Quality Improvement Program

The Quality Improvement (QI) Program reflects NBH’s commitment to facilitate ongoing improvement in the delivery of high-quality healthcare.

Highlights of NBH’s QI Program are presented in an annual report, which is sent to all participating practitioners. Practitioners and members may request a copy of this publication by writing to:

Quality Department

Nevada Behavioral Health Systems

2921 N Tenaya Way

Las Vegas, NV  89128

Purpose 

The purpose of the QI Program is to increase the quality of care for NBH members by optimizing the delivery of cost-effective healthcare services. This goal is achieved by monitoring clinical care, clinical service, organizational service, and member experience.

Quality Improvement (QI) Program Goal and Objectives

The goal of NBH’s QI Program is to monitor the clinical care, clinical service, organizational service, and member experience provided to members while identifying opportunities for prioritizing, improving and implementing quality improvement activities.

Below are objectives of the QI Program: 

  • Provide information and resources to members, providers and other stakeholders who can improve the process of care
  • Implement effective managed care programs that aide in the transition of care throughout the continuum of services.
  • Practice the principles of continuous quality improvement
  • Reduce variations in care and clinical practice patterns

 

Quality Improvement (QI) Program Activities                 

The primary activities of the QI Program focus on preventive care and disease management.  These activities include 

  • Data analysis and reporting, particularly for programs involving acute inpatient psychiatric admission and outpatient care (Partial Hospitalization Programs, Intensive Outpatient Programs, Medication Management, Psychotherapy, etc.)
  • Member satisfaction surveys
  • Accessibility standards and timeliness
  • Network Adequacy and Practitioner Credentialing
  • Monitoring member complaints and appeals
  • Utilization monitoring

Evaluation of the Quality Improvement (QI) Program

The QI Program is evaluated annually to assess the extent to which the scope, methodology, and activities succeed in meeting performance standards as they relate to NBH’s purpose, goals and objectives. Quality Improvement Activities (QIAs) are reviewed to determine their appropriateness, compliance with clinical standards, and impact on the quality of patient care and service rendered. 

Evaluation of the QI Program should result in 

  • Improved performance in the delivery of healthcare and services where the plan has identified problems and corrective actions have been implemented.
  • Identifying the plan’s performance in quality improvement as it relates to improved outcomes and patient satisfaction using (Healthcare Effectiveness Data and Information Set) HEDIS 3.0 measurements and in accordance with standards set by the National Committee for Quality Assurance (NCQA).
  • Ensuring an appropriate level of effectiveness and efficiency in the plan’s performance.