teams
Review: Chapter 6 (Six Sigma)
Review: Chapter 4
Week 10 – October 27
Week 11 – November 3
a) Customer Service and Quality
b) Understanding Regulatory Requirements (Guest Lecturer)
c) Health care Quality and Long Term care (Guest Lecturer)
Review: Chapter 8 (Prescribed Text Book),
Lecture Notes
Return Mid Term Papers in Class
a) Long Term Care and Quality – Guest Lecture
b) Quality Improvement Class Project
Week 12 – November 10
GUEST LECTURE- Obama care and Quality
Week 13 – November 17
Prepare For Finals Project
a) Medicare Star Program
b) Health Information Technology, Information Management (Guest
Lecture?)
c) Disease Management Programs
d) Chronic Care Improvement Programs/Care Management
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
November 23 – November 25
FALL BREAK
Week 14 – December 1
a) Accreditations
b) Safety and Quality
c) Leap Frog
Week 15 – December 8
FINAL EXAM / PRESENTATIONS- Part I (4 Teams to Present)
a) Group Presentations of Quality Improvement Projects
b) Students to submit their individual written project reports
Week 16 – December 15
FINAL EXAM / PRESENTATIONS- Part II (4 Remaining Teams to
Present)
1.
2.
3.
4.
Course Summary
The Future of Health Care Quality
Job opportunities in Quality Improvement
Wrap Up
BASIS FOR ASSIGNING THE COURSE GRADE
This being a double numbered course, university policy requires greater expectations, additional work and
different grading scales for graduate students. Due importance will be given to student participation in
projects, papers, class work and exams. Letter Grades are assigned from A-F for level of achievement in the
course. For final computation of the letter grades, following weights for each course component will be used:
Component HCA 450
Short Essays:
#1
#2
Percent of Grade
Comprehensive QUIZ
10%
Mid Term Exam Paper
Final Exam
Development of a Quality
Management Program
Project
Class Participation (Including
Attendance and at least two
in class projects)
30%
30%
TOTAL
100%
HCA 450 SPRING 2015
10%
10%
10%
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
STUDENT RESPONSIBILITIES AND EVALUATION
Attendance
Students are required to attend and to be prepared for each session by reading any assigned or referenced
materials. Attendance is expected at each class session. However, if there are compelling circumstances,
an absence may be excused. It then becomes the responsibility of the student to bring her/himself up to
date with the class material. Please notify the lecturer of any absenteeism either in advance if preplanned or
after the fact if due to emergent situations. More than two absences during the semester will impact the class
participation score adversely.
Drops
It is the responsibility of the student to file for a drop status if he or she desires. No drops will be signed by
the instructor after the third week.
Exams
A traditional grading system is required for evaluation of student performance in this course. There will be
one mid-term and one final exam. Exam formats will be developed and announced by the Instructor. No
make-up exams will be offered unless the student has made specific arrangements with the instructor prior
to the exam.
Student Course Evaluation
Students will have an opportunity to evaluate this course. Feedback from students is very important and is
considered critical to improving this course.
ADDITIONAL INTERNET RESOURCES:
America’s Health Insurance Plans
American College of Medical Quality
American Health Information Management Association
American Health Information Management Association
American Healthcare Association
American Society for Healthcare Risk Management
American Society For Healthcare Risk Management
Association for Quality
association for quality
California Association for Healthcare Quality
California Code of Regulations
California Department of Corporations
California Medical Association
Joint Commission on Accreditation of Healthcare Organizations
Medicare
National Guideline Clearinghouse
National Library of Medicine
National Network of Libraries of Medicine
Quality Indicator Project
HCA 450 SPRING 2015
www.ahip.org
www.acmq.org
www.ahima.org
http://www.ahima.org/
www.aha.org
www.ashrm.org
http://www.ashrm.org/ashrm/index.jsp
www.asq.org
http://www.asq.org/
www.cahq.org
http://ccr.oal.ca.gov/
www.corp.ca.gov
www.cmanet.org
www.jcaho.org
www.cms.hhs.gov
www.guideline.gov
www.nlm.nih.gov
www.nnlm.gov
www.qiproject.org
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
CHEATING AND PLAGIARISM:
The following is excerpted from the California State University, Long Beach Policy Statement 85-19,
dated December 13, 1985.
