The 5 Elements of Quality Assurance & Performance Improvement
Effective Quality Assurance & Performance Improvement (QAPI) programs are essential to improving the quality of life and quality of care delivered in senior living communities. These programs merge two complementary quality approaches together.
The first approach, quality assurance, is the process of meeting standards and assuring that care reaches an acceptable level. The second, performance improvement, is the pro-active, continuous study of processes with the intent to prevent or decrease the likelihood of problems. Together, these two approaches are critical for improving care for individuals while improving health for populations.
The Centers for Medicare & Medicaid Services (CMS) has created a variety of tools to help you understand the importance of QAPI. We’ve used their tools to summarize the five elements of QAPI below.
- Design and Scope
A QAPI program should be ongoing and comprehensive, dealing with the full range of service offered by the community. It should aim for safety and high quality with all clinical interventions while focusing on autonomy and choice in daily life for residents. Qualified by using the best available evidence to define and measure goals, senior communities should have written QAPI plans in place adhering to these principles.
- Governance and Leadership
The administration of the nursing home should ensure leadership seeks input from staff, residents
andtheir families. This governing body should also verify that adequate resources exist to conduct successful QAPI efforts by requiring facility-wide QAPI training and holding several people accountable. Their responsibilities should include creating safety expectations, quality, rights, choice andrespect.
- Feedback, Data Systems
The community should put systems in place to monitor care and services using data from multiple sources. For example, feedback systems actively incorporate input from staff, residents, families
andothers as appropriate. This includes using performance indicators to monitor a wide range of care processes and outcomes and comparing performance to benchmarks. This element also includes tracking, investigating and monitoring adverse events that must be investigated every time they occur, as well as action plans implemented to prevent recurrences.
- Performance Improvement Projects (PIPs)
A PIP is a focused effort on a specific problem in the community that aims to gather information in order to clarify issues or problems and take action to improve the outcome. The purpose of conducting PIPs is to examine and improve care or services in areas that the facility identifies as needing attention.
- Systematic Analysis and Systematic Action
This element includes the facility taking a systematic approach to determine when an analysis is needed in order to fully understand a problem, its causes
andimplications of change. This approach will determine whether and how identified problems may be caused or worsened by the way care and services are organized or delivered. Communities will also be expected to develop policies and procedures and demonstrate proficiency in the use of Root Cause Analysis. In hopes of preventing future instances, continual learning and continuous improvement are necessary.
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