N.M. Code R. § 7.21.2.11 - STANDARDS FOR QUALITY MANAGEMENT AND IMPROVEMENT
A.
Program structure and
operations: Quality management is an integrated approach that links
knowledge, structure and processes together throughout a BHE's system to assess
and improve quality. The BHE's quality management (QM) and improvement (QI)
structures and processes shall be planned, systematic, clearly defined, and in
full compliance with the BHE contract. The BHE shall comply with the provisions
of 8.305.8.12 NMAC, regardless of the funding source of services. The BHE shall
ensure that the QM/QI program is applied to the entire range of covered
services and all major demographic population groups in accordance with the BHE
contract. The BHE shall have an annual QM/QI work plan, prior approved by the
collaborative, and as specified in its BHE contact with the collaborative.
B.
Continuous quality
improvement/total quality management: The BHE shall base its
administrative operations and service delivery on principles of continuous
quality improvement/total quality management (QM/QI). Such an approach shall
include at least the following:
(1) recognize
that opportunities for improvement are unlimited;
(2) ensure that the QM/QI process shall be
data driven;
(3) require the
continual measurement of clinical and non-clinical effectiveness and
programmatic improvements of clinical and non-clinical processes driven by such
measurements;
(4) require the
re-measurement of effectiveness and continuing development and implementation
of improvements as appropriate; and
(5) rely on consumer and stakeholder
input.
C.
Prevention and coordination of care: The BHE shall institute QM/QI
policies and procedures that emphasize and promote prevention and coordination
across multiple providers and systems.
D.
Consumer/family satisfaction:
The BHE shall work with the collaborative in conducting the annual adult and
child/family consumer satisfaction survey based on the national mental health
statistics improvement project or successor projects. If the BHE conducts any
other or separate satisfaction survey, such survey, including the survey
instrument and methodology, shall be prior approved by the collaborative. The
BHE shall comply with requirements of 8.305.8.11 and such other requirements as
the BHE contract may require.
E.
Clinical practice guidelines: The BHE shall disseminate
recommended practice guidelines, practice parameters, consensus statements and
specific criteria for the provision of services for acute and chronic
behavioral health care conditions.
(1) The BHE
shall select the clinical issues to be addressed with clinical guidelines based
on the needs of consumers.
(2) The
clinical practice guidelines shall be evidence-based.
(3) The BHE shall comply with the provisions
of 8.305.8.12 NMAC regardless of the funding source for services. The BHE shall
fully comply with all specifications of the BHE contract regarding clinical
practice guidelines and evidence-based practices.
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