It is the policy of the faculty and administration to deal effectively with the student who practices cheating or
plagiarism. These acts are fundamentally destructive of the process of education and the confident
evaluation of a student's mastery over a subject. A University maintains respect and functions successfully
within the larger community when its reputation is built on honesty. Similarly, each student benefits in
helping to maintain the integrity of the University. This policy, therefore, provides for a variety of faculty
actions including those, which may lead to the assignment of a failing grade for a course and for
administrative actions, which may lead to dismissal from the University. It is the intent to support the
traditional values that students are on their honor to perform their academic duties in an ethical manner.
GENERAL:
The following definitions of cheating and plagiarism shall apply to all work submitted by a student.
DEFINITION OF PLAGIARISM:
Plagiarism is defined as the act of using the ideas or work of another person or persons as if they were one’s
own, without giving credit to the source. Such an act is not plagiarism if it is ascertained that the ideas were
arrived at through independent reasoning or logic or where the thought or idea is common knowledge.
Acknowledge of an original author or source must be made through appropriate references, i.e., quotation
marks, footnotes, or commentary. Examples of plagiarism include, but are not limited to, the following: the
submission of a work, either in part or in whole, completed by another; failure to give credit for ideas,
statements, facts or conclusions with rightfully belong to another; in written work, failure to use quotation
marks when quoting directly from another, whether it be a paragraph, a sentence, or even a part thereof;
close and lengthy paraphrasing of another writing or paraphrasing should consult the instructor.
Students are cautioned that, in conducting their research, they should prepare their notes by (a) either
quoting material exactly (using quotation marks) at the time they take notes from a source; or (b) departing
completely from the language used in the source, putting the material into their own words. In this way,
when the material is used in the paper or project, the student can avoid plagiarism resulting from verbatim
use of notes. Both quoted and paraphrased materials must be given proper citations.
DEFINITION OF CHEATING:
Cheating is defined as the act of obtaining or attempting to obtain or aiding another to obtain academic credit
for work by the use of any dishonest, deceptive or fraudulent means.
Examples of cheating during an examination would include, but not be limited to the following: copying,
either in part or in wholes, from another test or examination; discussion of answers or ideas relating to the
answers on an examination or test unless such discussion is specifically authorized by the instructor; giving
or receiving copies of an exam without the permission of the instructor; using or displaying notes; "cheat
sheets," or other information or devices inappropriate to the prescribed test conditions, as when the test of
competence includes a test of unassisted recall of information, skill, or procedure; allowing someone other
than the officially enrolled student to represent the same. Also included is plagiarism, which is defined as
altering or interfering with the grading procedures.
HCA 450 SPRING 2015
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
It is often appropriate for students to study together or to work in teams on projects. However, such students
should be careful to avoid use of unauthorized assistance, and to avoid any implication of cheating, by such
means as sitting apart from one another in examinations, presenting the work in a manner which clearly
indicates the effort of each individual, or such other method as is appropriate to the particular course.
ACADEMIC ACTION:
One or more of the following academic actions are available and may be invoked by the faculty
member who finds a student has been cheating or plagiarizing.
a) Review -- no action.
b) An oral reprimand with emphasis on counseling toward prevention of further occurrences;
c) A requirement that the work be repeated;
d) Assignment of a score of zero (0) for the specific demonstration of competence, resulting in
the proportional reduction of final course grade;
e) Assignment of a failing final grade;
f) Referral to the Office of Judicial Affairs for possible probation, suspension, or expulsion
In addition students may refer to the following website for information.
http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2008/02.
