Quality Improvement Activities
Clinical Initiatives:
The Disease Management Programs emphasize the prevention of complications and exacerbations of disease, support the practitioner-member relationship, promote member self-management and strive to provide superior clinical quality and excellent customer service.
Diabetes – To help those with diabetes avoid or delay complications through early detection, improved delivery of care and providing education toward self-management.
Asthma – To help those with asthma and their families improve their quality of life, prevent the long-term effects of persistent asthma and reduce related activity restrictions.
Heart and Stroke – To improve the quality of life for those with atherosclerotic disease through secondary prevention by promoting early education, treatment and self-management.
Depression – In the program’s early stages, to improve the depression care provided in medical settings via collaborative efforts between selected primary care clinics and NHP’s Behavioral Health Team.
Heart Failure – To improve the health and well being of Medicare members with heart failure by focusing on continuous monitoring of their condition and adherence to treatment plans in collaboration with the Affinity Medical Group Heart & Lung Center and Affinity NurseDirect.
Prevention of Pre-Term Delivery - Improve maternal and infant health by focusing on early detection of prenatal risk factors. Implementation of the NHP/NHIC comprehensive Baby and Me: Steps to a Healthy Pregnancy Program in collaboration with Affinity NurseDirect is the major intervention.
Breast and Cervical Cancer Screening Reminder Program - Improve the health and well being of members by focusing on periodic reminders and education to women overdue for cancer screenings. The breast cancer screening reminders are managed through a collaborative effort with the Affinity Breast Centers and Affinity NurseDirect.
Immunization Reminder Program - Improve the health and well being of members by focusing on reminders and education to parents of children and adolescents due for immunizations.
Colorectal Cancer Screening Reminder Program - Improve the health and well being of members by focusing on periodic reminders and education according to nationally recognized preventative recommendations.
Service Initiatives:
Access to After Hours Care - Improve member access to care after hours by focusing on providing phone access and clear directions for care outside of routine physician office hours. Directing members to contact Affinity NurseDirect or, in the case of an emergency, the ER via standard answering machine or answering service messages is the major intervention. Access to Preventive health Services - Improve member access to preventive care by focusing on providing preventive care appointments within 30 days of request. Site specific interventions include "open access" initiatives and recruitment of primary care physicians to underserved locations.
Access to NHP Customer Service - Improve member access to NHP customer service staff by focusing on providing timely and efficient phone service. Staff for peak access times, recruitment for unfilled positions and training are major interventions.
