Highlights
  • Diplomate Article: Touchpoints and Nurse Sensitive Indicators
  • HCQM Certification Exam
  • ABQAURP Membership
 
    Important Dates
  • May 27: Memorial Day
  • Aug 12: Annual Conference Hotel Deadline
  • Sept 12-13: Annual Conference
Health Care News:
  • The Centers for Medicare & Medicaid Services (CMS) announces an update to the current policy that texting patient information and patient orders among members of the health care team is permissible when shared through a secure platform. Read more.

  • The U.S. Department of Health and Human Services (HHS) issues a final ruling that modifies the confidentiality of Substance Use Disorder (SUD) patient records regulations. Read more.

  • Medicare Advantage (MA) plans must provide coverage for an inpatient admission when the admitting physician expects the patient to require hospital care for at least two midnights. Read more.

CE Spotlight Course
Stabilize, Optimize, Energize: Next Level Performance

Jeff Doucette, DNP, RN, NEA-BC, FACHE, FAAN
Senior Vice President & Chief Nursing Officer 
Press Ganey


Press Ganey thought leader and Chief Nursing Officer, Dr. Jeff Doucette, shares the most recent national data on healthcare workforce and patient engagement and discusses the critical connections between engagement, safety, and quality outcomes. This course will provide a fresh perspective on the basics and a deep understanding of the latest best practices to achieve the next level of performance in your organization.

At the conclusion of this activity, participants should be able to:
  • Identify the latest national level data for healthcare workforce engagement.
  • Discuss the impact of COVID-19 on patient and workforce engagement.
  • Recognize best practice, evidenced-based strategies for patient and workforce engagement.

CE Spotlight Course – Complimentary from April 25, 2024 through May 26, 2024
Use Promo Code: NMFREECEN in cart during checkout 


Click here for course details and to register


View the full course catalog here

The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

ABQAURP designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1 contact hour through the Florida Board of Nursing, Provider # 50-94.

This program is approved for Category 2 credit by the American Osteopathic Association.


Touchpoints and Nurse Sensitive Indicators: Exploring Opportunities to Identify Nursing's Contribution to Quality in Primary Care

By Honor Carroll Martin, RN, MS, NE-BC, CHCQM, FABQAURP
HCQM Certified: 9/14/1997

BACKGROUND

As patients and healthcare professionals, we all can appreciate the roles that nurses fulfill in supporting clinical systems. Patient outreach and teaching, assisting providers, overseeing quality audits, conducting telephonic and virtual triage, and responding to patients’ urgent care needs, are just a few of the many ways in which the primary care environment is enriched through nursing practice. The roles of Clinical Care Coordination and Transitional Care Coordination, both of which have been identified as important navigational elements in healthcare and which have become more developed in the past ten years, are considered to be best performed by registered nurses in primary care settings. (The American Nurses Association: The Value of Nursing Care Coordination: A White Paper, 6/12: p. 6.)  

As reimbursement models continue to evolve over time and sustain an ever-growing registry of quality indicators, the caliber of practice required to identify excellence in the primary care environment also expands. Batiste-Brown (2023) states that true clinical effectiveness will require nursing leaders to move away from historical training and roles and look toward new ways to employ resources. The mining and analytics required for accurately reporting evidence of quality supports the need to develop new ways to coordinate the patient experience. This article will explore ways in which the practice contributions of nurses in the primary care environment are linked to quality industry standards as well as to Nurse Sensitive Indicators (NSIs).


Continue Reading the Article


Congratulations to Our 2023 Membership Referral Drive Winner – Chandrasekhar Dinasarapu, MD, MPH, FHM, CCDS, CHCQM-PHYADV

We are pleased to announce that Chandrasekhar Dinasarapu, MD, MPH, FHM, CCDS, CHCQM-PHYADV is our newest Membership Referral Drive winner.

Our sincere thanks to Dr. Dinasarapu for his dedication to Health Care Quality and Management (HCQM)! Member participation and influence help ABQAURP to foster the concepts of health quality and safety throughout the health care system. Improved patient care is the result of our combined efforts.

