Qsource, a Part of atom Alliance, is Your Go-To for QAPI Assistance

Transcription

1 Qsource, a Part of atom Alliance, is Your Go-To for QAPI Assistance Is your facility struggling to implement a strong QAPI plan? Reach out to Qsource, a part of atom Alliance, for assistance with your Quality Assurance and Performance Improvement (QAPI) efforts. There is no cost for assistance or additional work to complete your priorities. QAPI is the application of quality assurance and performance improvement. The Centers for Medicare & Medicaid Services (CMS) describes QAPI as a systematic, comprehensive and data-driven approach to maintaining and improving safety and quality in nursing homes while involving all nursing home care givers in practical and creative problem solving. It represents an ongoing method of providing care to achieve optimum results. A nursing home can prevent adverse events, promote safety and quality and reduce risks to residents and caregivers. The definitions below further describe QAPI. a) Quality Assurance (QA): Assuring that care is maintained at acceptable levels in relation to standards for quality of services and outcomes. b) Performance Improvement (PI): Also called quality improvement, is continuous study and improvement of processes with the intent to better series or outcomes, prevent or decrease the likelihood of problems and identify areas of opportunity and test new approaches. The chart below was adapted from the Health Resources and Services Administration (HRSA) and shows some key differences between QA and PI efforts. Motivation QUALITY ASSURANCE Measuring compliance with standards PERFORMANCE IMPROVEMENT Continuously improving processes to meet standards Means Inspection Prevention Attitude Required, reactive Chosen, proactive Focus Outliers: bad apples Individuals Processes or Systems Scope Medical provider Resident care Responsibility Few All INITIAL STEPS QA + PI = QAPI Build your team A strong team is crucial to implementing a successful QAPI program and fostering teamwork is a core component. To encourage an effective team, it is important to provide a clear purpose, define roles for each team member and commit to actively engage each member. Activities of QAPI plans encompass members at all levels of the organization in identifying opportunities for improvement; addressing gaps in systems or processes; developing and implementing an improvement or corrective plan; and continuously monitoring effectiveness of interventions. Key items to consider when developing your team include the following. a) Do not limit the team to leadership, nor does leadership need to work in isolation. Include and solicit input from a

2 variety of staff to identify the focus of your QAPI plan and resource needs. Examples of team members include the medical director, nursing staff, certified nursing assistants (CNA), housekeeping, dietary staff, grounds keeper and family members. Develop QAPI Champions! b) Provide resources for QAPI activities and include equipment and training: a. Caregivers may need time to attend team meetings during working hours, requiring others to cover their clinical duties for a period. b. Equipment might include anything from additional computers, to low-cost supplies like posters to create story boards, or multiple copies of resource books or CDs. c. Leadership may want to consider sending one or more team members to a specialized training. Communication is Vital Establish a climate of open communication and respect. Leadership may wish to consider: a) Having an open-door policy to communicate with staff and caregivers. b) Emphasizing communication across shifts and between department heads. c) Creating an environment where caregivers feel free to bring quality concerns forward without fear of reprisal. d) Understanding your home s current culture and how it will promote performance improvement. e) Creating the expectation that everyone in your nursing home is working on improving care and services. f) Establishing an environment where caregivers, residents, and families feel free to speak up to identify areas that need improvement. g) Expecting and building effective teamwork among departments and caregivers. How does the Team Get Started? An initial challenge is deciding where the team should start with QAPI activities. Perhaps, the team could begin with a small test of change model, like the PDSA (Plan, Do, Study, Act). The PDSA Model for Improvement is used by the Institute for Health Care Improvement and was developed by Associates in Process Improvement. Using the PDSA model can: accelerate improvement, indicate if the change will result in improvement, provide an opportunity to test several proposed changes, gage the amount of improvement expected, evaluate costs, social impact and side effects and minimize resistance upon implementation. Remember, it is okay to start small and go slow.

3 Step 1: Plan Plan the test or observation, including a method for collecting data Step 2: Do Try out the test on a small scale Step 3: Study Set aside time to analyze the data and study the results Step 4: Act Refine the change, based on what was learned from the test An example of a small test of change is demonstrated by the following. Implement a test of change with one CNA CNA implements test of change for one week in one neighborhood Collect the data from the one week test of change in one neighborhood Make/adjust identified changes to the process based on the data Implement the test of change with all staff in one neighborhood for two weeks Collect the data from the two week test of change by all staff in one neighborhood Make/adjust identified changes to the process based on the data Implement permanent changes in all neighborhoods as staff implements process Monitor and trend data for full implementation and changes Lean on Us! Let us help you. All of our services are free and we offer many educational tools to assist you with your QAPI efforts. For more information, visit the atom alliance website here or contact the Qsource Quality Improvement Advisor for Kentucky, Scott Gibson at scott.gibson@area-g.hcqis.org or by phone at

4 More on atom Alliance Formed as a partnership between three leading healthcare consultancies, atom Alliance is working under contract to CMS throughout Alabama, Indiana, Kentucky, Mississippi and Tennessee to improve quality and achieve better outcomes in health and healthcare and at lower costs for the patients and communities we serve. Through atom Alliance, AQAF in Alabama, IQH in Mississippi and Qsource in Indiana, Kentucky and Tennessee are carrying out an exciting strategic plan, with programs in place to convene, teach and inform healthcare providers, engage and empower patients, and inspire, share knowledge and spread best practices with communities across the entire healthcare continuum. Learn more at Reference 1. QAPI Description and Background, U.S. Centers for Medicare & Medicaid Services, last modified 09/13/16,

5