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Quality Management

DVHA’s approach to quality management combines quality assurance (QA) with performance improvement (PI) to form one larger QAPI program. The QA activities “assure” compliance with various state and federal regulations related to operating the Vermont Medicaid program and the PI activities respond to any deficiencies or areas of concern. DVHA promotes a culture of continuous quality improvement; it is constantly measuring its performance and analyzing available data.

Quality Management Plan

DVHA’s QAPI Program is outlined in its Quality Management Plan. This plan explains the structure of the program, the goals and guiding principles at the core of the work, performance measurement, monitoring and oversight and performance improvement.

Quality Improvement Frameworks
 

Formal Performance Improvement Projects (PIPs)

DVHA actively works on at least one formal PIP at all times. It is considered “formal” because the project follows outlined Center for Medicaid Services (CMS) protocol and summaries are submitted annually by DVHA to AHS and our external quality review organization (EQRO) for validation. The CMS protocol follows a standard Plan Do Study Act (PDSA) methodology.
 

Results Based Accountability (RBA)/LEAN

RBA is a disciplined way of thinking and taking action that can be used by agencies to improve the performance of their programs. It can also be used by communities and therefore is broken out into two parts:  population accountability and performance accountability. The Agency of Human Services has adopted an RBA-based software tool that every Department within the Agency is using to present their performance measure data, and the narrative behind that data, identifying the partners they work with and the improvement strategies they employ. Additionally, this methodology combined with LEAN concepts is the basis for a set of internal trainings that are actively building an Agency Improvement Network of staff who are trained to facilitate process improvement.

Agency Improvement Model (AIM)

AIM is a simple approach to process improvement where staff directly involved with the work engages in a structured methodology to recommend and implement changes. These approaches are data driven to identify whether a change has been an improvement. This tool is primarily used for program level improvement.