Commitment to Inclusion
California State University, Long Beach is committed to maintaining an inclusive learning community that
values diversity and fosters mutual respect. All students have the right to participate fully in university
programs and activities free from discrimination, harassment, sexual violence, and retaliation. Students who
believe they have been subjected to discrimination, harassment, sexual violence, or retaliation on the basis
of a protected status such as age, disability, gender, gender identity/expression, sexual orientation, race,
color, ethnicity, religion, national origin, veteran/veteran status or any other status protected by law, should
contact the Office of Equity and Diversity at (562) 985-8256, University Student Union (USU) Suite 301,
http://www.csulb.edu/depts/oed.
Additional information resources
Students interested in acquiring more information on the university syllabus policy please go to the Faculty
Center for Professional Development website at:
http://www.csulb.edu/divisions/aa/personnel/fcpd/.
The faculty handbook can also be found online at the following link:
http://www.csulb.edu/divisions/aa/personnel/documents/2006FacultyHandbook_REV-2-08-07_000.pdf
HCA 450 SPRING 2015
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Quality Management In Health Care Delivery HCA 450- Course Syllabus
COURSE BIBLIOGRAPHY
For convenience, Course Bibliography is presented in two sections. Section 1 includes published
articles over the past 3 years (2012-2015) that are most relevant to this course. Lectures include
information from these readings. Section 2 includes older published literature that is currently relevant
and includes many a classic writing that continues to be included in current teachings. For both
sections, the references are organized alphabetically by last name of primary author.
Section 1: 2012-2015
1. Davies, S. et al, Impact of including Readmissions for qualifying events in the patient safety
indicators; American Journal of Medical Quality 2015, Vol. 30(2) 114–118.
2. Frist, William H., Connected Health and rise Of the Patient-Consumer, Health Affairs, 33, no.2
(2014):191-193.
3. Gallagher, Thomas H and Mazor Kathleen, M; Taking Complaints Seriously: using the patient
safety lens, BMJ Qual Saf 2015; 24:352–355.
4. Graber, Mark I, et al, JAMA, September 26, 2012—Vol 308, No. 12, 1211-1212.
5. Harder, B., Comarow, A., Hospital Quality Reporting by US News and World report: Why, How
and What’s Ahead, JAMA May 19, 2015 Volume 313, Number 19; 1903-1904
6. Hebert, Philip C, Disclosure after large scale events: Price of honesty? BMJ Qual Saf
2015;24:293–294.
7. Himmelstein ,David U., MD, Steffie Woolhandler, MD, MPH,Letter- Physician Payment Incentives to
Improve Care Quality, JAMA January 15, 2014 Volume 311, Number 3, 304.
8. Iglehart , John K., Mission Versus Reality In Emergency Care, Health Affairs, 32, no.12
(2013):2066.
9. James III, A. Everette,J D, Gellad Walid F., MD and Primack Brian A., MD, Implications of New
Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement JAMA January 15, 2014
Volume 311, Number 3.
10. Liberatore Matthew J., (2013) "Six Sigma in healthcare delivery", International Journal of Health
Care Quality Assurance, Vol. 26 Issue: 7, pp.601 – 626.
11. Meltze ,David O. and Chung,Jeanette W., The Population Value Of Quality Indicator Reporting: A
Framework For Prioritizing Health Care Performance Measures, HEALTH AFFAIRS 33, NO. 1
(2014): 132–139.
12. Ouyang, Helen; The art of Discharge; JAMA May 26, 2015 Volume 313, Number 20, 2027-2028
13. Papanicolas ,Irene, Cylus ,Jonathan and Smith Peter C., An Analysis Of Survey Data From
Eleven Countries Finds That 'Satisfaction' With Health System Performance Means Many Things
Health Affairs, 32, no.4 (2013):734-742.
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14. Perlin, Jonathan B., Rapid Core Measure Improvement Through a “Business Case for Quality”
Journal for Healthcare Quality, Mar/April 2012, Vol. 36, No. 2, pp. 50–61.
