Measuring for QAPI Success
By Susan Chenail
Quality Assurance, Performance Improvement better
known as QAPI is not a new notion. QAPI is a data-driven,
proactive approach to improving the quality of life, care
and services in Nursing Facilities. The QAPI movement
has been supported by Centers for Medicaid and Medicare
Services (CMS) since March 2010 to improve quality of
care in Nursing Facilities. More importantly it is viewed by
CMS as a tool to prevent harm to residents.
In February 2014, the Office of Inspector General (OIG)
released a report, Adverse Events in SNF: National Incidence
among Medicare Beneficiaries. It reported that one-third of
Skilled Nursing Facility (SNF) beneficiaries were harmed by
an adverse event or temporary harm event within the first
35 days of their skilled stay. The OIG determined that 60
percent of those events were preventable.
The three categories of Temporary Harm are:
• Events related to Medications, 43 percent (example,
hypoglycemic episodes);
• Events related to Resident Care 40 percent (example,
– pressure Injuries); and,
• Events related to Infections 17 percent (example,
CAUTI catheter associated Urinary Tract Infection).
Recently, because of the Mega Rule released in October
2016, QAPI is now a part of the Survey process. In
November 2017, nursing facilities will be expected to
show their QAPI plans to surveyors. It must include
a preamble – with purpose, guiding principles and
scope – and the selection of areas to study, goal setting,
incorporating all staff education and participation,
accountability, reporting, committee membership and
much more.
By November 2019, full implementation of QAPI is
expected. To ensure residents are protected from harm
CMS will require QAPI be involved in all allegations/
incidences of abuse, neglect and exploitation. QAPI is
not just another burden of regulation; rather it is known
to produce high customer and staff satisfaction. Nursing
Facilities looking for a proven method for staff retention,
longevity and mastery are looking to QAPI to get staff
involved, engaged and take ownership of care processes.
Residents of facilities which use QAPI report increased
satisfaction in care processes. CMS is promoting resident
engagement, voice and choice, and with QAPI that is
possible. Nursing facilities don’t have time to waste.
Leading Age New York has a long history of providing
technology solutions for continuously improving resident
outcomes using publicly reported data.
A major part of QAPI involves using data to select
process improvement plans, set goals and monitor success
at the resident level using the most current facility specific
data. Quality Apex, LeadingAge New York’s newest
product, fills these requirements and much more with
features that nursing facilities need, including a dashboard
view. Nursing facilities have limited resources and for just
pennies per day Quality Apex can crunch and display the
numbers providing passive monitoring of progress toward
goals which are essential for QAPI success.
leadingageny.org
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