Using the information in the background readings as well as some research in peer-reviewed sources of your own, create a professional-looking PowerPoint presentation of 10-14 slides (not including the title slide or the reference slide) which clearly summarizes each of the items below. Include thorough speaker’s notes to further expand upon and explain your points. Use in-text citations on your slides, as well as a reference slide at the end of the presentation.
- Summarize the three types of assessment to be completed during utilization review. What is involved in each process and who completes this work? What is the health care manager’s specific role in the review?
- Provide an example of how each of the three types of assessment are performed in the current health care settings. In your three examples, specifically explain how quality was/was not preserved, and how cost was/was not controlled.
- Describe the role of communication between all stakeholders involved in utilization review. Who are each of the stakeholders, and how should this communication take place? How are decisions best made and communicated, when the review involves competing interests among stakeholders (e.g., for off-label drug uses for terminal patients, handling bed shortages, etc.).
SLP Assignment Expectations
- Conduct additional research to gather sufficient information to support your presentation.
- Provide 10-14 quality PowerPoint slides of bulleted-point information content (with speaker’s notes), not including title page and reference slides. Don’t forget to use in-text citations on the slides.
- Support your paper with peer-reviewed articles and reliable sources. Use at least two references from peer-reviewed sources.
Required Reading/Viewing
View:
Carasso, S. (2017). Is that test necessary? The key to laboratory utilization management.
The Journal of Medical Practice Management: MPM, 33(3), 160-164. Available in the Trident Online Library.
Desai, S., Gruber, P. F., Eiting, E., Seabury, S. A., Mack, W. J., Voyageur, C., . . . Terp, S. (2017). The effect of utilization review on emergency department operations. Annals of Emergency Medicine, 70(5), 623-631.e1. Available in the Trident Online Library.
El-Othmani, M. M., Sayeed, Z., Ramsey, J. A., Abaab, L., Little, B. E., & Saleh, K. J. (2019).
The joint utilization management program: Implementation of a bundle payment model and
comparison between year 1 and 2 results. The Journal of Arthroplasty, 34(11), 2532-2537.
Available in the Trident Online Library.
Parast, M. M., & Golmohammadi, D. (2019). Quality management in healthcare
organizations: Empirical evidence from the Baldrige data. International Journal of Production
Economics, 216, 133-144. Available in the Trident Online Library.
Šuklar, S. (2019). Ensuring and measuring quality in primary healthcare. Revija Za Univerzalno Odličnost, 8(2), 153-168. Available in the Trident Online Library.
Wakefield, E., Keller, H., Mianzo, H., Nagaraj, C. B., Tawde, S., & Ulm, E. (2018). Reduction
of health care costs and improved appropriateness of incoming test orders: The impact of
genetic counselor review in an academic genetic testing laboratory. Journal of Genetic
Counseling, 27(5), 1067-1073. Available in the Trident Online Library.
Optional Reading
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Available at https://www.ncbi.nlm.nih.gov/books/NBK222274/
(Use this link for free full text .pdf download).