15. Platonova, E and Shewchuk, R.; Patient Assessment of Primary Care physician Communication:
Segmentation approach; International Journal of Health Care Quality Assurance, Vol 28, No. 4,
2015, 332-334
16. Portela, M.C., et al, How to study improvement interventions: A brief overview of study types;
BMJ Qual Saf 2015;24:325–336.
17. Robert Shauna R. et al, Addressing Social Determinants to Improve HealthCare Quality and
Reduce Cost, Journal for Healthcare Quality, Vol. 34, No. 2, 2012 pp. 12–20.
18. Roland Martin, D.M., and Campbell Stephen, Ph.D. Successes and Failures of Pay for
Performance in the United Kingdom, N Engl J Med (NEJM)370;20, May 15, 2014 Vol. 370 No.
20,1944-1949.
19. Solecito, William A and Johnson Julie, K, 2013, McLaughlin and Kaluzny’s Continuous Quality
Improvement in Healthcare, 4th Edition, Copyright 2013, Jones and Bartlett Publication,
Massachusetts; ISBN 13: 978-0-7637-8154-5.
20. Spath Patrice, Introduction to Quality Health Care Management, 2013, 2nd Edition, AUPHA, Health
Administration Press, Chicago, Illinois.
21. Spittal, J.M., et al; The PRONE score: An algorithm for predicting doctors’ risk of formal patient
complaints using routinely collected administrative data; BMJ Qual Saf 2015;24:360–368.
22. Westover Chad et al, Quality of Care in a Low-Income Consumer-Driven Health Plan:
Assessment of Healthcare Effectiveness Data Information Set (HEDIS) Scores for Secondary
Prevention Journal for Healthcare Quality, Volume 36, Issue 3, 28-34.
23. Zuger, Abigail ; Hospital Ratings: A guide for the perplexed; JAMA May 19, 2015 Volume 313,
Number 19, 1911-1912.
Section 2: Pre 2011- Important and Currently Relevant References:
1. Adams, Karen, Greiner, Ann C., Corrigan, Janet M., Committee on Crossing the Quality Chasm: Next
Steps toward a New Health Care System, 2004, 176 pages.
2. Aspden, Philip, Corrigan, Janet M., Wolcott, Julie, Erickson, Shari M., Editors, Committee on Data
Standards for Patient Safety; Patient Safety: Achieving a New Standard for Care, 2004, 550 pages
3. Auerbach Andrew D., M.D., M.P.H., The Tension between Needing to Improve Care and
Knowing How to Do It N Engl J Med, 357;6, August 9, 2007
4. Benneyan J C, Statistical Process Control as a Tool for Research and Healthcare Improvement,
Qual Saf Health Care 2003;12:458–464
5. Berwick Donald, Payment by Capitation and the Quality of Care- Part 5 (1996) The New England
Journal of Medicine, 335,16,1227-1231
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6. Blumenthal David, Quality of Care – What is it? – Part I, (1996) The New England Journal of
Medicine, 335, 12, 891-894
7. Blumenthal David, The Origins of Quality of Care Debate- Part 4 ( 1996) The New England Journal of
Medicine, 335, 15, 1146-1149
8. Brook Robert, McGlynn Elizabeth, Measuring Quality of Care – Part 2, (1996) The New England
Journal of Medicine, 335, 13, 966-970
9. Brown, RN, CPHQ, Janet A., The Healthcare Quality Handbook: A Professional Resource and Study
Guide, 2004/2005 Edition (20th edition available after 7/31/05)
10. Budetti, PP; 10 Years beyond the Health Security Act Failure: Subsequent Developments and
Persistent Problems. 2004, JAMA; 292: 2000-2006
11. Bush, GW, Ensuring Access to Health Care: The Bush Plan. JAMA, 2004; 292: 2010-2011
12. Chassin Mark, Improving the Quality of Care- Part 3, (1996) The New England Journal of Medicine,
335, 14, 1060-1063
13. Chassin Mark, Hannan Edward and DeBuono Barbara , Benefits and Hazards of Reporting Medical
Outcomes Publicly ( 1996) The New England Journal of Medicine, 334,6, 394-398
14. Couch James (Editor), Health Care Quality Management/Improvement Program for the 21st Century,
1991, American College of Physician Executives and American College of Medical Quality.
