qapi “quality assurance performance improvement for nursing homes” leadingage wyoming spring...
TRANSCRIPT
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QAPI“Quality Assurance Performance
Improvement for Nursing Homes”
LeadingAge WyomingSpring Conference
May 23, 2013
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What Do You Want to Learn Today?
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Today’s Objectives
• Provide the regulatory mandate information• Describe the elements of QAPI• Highlight QAPI-At-A-Glance• Discuss tools and resources that support QAPI• Where are we today with QAPI evolution?
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Why Quality Care Focus?
• The government demands it!• Acute care providers demand it!• 5-STAR Ratings demand it!• Families demand it!• Your success depends on it!• Residents deserve it!
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What is QAPI?SEC. 6102. Accountable Care Act (March 2010)ACCOUNTABILITY REQUIREMENTS FOR SKILLED
NURSING FACILITIES AND NURSING FACILITIESNursing Home QAPI is requiredLegislation requires CMS to establish QAPI
program standards and provide technical assistance to nursing homes
Identify training needs for LTC surveyorsDemonstration project to create a model QAPI
Plan
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The BIG Picture
The ultimate goal is to provide person-
centered care – to focus on the person living in the nursing
home
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The BIG Picture
• Quality Assurance and Performance Improvement (QAPI) does not refer to a program; rather, this is the way we should do our work
• The ability to think, make decisions and take action at the system level is required for sustainable QAPI success
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• Comprehensive approach to ensuring high quality care
• Data-driven, proactive approach to improve the quality of life, care and services in nursing homes
• Involves members at all levels of the organization to: I.D. opportunities for improvement Address gaps in systems or processes Develop and implement improvement or corrective plan Continuously monitor effectiveness of interventions
QA + PI = QAPI
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Five QAPI Plan Framing Elements
Governance and Leadership
Quality of Care. Quality of Life. Resident Choice.
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Systematic Analysis and Systemic Action
Feedback, Data Systems and Monitoring
Performance Improvement Projects
Design and Scope
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Design and Scope
Characteristics of how QAPI is designed and thescope of what it includes:
Ongoing and comprehensive program across the full range of services and departments
Addresses clinical care, quality of life, residentchoice, and care transitions
Aims for safety and high quality clinicalinterventions while emphasizing choice
Utilizes best available evidenceWritten plan
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Governance & Leadership
Leadership actively engaged with setting expectations and priorities, including:Systematic approach to gather input from staff,
residents, family, stakeholdersAdequate resources-time, money, otherOngoing and consistent staff trainingAccountability for process and resultsBalance culture of safety and rightsNon-punitive culture
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Feedback, Data System, and Monitoring
Systems to monitor a wide range of care and service, drawing from multiple sources:Data from staff, residents, stakeholders, othersUse of goals, thresholds, and benchmarksAbility to analyze, interpret, and translate data
into meaningful and actionable informationUsing data to systematically prioritize and select
performance improvement projects (PIPS) appropriate for the nursing home
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Performance Improvement Projects
Conduct Performance Improvement Projects (PIPs) to improve care or services in areas relevant to your residents: Gather information systematically to clarify
issues and identify opportunitiesTest and implement changesUse data to determine whether goals were
accomplished
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Systematic Analysis & Systematic Action
Create real impact and long-lasting improvement as the result of QAPI through:Take into consideration all aspects of the organization
when making changesAddress variations in practice and causes of errors at
the system level instead of at the individual levelLink outcomes of QAPI efforts to policies and
procedures, staff orientation and ongoing education, performance expectations, strategic planning
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What did the Demonstration Project Teach us?
Value of having tools to help guide and teach systems thinkingOffers framework and structureHelps critical steps from being skipped
QAPI is not a magic wandThe impact comes in the implementation
QAPI needs a strong champion(s) but it cannot be one person’s jobLeadership sets the tone and provides resourcesThe work is done by a variety of teams
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Where do Nursing Homes Begin?
• QAPI Tools and Resources– QAPI-At-A-Glance– QAPI Facility Self-Assessment– Define facility guiding principles and scope– Development of a QAPI plan– Learn how to create/develop PIPs
• Alignment with state and national initiatives– 10SOW & National Nursing Home Quality Care Collaborative– Advancing Excellence In America’s Nursing Homes
Campaign– Partnership for Dementia Care
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QAPI-At-A-Glance = Step by Step Guide
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QAPI Self-Assessment
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QAPI Plan Outline
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Goal Setting Worksheet
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QAPI Resources
• CMS link for QAPI– Website:
http://cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/QAPI.html (Just Google: nursing home QAPI)
– Mountain Pacific Quality Health• Pat Fritz, Nursing Home Project Manager
– 307-568-2797– [email protected]
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National Nursing Home Quality Care Collaborative Teams from Wyoming
• Star Valley Care Center• Bonnie Bluejacket Memorial
Nursing Home• Poplar Living Center• Shepherd of the Valley Care
Center• CRMC-TCU• Kindred Healthcare-Cheyenne• Kindred Healthcare-Rawlins• Kindred Healthcare-Wind River• Douglas Care Center• Rocky Mountain Care-Evanston• Pioneer Manor
• St. John’s Nursing Home• South Lincoln Nursing Center• Westward Heights Care Center• Ivinson Hospital-ECU• Laramie Care Center• New Horizon’s Care Center• Weston County Health Services• Deseret Healthcare of Saratoga• Goshen Care Center• Platte County Memorial Nursing
Home• Worland Healthcare• Castle Rock Convalescent Center
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Thank You!
Questions?
This material was prepared by Mountain-Pacific Quality Health, the Medicare Quality Improvement Organization for Montana, Wyoming, Hawaii and Alaska, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency for the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10SOW-MPHQHF-WY-IPC-13-37