FACSS

MOST Program

Medical Oversight and System Tracking

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What is the MOST program?

The MOST program is designed to assist organizations in improving oversight requirements and responsibilities within the healthcare environment they operate in. The program consists of three primary levels that address medical oversight and are tailored to the individual client. Level I is medical oversight and preparation for certification, level II is initiation of medical oversight with system tracking and level III is improvements in medical oversight and tracking.

Level I - Preparation for Certification

A healthcare institution or transport agency has been mandated to achieve a certification status in their specialty area of healthcare. Up until now there have been some tracking, CQI and credentialing processes in place that have for the most part worked at monitoring the current system status at a basic level. The required mandate though has a number of specific criteria, matrices and requirements that must be met in order to achieve the desired certification. So now what does the organization do? Wait for the evaluation by the certification and/or credentialing bodies, i.e. CAMTS, CAAS, ACS and see if what is in place meets the requirements? Institute an internal process that utilizes current staff whom will work through all of the criteria and requirements in preparation while maintaining their current responsibilities? Utilize an outside entity to lead the process while working collaboratively within the organization to prepare and meet the requirements? 

In the MOST program the preferred choice is to utilize an outside entity to lead and assist the organization in preparation for the certification process. A mandated requirement confers a significant impact on the organization and is usually a vital component to continued financial success. Accreditation and/or certification is a long process and requires consistent leadership that will keep the focus on the upcoming accreditation/certification and not be overwhelmed with other projects or needs within the organization. In addition it is not uncommon for new matrices and quality assurance objectives to be added to those currently tracked. Developing an appropriate tracking system is crucial at the initial stages so that time, energy and funding for later refinements in the processes is kept at a minimum. 

A project manager will lead the process and work collaboratively with the organizations staff throughout the preparation, submission and on-site visit process. The assigned project manager is chosen based on location of the client and experience both in the particular medical environment as well as the specific accreditation process. In addition the project manager will utilize additional external and internal personnel as needs arise. The end result is appropriate preparation for the accreditation/certification process which greatly enhance the success of the client.

Level II - Initiation of Medical Oversight and Appropriate System Tracking

The key factor in initiating and developing any new medical oversight and tracking system is to always use experienced individuals to lead the process. It is fairly common for organizations to develop unique internal systems utilizing current staff that result in significantly more time and a higher cost then if an outside expert assisted in the process. Too often the final product also contains significant flaws that prevent unforeseen areas of interest that come up in the ever changing environment of medical oversight. Additional time and energy is then necessary in order to attain the appropriate level of oversight and tracking necessary.

The MOST program focuses on working collaboratively with the medical oversight leadership within an organization and helping to guide and build an appropriate system. The  program can incorporate a number of attributes into the new system including but not limited to:
  • Institution of a Public Safety Review Organization (PSRO) to build collaboration between healthcare entities in the system
  • Development of quality matrices to track key factors within a system (STEMI, trauma activation, cardiac arrest resuscitation enhancement, etc.)
  • Implement Standardized Evaluations (SE's) for initial and continued credentialing of individuals for key factors (Intubation, protocol knowledge, etc.)
  • Integration of existing electronic medical records (EMR)  into matrices that can capture key components
  • Creation and/or expansion of medical education programs to meet the needs of the individual practitioners and system

A project manager will work collaboratively with the medical oversight leadership to evaluate, guide and assist in building an appropriate system. The assigned project manager is chosen based on the location of the client, estimated time for project completion as well as the specific attributes that the new system will incorporate. Additional personnel will be directed by the project manager as needed when assistance or specialization is required. The result is creation of an appropriate medical oversight and tracking system that will provide the organization with a turnkey solution.

Level III - Improvements in Medical Oversight and Tracking

Medical control authorities and other medical oversight leaders often inherit a previously established system that no longer meets the requirements within the local community or organization.  Whether the system was underfunded, understaffed or just didn't keep up with current recommendations it has been identified as an area for improvement.  The current leadership then must decide whether to postpone the needed improvements, utilize internal resources or bring in an outside expert to assist.  Certainly there are advantages and disadvantages to each available choice and funding is often a key factor in making that decision.

The MOST program focuses on providing clients with the most cost effective enhancements to their system by working on smaller, specific areas of improvement. These areas include the same outlined above; PSRO, SE's, etc., but require more client participation in order to complete in a  timely manner while keeping costs low. Clients with a longer list of desired improvements will find significant benefit in utilizing this tailored approach when funding is a critical issue by continuously initiating process improvements in a consecutive fashion. The result can be a complete revamping of the current system in smaller aliquots over a longer period of time with funding spread out over that period of time. 

A level III MOST program will attempt to keep the same project manager assigned to an organization over time. This improves communication and collaboration between the client and the assigned project manager and provides a point contact person for new inquires. In addition it allows the "flow" of new projects to capitalize on preceding projects when applicable so that each individual project becomes systemized over time.  As before the project manager is chosen based on the clients location as well as the specific experience needed for the assigned project. The project manager will utilize additional expertise as needed but will limit this as applicable in order to control costs of the individual project. 
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