Quality Assessment & Performance. CMS Conditions for Coverage
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1 Quality Assessment & Performance Improvement Meeting Condition Of CMS Conditions for Coverage Raynel Kinney, RN,CNN,CPHQ QI Director Mary Ann Webb, RN, MSN, CNN QI Coordinator Cindy Miller, RN, CPHQ QI Coordinator
2 CONDITIONS OVERVIEW Conditions for Coverage are minimum health and safety standards. They are the foundation for improving care and protecting beneficiaries. Facilities must meet the Conditions for Coverage in order to be paid by Medicare and Medicaid State Surveyors use these regulations to evaluate dialysis providers compliance with the laws
3 EFFECTIVE DATE October 14, 2008
4 Noteworthy Additions/Changes Patient Care Technician Certification Required PCTs must be certified under a state or national certification program For Current PCTs 18 months from Oct. 14, 2008 For New PCTs 18 months from date of hire. Infection Control Must comply with the CDC s Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients. Isolation Room required for all new facilities Existing facilities must have ability to dialyze HBV patients
5 Additions/Changes Continued Patient Assessment & Plan of Care Utilizes an Interdisciplinary Team (IDT) that works collaboratively and communicates regularly about patient status and the evolving Plan of Care. >An initial individualized comprehensive Patient Assessment based on 14 criteria >Plan of Care is based on the comprehensive assessment and must result in patient outcomes that meet minimum levels of defined standards
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8 Quality Assessment & Performance Improvement (QAPI) Condition: QAPI Facilities must develop, implement, maintain and evaluate an effective, data-driven, quality assessment and performance improvement program. All professional members of the interdisciplinary team must participate. Program must reflect the complexity of the facility s organization & services(including services provided under arrangement)
9 QAPI-continued Must focus on indicators related to improved health outcomes & the prevention and reduction of medical errors. Each facility must maintain & demonstrate evidence of its quality and performance improvement program for review by the surveyors for CMS. The facility must measure, analyze, and track the quality indicators it adopts or develops that reflect processes of care and facility operations.
10 Show Me The Progress!!! (V629) Adequacy (V630) Nutrition (V631) Bone disease (V632) Anemia (V633)Vascular access (V634) Medical errors (V635) Reuse (V636) Pt satisfaction (V637) Infection control Kt/V, URR Albumin, body weight PTH, Ca+, Phos Hgb, Ferritin Fistula, catheter rate Frequency of specific errors Adverse outcomes Survey scores Infections, vaccination status
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12 Show Me The Progress!!! The facility must: Continuously monitor its performance Take actions that result in performance improvement Track to assure improvements are sustained over time
13 QAPI Templates Developed by The Renal Network, Inc. to assist dialysis facilities in meeting It is not mandatory for facilities to use these QAPI templates (unless participating in a Network project) Facilities may use these templates or adapt them to better fit their specific needs. Templates will be posted on The Renal Network website as they are completed.
14 QAPI Template Objectives To help facility staff understand and meet the requirements of condition. Provide tools necessary for an evidence-based quality improvement program. Provide tools to assist facilities in sustaining improvements. Provide an appropriate format for a facility to demonstrate evidence of its quality assessment and performance improvement program.
15 Vascular Access Template Components Of This Template Include: - CQI Action Plans - Barriers Questionnaire - Data Collection Tool which includes facility, nephrologist and surgeon reports. - Needs Assessment Tool
16 Adequacy Template Components Of This Template Include: - Adequacy CQI Action Plan - Barriers Questionnaire - Data Collection Tool With Report
17 Quality Assessment and Quality Assessment and Performance Improvement
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