Core for Health Plan 3.2

CORE 5 - Inter-Departmental Coordination

Submited by: Tom Goddard

The Basics

This standard requires that the organization have mechanisms for interdepartmental coordination that weave QM, administrative and, where applicable, clinical functions. What this means to all employees is that you need to see yourself as working in a team with people from other departments, and be familiar with how communication among departments happens in your organization. Teamwork might happen via committees with representatives of multiple departments, or less formally through emails, impromptu meetings, or in-house newsletters. Just be ready, if asked, to describe how your or people in your department interface with people in other departments, in as many ways as possible.

Management Tips

The key management responsibility is to make sure the interdepartmental activity is clearly documented. For example, if you have an interdepartmental committee, make sure the department affiliations of the various members is reflected in the committee charter and committee meeting minutes.

Accreditation Tips

Desktop Review
At this phase, submit documentation of a recent inter-departmental meeting (often the quality committee), such as agenda, meeting minutes, and attendance roster. Make sure that the meeting attendees are identified by name, credentials, and affiliation or department so that the reviewers can see that the meeting was, in fact, interdepartmental.
Validation Review
Interview
The reviewer will interview staff members throughout the review to ensure that interdepartmental coordination is going on in a way that is meaningful to staff members.
Document Review
The reviewer will examine meeting minutes demonstrating interdepartmental coordination.

  • Core 3.2 / 06.03.2019

    CORE 11 - Written Business Agreements

    My colleagues and I have noticed, as have some veteran URAC reviewers to whom we've spoken lately, that some folks are still misinterpreting this standard. Let me see what we can do to help sort out the confusion.The standard requires that your organization keep "signed written agreements with all clients describing the scope of the business arrangement.""For which organizations does your organiza...

    READ FULL POST
  • Core for Health Plan 3.2 / 06.03.2019

    CORE 40 - Health Literacy

    This standard, a new, experimental standard, suggests that your organization should have policies and procedures that address health literacy. In this context, the meaning of health literacy is, "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate decisions regarding their health." The three suggested...

    READ FULL POST
  • Core for Health Plan 3.2 / 06.03.2019

    CORE 39 - Consumer Satisfaction

    This short standard requires that your organization have a mechanism to collect information about your consumers' satisfaction.This often is done in the form of customer satisfaction surveys, consumer complaints, and sometimes even focus groups. Find out what your organization does -- it's likely more than one mechanism.

    READ FULL POST
Top