Independent Medical Reviews

2019 in Review: Growing Our Total Quality Management Initiative

March 03, 2020

The words "total quality management' are displayed on a chalkboard to showcase that Advanced Medical Reviews has been focused quality care improvements.

2019 was a great year and 2020 has already started off with exciting growth at Advanced Medical Reviews. Each year, we focus on new opportunities for growth in our range of review services, our approach to client support, and the security and flexibility of our technology. Our team sat down to discuss some key changes in 2019, with a focus on our Total Quality Management (TQM) initiative. The leadership at AMR, including Megan Kaufman (General Manager), Lu Crowder (Clinical Quality Director), and Norma Nevarez (Director of Client Success), shared a unique perspective on how AMR’s commitment to total quality management is visible in our work with clients.  

“The total quality management initiative is nothing new, we’ve always been focused on the quality of work that we do,” said General Manager, Megan Kaufman. “We’ve taken a more holistic approach, adapting our view of our quality assurance program so that it’s more than one step in our progress; it's included at every level and with every staff member. It's a practice of looking from start to finish to determine how we can ensure a quality product to our clients.”

Clinical Quality Director, Lu Crowder, added that she led the enhancement of the quality program at AMR to reflect the teachings of W. Edwards Deming, a famous statistician and business consultant who revolutionized the ‘Total Quality Management’ in the 1980s by applying statistical process control concepts to non-manufacturing environments. “I suggested that we shift from a single quality assurance step to total quality management because this better reflects quality being continuous and organization-wide,” said Crowder.

“Alongside the TQM initiative, we’re focusing on becoming the IRO-next-door. Our account managers are looking to form partnerships with each client that allow us to work together to jointly strengthen quality in every step of the review process,” said Director of Client Success, Norma Nevarez.

Ensuring Continuous Quality

The quality management process at AMR analyzes problems and solutions on every level. First, we innovate relative to changes in the business and regulatory environment of the service we provide and to the specific needs and expectations of each client. Then, we prepare, implement and execute the process. After each client implementation, we continuously assess and improve our performance and redevelop our strategy. “The AMR service process represents the continuous circle of service excellence we seek to achieve for every client and every interaction,” noted Nevarez. “This process supports our TQM success, as well.”  

Approaching Quality from Within

Nevarez spoke on the importance of including every department to provide great customer service. “Working with the client is not limited to account management. It includes the operations team, the physician reviewers, the sales executives, and more. I’ve learned you can discover more breadth and depth when you listen to and take action on the conversations other departments have,” said Nevarez.

“This is why we engage every department when we’re bringing on a new customer,” said Crowder. “We have a client-specific review process for each implementation and robust training. We engage the quality process at the very beginning and with every person that touches the client and the client’s cases.”

Along with improving communication and customer service, new system updates to the AMR portal have helped increase efficiency and quality. For example, the data gathered can evaluate any gaps, make sure we’re staffing appropriately and streamline communication.

“As a former client of AMR’s before joining them as their quality leader, I had never experienced a system where the electronic and technical processes provided such great support to the case review team, process and clients. The work gets done by actually copying a case electronically into the AMR system and downloading the data into relevant stages of the process. This allows for immediate access to each key party involved with the case – processors, QA, nurses and physicians – and the clients can view each step as the case works through the process.” said Crowder. “It allows us to have a finger on the pulse of what's going on at all times and provides real time and retrospective data for quality analysis.”

Presenting Quality to the Client

Kaufman addressed how we’ve implemented client facing tactics to improve quality. “Everything that we’re doing is in service of meeting our clients’ expectations of quality. Part of our stewardship values is that our partnership continually assesses our performance with clients and addresses issues in a timely manner. The relationships that we work really hard to build are also in service of ensuring that what we are putting out at the end of the day, is a quality product,” said Kaufman.

Nevarez, who was promoted to Director of Client Success in 2019, took hold of her new leadership position to establish changes in the department. “One thing I did was add more structure to the periodic calls with our clients,” said Nevarez. “The structure includes involving more people internally and creating this cross-functional opportunity for everyone to give their input. We've introduced the idea of bringing more value to our clients by understanding what's going on with them internally, the outcomes of their cases and how else they’re functioning in the industry. This allows us to dive into deeper conversations with our clients in addition to the KPIs that we report on. We want to be one foot forward and see how AMR can bring value to each client. I’ve been looking at how to be seen more as a partner, rather than just a vendor.”

Beyond routine client check ins, Nevarez also noted working on a flexible approach with each client. “These reviews are rarely uniform, each client needs a specific type of review and then that dictates all of the details that our clients are measuring. So we have to continually adjust to their standards and customize our services.”

The AMR Belief Statement

We believe every patient should receive quality healthcare. 

Crowder expressed how the TQM initiative is entwined with the AMR belief statement. “At the root of it all, the person who received the care is at the center of everything. Our philosophy is quality healthcare because everyone deserves it. The nurses that I work with in the clinical quality department often remind each other that the end result is about the quality of service to the end user. It’s really the ultimate measure of quality. Every employee at AMR understands their stake in ensuring the work represents our belief statement. We’ve always been strong on this and had an edge with our technology presence, but this final TQM piece is what brings everything together,” said Crowder.

What 2020 Brings

Kaufman summed up how she wants to enhance her team’s quality approach in the next year. “Quality is what we live and breathe. I want to connect how everything we do is a variable into a quality outcome. We have historical measures of quality, which include meeting our turnaround times, consistency in reviewers’ recommendations and decisions, access to services, and use of evidence-based medicine. This year we added regular clinical and business meetings with clients where we discuss their expectations and our performance based on their definitions of quality. We emphasized and expanded cross-departmental deployments, improving and expanding audits, and more. I want to build on the idea that everything we do is connected to quality,” said Kaufman.

Nevarez spoke on a strategy she wants to work on with clients in 2020. “We want to play more of a role in providing value to our clients. We want to shape our message to help inform them of changes in medical standards, literature, experimental medicine, or whatever it may be. This will help improve our communication and offer guidance in navigating the industry’s constant changes,” said Nevarez.

Quality will always be at the forefront of everything we do at AMR. As we continue to grow the TQM initiative and execute other changes in the next year, we want to usher this whole new approach at every touch point with a client. Let us know what changes you’d like to see in 2020!

2019 in Review: Growing Our Total Quality Management Initiative