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Quality Assurance and Performance Improvement (QAPI)

Quality Assurance and Performance Improvement (QAPI). QualityNet 2012 | Baltimore Marriott Waterfront Hotel December 11-13, 2012. Today’s Objectives. Apply QAPI and person-centered care as a foundation for improvement in the NH Collaborative Describe the principles of QAPI

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Quality Assurance and Performance Improvement (QAPI)

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  1. Quality Assurance and Performance Improvement (QAPI) QualityNet 2012 | Baltimore Marriott Waterfront Hotel December 11-13, 2012

  2. Today’s Objectives • Apply QAPI and person-centered care as a foundation for improvement in the NH Collaborative • Describe the principles of QAPI • Discuss how QAPI supports the work of Quality Improvement Organizations (QIOs) • Identify how QIOs already incorporate and teach the principles of QAPI with nursing homes • Explain how CMS plans to rollout QAPI nationally • Access QAPI tools and resources • Update your personal Collaborative planning tool

  3. The Big Picture • The ultimate goal is to provide person-centered care – to focus on the person living in the nursing home

  4. The Big Picture – the Basics • Quality Assurance and Performance Improvement (QAPI) do not refer to a program; rather, this is the way we do our work • The ability to think, make decisions and take action at the system level is a prerequisite for QAPI success

  5. Background • QAPI program in Nursing Homes was required in Affordable Care Act, enacted March 2010 • Legislation requires CMS to establish QAPI program standards and provide technical assistance to nursing homes • Opportunity for CMS to develop and test QAPI technical assistance tools and resources program before rule promulgation

  6. Context • QAPI is required in other federally certified health care programs • hospitals, transplant programs, dialysis centers, ambulatory care, hospice • NH QAPI is to be consistent with other settings at a high level, but also take into account issues unique to NH setting

  7. QAPI as a Foundation • For person-centered care • Relies on the input of residents and families • Measurement of not only process but also outcomes • For defining quality as ‘how work is done’ • Broad scope – entire organization (all staff and all depts) • Leadership expected to be a model • For systems thinking • Proactive analysis • Data and measurement driven • Supported by tools

  8. Five Elements of QAPI • Design & Scope • Governance & Leadership • Feedback, Data Systems & Monitoring • Performance Improvement Projects (PIPs) • Systematic Analysis & Systemic Action

  9. Highlights from a Nursing Home • How do these come together in practice? • Role of tools to guide system thinking • Role of consistent support from leadership • What does it really mean to be person directed?

  10. Where do Nursing Homes and QIOs Begin? • QAPI tools and resources • QAPI at a Glance • Facility Self Assessment • Define guiding principles and scope • Development of a QAPI plan • How to create/ develop goals • Alignment with state and national initiatives • QIO 10th SOW & National Nursing Home Quality Care Collaborative • Advancing Excellence in America’s Nursing Homes Campaign • Partnership for Dementia Care • QIO expertise and experience!

  11. QAPI at Glance – Step by Step Guide

  12. QAPI Self Assessment

  13. Guiding Principles and Scope

  14. QAPI Plan Outline

  15. Goal Setting Worksheet

  16. Discussion – Small Group Work • How do QIOs view what they know of QAPI as different than what is current practice? • Identify ways to explain these differences to NHs • What work currently underway can QIOs build on in order to keep focus on the ultimate goal (person centered care) and get the basic concepts (QAPI is not a program, it is systems thinking) engrained into LTC facilities • Update individual QIO collaborative plans Report out on highlights of discussions

  17. CMS Updates What does the future hold? • CMS vision for QAPI Provider, Consumer, and Surveyor materials

  18. CMS Updates What does the future hold? • CMS vision for QAPI Provider, Consumer and Surveyor materials • National roll-out Website: http://go.cms.gov/Nhqapi

  19. CMS Updates What does the future hold? • CMS vision for QAPI Provider, Consumer and Surveyor materials • National roll-out Website: http://go.cms.gov/Nhqapi • Baseline Survey Results – 4,200 NHs 71% response rate 2nd wave Spring of 2014

  20. CMS QAPI Website http://go.cms.gov/Nhqapi

  21. QAPI Team Acknowledgements • CMS Team: Alice Bonner, Debbie Lyons, Israel Cross, Cathleen Lawrence (previously: Karen Schoeneman, Kim Clayton) • Project team: Rosalie Kane, Robert Kane, Janie Moore, Pat Schommer, Jennifer Lundblad, Jane Pederson, Kelly O’Neill, Marilyn Reierson, Kathie Nichols • Technical Expert Panel and other consultants

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