Dr. Dinasarapu is a physician advisor for XSolis health technology company and reviews observation cases at several hospitals in Pennsylvania using evidence-based criteria, reviews denials and short stays, and participates in peer-to-peers when necessary. He also participates on the hospital’s UM Committees, blogs about common physician advisor topics, and coordinates a Facebook group, “Physician Advisors, Chart Reviews, CDI, Utilization Management (UM)” that facilitates learning from other experienced people in the field. He also holds the position of Adjunct Assistant Professor at Penn State Health Milton S. Hershey Medical Center.

He was certified in HCQM with the Physician Advisor sub-specialty in 2019. We are proud to have him and his colleagues as ABQAURP members!

              

“As a Physician Advisor, achieving HCQM certification in the beginning of my physician advisor journey had been pivotal in enhancing my expertise and credibility in Utilization Management. The courses at ABQAURP and comprehensive examination process equipped me with invaluable skills to do my job as a physician advisor effectively and confidently. CHCQM certification not only signifies my commitment to ensuring patient-centric care but also empowers me to drive quality improvement initiatives within my organization. I highly recommend CHCQM to fellow Physician Advisors seeking to elevate their proficiency and make valuable contributions to healthcare quality and efficiency.”

– Chandrasekhar Dinasarapu, MD, MPH, FHM, CCDS, CHCQM-PHYADV


You could be next! 2024 Membership Referral Drive!

Refer your colleagues! Your involvement in this year's membership development program plays an essential role in the vitality of your organization. Diplomates and Members are our most valuable resource! To say thanks and recognize your commitment to quality, ABQAURP credits your account $25.00 for each referral that becomes a Professional Member or sits for the HCQM Exam. The member who recruits the most is awarded a Member Spotlight in the ABQAURP newsletter, a $500 Visa Gift Card, and registration for the annual conference with CME/CE.

Don't miss this opportunity to advance your association's goals and save money on your annual dues!

Click here for details


A Message from Our Corporate Sponsor

Denial Management Physician Advisor Services to Optimize Reimbursement

We provide denial management and physician advisor services to help hospitals achieve excellence in utilization review. Our physician-driven solutions focus on clinical medical necessity determinations to mitigate denials and increase reimbursement to enhance revenue cycle.

Physician Advisor Utilization Management Services

  • Second-level utilization reviews
  • Payer peer-to-peer reconsideration reviews
  • Medicare short stay chart audit reviews
  • Utilization review education
  • Discharge reviews
  • Appeal reviews

Learn more about AppriseMD

Registration is Open to Attend ABQAURP’s 47th Annual Conference!

As the future of health care advances, the collaborative care team must forge ahead while providing quality patient care. Gaining the knowledge and practical tools to incorporate innovative technology, like artificial intelligence, while maintaining quality and safety standards is integral in developing health care leaders.

ABQAURP's 47th Annual Conference will provide insight into emerging technology, aligning digital quality to care delivery, and strategies to improve processes and utilization while decreasing payment denials. Discover how new strategies can be incorporated without losing sight of the return on investment or quality of care. A panel discussion will examine how the interprofessional health care team can work together to improve care transitions into the community and is committed to advocating for patients and providers as we traverse into the future.

Expert faculty will discuss key communication strategies for participating in peer-to-peer discussions to decrease denials and improve success. Attendees will discover strategies to assess their utilization programs to transform their review process into a robust utilization management program. Join us for this opportunity to learn firsthand from health systems that have developed internal physician advisor programs.

View the Annual Conference Agenda and Faculty.

Register here



Disney’s BoardWalk
Inn

The room rate is $275 per night, plus applicable taxes, single/double occupancy. Rate includes complimentary Internet access, health club admission, phone calls, and local area transportation throughout the Walt Disney World® Resort, including theme parks and Disney Springs®. Rooms in this block are available at a limited quantity and on a first-come, first-served basis. Reservations must be made no later than August 12, 2024.

To make your reservations, reserve online or call the Disney Group Reservations Phone Team at (407) 939-4686. Be sure to identify yourself as an ABQAURP Conference Attendee to receive the ABQAURP room rate and benefits.

Reserve your hotel room here

Why Attendees Value ABQAURP's Annual Conference

"Quality speakers with excellent, relevant topics and engaging conversations."