15. Davies, H. O., Washington, A. Eugene, Health Care Report Cards: Implications for vulnerable
patient groups and the organizations providing them care (2002), Journal of Health Politics, Policy
and Law, Vol. 27, 379- 399
16. Dlugacz, Yosef D., Alice Greenwood, Andrea Restifo; The Quality Handbook for Health Care
Organizations: A Manager's Guide to Tools and Programs ISBN: 0787969214 Pub. Date: March
2004 Series: J-B AHA Press, #131
17. Ellen Nolte and C Martin McKee, Measuring the health of nations: Updating an earlier analysis,
Health Affairs, Volume 27, 58-71, 2008.
18. Golub, Robert M, Beyond Mental Mediocrity, JAMA, 2006, 296, 1139-1140
19. Gruen, RL, Pearson, SD, Brennan, TA, Physicians-Citizens-Public Roles and Professional
Obligations. JAMA, 2004; 291: 94-98
20. Hagland, Mark, Transformative Quality, 2009, CRC Press, ISBN: 13: 978-1-4200-8492-4
21. Health Employer Data Information Set –HEDIS 2005/2006, Published by NCQA
22. Hersh, W, Health Care Information Technology: Progress and Barriers. JAMA 2004; 292: 2273-2274
23. Iezzoni Lisa, Assessing Quality Using Administrative Data, (1997) Annals of Internal Medicine , 127,
8 (Part 2), 666-674
24. Lighter Donald, E., Advanced Performance Improvement in Health Care-Principles and Methods,
2011, Jones and Bartlett Publishers, ISBN: 13: 978-0-7637-6449-4
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25. Kerry, J., Ensuring Access to Health Care: The Kerry Plan. JAMA, 2004; 292: 2010-2011
26. Landrum, Mary Beth et al, Is spending more always wasteful? The appropriateness of care and
outcomes among colorectal cancer patients. Health Affairs, Volume 27, 159-168, 2008
27. Leach, David C, Philibert, Ingrid, High Quality Learning for High Quality Health Care-Getting it Right,
JAMA, 2006, 296: 1132-1134
28. Mclaughlin Curtis and Kaluzny Arnold, Continuous Quality Improvement in Health Care, 3rd Edition,
2006, Aspen Publication (Replaced with 4th Edition, See Below under # 35)
29. Neuhauser Duncan, Provost Lloyd, Bergman Bo,The Meaning of Variation to Healthcare
Managers …… BMJ Qual Saf, 2011;20(Suppl 1):i36-i40
30. Prevalence of Overweight and Obesity among US Children, Adolescents and Adults, 1999-2002.
JAMA, 2004; 291 2847-2850
31. Quality First: Better Healthcare for All Americans, Advisory Commission on Consumer Protection
and Quality in the Healthcare Industry (Call 800/732-8200 for your free copy)
32. Ransom, Elizabeth, Joshi, Maulik, S., Nash, David, B., Ransom, Scott, B., The Healthcare Quality
Handbook, Second Edition, 2008, ISBN: 978-1-56793-301-7
33. Reschovsky, J, D., Hargraves, J. Lee., and Smith, A. F., Consumer beliefs and health plan
performance: It’s not whether you are in an HMO but whether you think you are. ( 2002), Journal of
Health Politics, Policy and Law, Vol 27, 353-377
34. Robinson, JC, Reinvention of Health Insurance in the Consumer Era. JAMA, 2004; 291: 1880-1886
35. Robinson, J.C., Slouching towards value based health care. Health Affairs, Volume 27, 11-12, 2008
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