The Utilization Review Plan For Chestatee Regional Hospital

The Utilization Review Plan for Chestatee Regional Hospital is sufficiently organized and detailed. The first section of the plan identifies the purpose, objectives, and scope of the UR plan. The plan states that the Board, through the Administration, and Medical staff, has established a comprehensive utilization process (Chestatee, 2014). The goal of the UR plan is to appropriate allocation of resources through identification, and elimination of over-utilization, under-utilization, and the inefficient delivery of health care services (Chestatee, 2014). This section of the plan includes several objectives to implement an effective process to achieve the highest quality of care in a cost-effective manner. The objectives include:†¦show more content†¦The listed components are: the board of trustees, administration, medical staff, resource management committee, medical direction for the utilization process, and hospital staff. The Board monitors the process through reports from the Medical Staff s Executive Committee and the Chief Executive Officer (Chestatee, 2014). The administration responsibility states that the Board has assigned accountability and delegated authority to the Chief Executive Officer for providing the Medical Staff with administrative and technical support for all components of the Utilization process (Chestatee, 2014). The plan (2014) states that the Medical staff fulfills accountability through internal assignment of functions to the Medical Staff, Resource Management Committee, and physicians selected to provide medical direction for the Utilization Process. The Resource Management Committee is responsible for discharging all duties and functions, and must have at least two physicians serving on the committee. Both the medical direction and hospital staff are responsible for the discharge of the utilization process. Including a list of authority and responsibilities gives a brief explanation for the UR plan, and provides readers wit h the opportunity to see the figures in charge of the process. The third section of the plan is the Resource Management Committee. The committee acts to facilitate, monitor, and promote the effectiveness of the utilization