"It was a very comprehensive conference. I had an opportunity to meet with a lot of administrative leaders and understand how the health care industry works."


Visit Our Conference Exhibitors!

     

ABQAURP's Annual Conference highlights the latest trends in the health care quality industry. Our annual event has become the preeminent conference to network with interdisciplinary health care professionals who serve as quality-minded decision-makers in their field!

View Exhibit and Sponsorship opportunities here

How Can My Organization Partner with ABQAURP?
 
Companies that participate as Corporate Members recognize the importance of quality in today’s health care environment and realize the impact certification and continuing medical education have on providing safe and effective care to patients. 

By joining ABQAURP as a Corporate Member , your company will have opportunities to connect with our membership and event attendees beyond traditional ad placements. The Corporate Membership program offers professional memberships, Annual Conference registrations, savings on HCQM and sub-specialty certifications, continuing education programs, discounts on recruitment ads to our Career Center, exhibit space at Annual Conference, and much more. 

Reach prominent health care leaders! Our membership is comprised of 80% physicians & 20% nurses and other health care professionals.


Corporate Membership benefits include:
  • Presence on the ABQAURP Website (over 53k visitors annually)
  • Exhibit Space at ABQAURP's Annual Conference
  • Discount(s) on Recruitment Services
  • Continuing Education Conference Registration(s)
  • Professional Membership(s)
Show your commitment to quality and safety by becoming a Corporate Member today!

Download the Corporate Membership Application here 


46th Annual Conference Courses Available in ABQAURP's Center for Continuing Education!

Were you unable to attend the 2023 Annual Conference? Don't miss out on the engaging and informative sessions presented at the annual conference.

Purchase the full 7-hour online course HERE, or purchase sessions as one-hour online courses individually.



Key Trends in Federal Quality and Safety Policy
Akinluwa Demehin, MPH
Senior Director, Quality & Patient Safety Policy - American Hospital Association

Protecting Patients, Practice, License, and Livelihood!
Alok Arora, MD, MBA, FACP, FRCP (UK), CHCQM-PHYADV, CPE
Hospitalist - Advocate Aurora Medical Center - Bay Area

Geriatric Emergency Departments Improving Quality and ROI
Kevin Biese, MD
Associate Professor of Emergency Medicine (EM) and Internal Medicine - University of North Carolina at Chapel Hill School of Medicine

Patient Centered Care within the Value-Based Care Model
Douglas Keith Fernandez, MD
Chief Clinical Officer - Privia Health

Stabilize, Optimize, Energize: Next Level Performance Complimentary Conference Course available April 25 through May 26, 2024!
Jeff Doucette, DNP, RN, NEA-BC, FACHE, FAAN
Senior Vice President & Chief Nursing Officer - Press Ganey

Left Behind Again-Addressing SDoH Barriers of Digital Equity
Ann Ingraham, PhD
CEO - Exponential HealthTech Advisors, LLC

Federal Health Quality Measurement - Complimentary Conference Course!
Ron Kline, MD, FAAP
Chief Medical Officer - Quality Measurement and Value-based Incentives Group Center for Clinical Standards and Quality Centers for Medicare & Medicaid Service

Courses may be taken individually to earn incremental CME/CE credits. However, if you plan on taking the full 7-hour course, you will not be able to claim credit for individual courses.

Click here to access the course catalog

ABQAURP Member Testimonial



Proudly display your ABQAURP certificate in a customized frame from Framing Success! 
Enter promo code ABQUA and save 20%


Frames and matboards are already conveniently custom-sized to fit your ABQAURP certificate. Black and gold double mat features gold-leaf embossing of the official ABQAURP Board seal.

The Conservation-Quality Preservation matboard protects your valuable certificate from the damaging effects of pollutants and contaminants. All hardwood frame styles are made with Forest Stewardship Council® (FSC®) certified wood from well-managed forests. 

Order your frame here


HCQM Certification Exam – Now Taking Applications!

