It is still unknown when QAPI will become a requirement for nursing homes, but the understanding that every nursing home will eventually need a QAPI program is driving some organizations to begin making plans (or at least think about making plans) for putting a program in place. However, for those looking into QAPI, there are a lot of questions to answer about where to begin and how to get started. Below are a few helpful bits of info for anyone in the early exploration stage of QAPI planning.
Understanding QAPI Basics
First of all, it is essential to understand that QAPI brings together two similar, yet distinct approaches to quality management. The marriage of quality assurance (QA) and performance improvement (PI) is meant to help drive high-quality care while also affording nursing home residents the best possible quality of life. The QA part of QAPI involves making sure that care and services meet specific performance standards. When quality falls below set thresholds, QA responds by making adjustments to processes and procedures. The other half of the QAPI quality management approach, which is performance improvement, really is an ongoing search for ways to prevent systemic issues and identify opportunities to make life better for residents. Therefore, putting together a successful QAPI program means investing in both quality assurance and performance improvement.
Identifying A Path To Success
The Centers for Medicare & Medicaid Services (CMS) constructed a framework that consists of five essential QAPI elements. While it recommends using this framework for QAPI program development, CMS also suggests that there are many paths that lead to QAPI success. And, although CMS offers tools and resources to guide nursing homes, there are no mandatory requirements surrounding the use of a certain tool or strategy. That means the door is open for nursing homes to design an approach to quality management that best reflects their unique resident makeup and services. Because of this flexibility, every QAPI program will look a little different. But there is at least one QAPI success factor that is essential for every nursing home: QAPI must be an organization wide effort. Every department and all levels of an organization must participate in quality management to make it work.
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Finding Resources and Support
There are a few things nursing homes can do early on to pave a way for an effective QAPI program.
- First, organizations should familiarize themselves with the available CMS tools and resources. CMS has a lot of materials available that can be very useful for learning about QAPI principles.
- Next, organizations should evaluate their existing quality management efforts to determine what is in place already that can be built up. CMS actually has a QAPI self-assessment tool that can be used for initial planning purposes, and also as an ongoing test to measure progress.
- Finally, it is a good idea to seek guidance from an outside expert that can help ensure QAPI is set up to address all systems of care and management; focus on clinical, quality of life and resident choice areas; and use evidence to define and measure indicators of quality and set goals.
Getting started on QAPI planning now, before there are any real time constraints, allows nursing homes to design a successful program tailored to their facility. It also ensures that nursing homes have time to find answers to their questions and locate the necessary resources, tools, and support from vendors.
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