SMI
A member pushes another member on an inpatient unit. No injury occurs.
What is a non-reportable event?
PC language used by Quality to indicate deficits.
What is "opportunities for improvement "?
Summary of requested Provider Information inclusive of licensing actions reviewed at Red Flag.
What is a CPE ?
The number of members on the HMT.
What is 8 ?
Frequently requested of provider to review and or revise.
What is a Policy and Procedure ?
SMI category in a 24/7 setting that most likely will lead to Red Flag meeting.
What is a member death ?
Just like the old phone numbers, this number has 7 digits in Psych Consult
What is the Member's Psych Consult number?
The number of Red Flags so far in 2024
What is four ?
Who are RedCo (12/7/21-3/3/23) and Tower Behavioral Health??( 6/22/22-10/30/23).
"Everything but the hold"
What is EQP?
Action indicating SMI collaboration between HMT and Local Contract.
What is MD Contract Coordination ?
Number of PCs never been impacted by a hold.
What is none?
Three defined conditions that could lead to a Red Flag
What are
Significant Member Incident(s) (SMIs) that could meet the designation of a Never Event/Provider Preventable Condition (PPC)
Newsworthy occurrences/media events (i.e., media events identifying quality of care concerns with an in-network provider and/or any member-specific media events)
Provider-centered incidents (Provider Centered PPIs) that resulted or could result in a Never Event/provider preventable condition or confirmed quality of care (QOC) issues of level 4 or 5.
First provider managed by the HMT.
Who is White Deer Run ?
Quality partners with this department during EQP.
What is Care Management ?
The Anatomy of the SMI refers to these three stages.
What is Prior, During the Incident and Post SMI?
Required a QIP be placed on Community Care.
Who is NBHCC ? or Who is BHARP?
Red flag meetings originated from this model.
What is the Sanctuary Model?
Which Medically Monitored Intensive Inpatient Provider had it's hold lifted and monitoring complete in 2023?
Medical oversight, coordination of care, and environment of care are examples of a type of category.
What are Quality of Care concerns ?
This standard deviation is used in SMI trending.
What is a SD of 1.5 ?
Carefully crafted communication summarizing Red Flag Meeting.
What is the message to oversights ?
Community Care has three new Divisions and associated Quality Directors.
What is Penn West (Red), Penn Central (Green) and Penn East (Blue) and who are Brittany Skrzypek and Renee Korney (West and Central) and Brittany and Tammy Pooler (Central and East)?
This provider was placed on two holds, went through an appeal and ultimately had a good outcome.
Who is Allegiance Rehabilitation Center ?
A homograph that can signify members of race car team or root source of the problem.
What are drivers?