Prepare for Excellence with HCQM Certification!
For 47 years, health care professionals certified in Health Care Quality and Management (HCQM) have shown their commitment and specialized focus in quality care and patient safety that distinguishes them from their colleagues

HCQM Certification demonstrates that ABQAURP Diplomates have the practical knowledge to reduce medical errors, ensure patient safety, eliminate waste and unnecessary services, while avoiding potentially harmful delays in care. Certification verifies to internal and external entities that you, your group practice, or hospital is accountable. The result is a safer, more efficient and cost-effective system that better satisfies the needs of patients, providers, purchasers, and payers.

Professionals who have achieved certification in HCQM are committed to patient safety, health care quality, and effective care. Those certified in HCQM demonstrate their superior ability to critically evaluate industry literature, identify evidence-based best practices, and make recommendations that balance appropriateness of health care services with cost and quality. 

The 2024 exam window is open from April 1st through September 30th. Test in-person at a Meazure Learning Test Center or test remotely via the MonitorEDU remote proctoring system. MonitorEDU allows you to test safely, reliably, securely, at any time, and from any location, through a proven remote online assessment platform.

Register here



Sub-Specialty Certifications are available in the following categories:

  • Case Management – CHCQM-CM
  • Managed Care – CHCQM-MC
  • Patient Safety/Risk Management – CHCQM-PSRM
  • Physician Advisor (US-licensed physicians only) – CHCQM-PHYADV™ 
  • Transitions of Care – CHCQM-TOC
  • Workers' Compensation – CHCQM-WC

Prepare Now with the Core Body of Knowledge Online Course!

To prepare for the certification exam, we have developed the Core Body of Knowledge (CBK) online course focusing on the key concepts and elements of HCQM.

In the CBK Online Course, you will learn the basics of health care quality, risk management, accreditation, and patient safety, including:


  • Identify tools and processes used to determine quality of care issues in a variety of health care environments
  • Discuss the use of peer review in assuring quality of care in a variety of settings
  • Recognize patient safety cultures outside of health care
  • Explain various ways utilization is managed and costs are controlled
  • Explore basic concepts and frameworks of case management
  • Identify essentials of safe and effective transitions of care
  • Discuss the differences between accrediting organizations and regulatory agencies
  • Discuss critical regulatory issues (Stark law, Anti-kickback statute, etc.)
  • Specify how privileges are granted, maintained, and how they may be removed
  • Examine the impact of managed care on quality and utilization
  • Recognize Workers’ Compensation terminology and common definitions
  • Describe the roles and areas of potential influence for the experienced physician advisor
  • Describe how the definition of observation services differs from inpatient status
This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME / CE credit offered for each profession.

Click here to order the Core Body of Knowledge


Core Body of Knowledge Online Course Credits:
ABQAURP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

ABQAURP designates this enduring material for a maximum of 26 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 26 contact hours through the Florida Board of Nursing, Provider #50-94.

*While MonitorEDU allows an exam candidate to test anywhere, it is recommended that your work network not be utilized due to firewall and other security concerns.


ABQAURP Professional Membership

Join ABQAURP Today and Be Recognized for Your Commitment to Health Quality Health Care and Patient Safety!

Be part of the success in improving health care and help support the advancement of the health care quality industry.

Professional Membership benefits include:
  • Complimentary CME/CEs in ABQAURP's Learning Management System. Credits earned for these programs may be applied toward eligibility for the certification exam.
  • Discounted tuition for ABQAURP-sponsored Continuing Education Conferences.
  • Discount on the Core Body of Knowledge online course for HCQM Exam preparation.
  • Discount on HCQM Certification Exam registration.
  • Discounted tuition for online courses in ABQAURP's Learning Management System.
  • Access to ABQAURP's CE Spotlight Courses which offer health care quality and management online courses from our course catalog for free several times per year!
  • Access to ABQAURP’s Career Center. Take advantage of employment opportunities through ABQAURP’s participating health care placement companies.
  • Listing in ABQAURP's online directory and unlimited access to the Member's Only section of the website.
Learn more about Professional Membership here

Follow ABQAURP on Social Networks
Follow us on social media to keep up to date on our announcements, special incentives on our programs and services, and topical discussions from fellow leaders in the health care arena! Share strategies with your peers to cope in this uncertain time.

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