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Engaging Front-line Staff in Quality Assurance & Performance Improvement

This presentation will discuss how CNAs can play a vital role in your organization's Quality Assurance and Performance Improvement processes. Participants will learn about the fundamentals of QAPI and explore various ways to engage caregivers in pursuit of quality. The session will also highlight examples of effective CNA engagement and encourage participants to commit to involving front-line staff in root-cause analysis and performance improvement projects.

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Engaging Front-line Staff in Quality Assurance & Performance Improvement

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  1. Engaging Front-line Staff in Quality Assurance & Performance Improvement Prepared for: The Members of LeadingAge Missouri Presented by: Jeff Wellman, MSHRD Chief Operating Officer National Association of Health Care Assistance (NAHCA)

  2. Presentation Description: • CNAs have the potential to play an important role in your organization’s Quality Assurance and Performance Improvement processes. This session will incorporate fundamental elements of QAPI and identify a variety of ways in which your caregivers can and should participate in the pursuit of quality. The audience will be encouraged to share their perspectives and best practices. Participants will come away with specific ideas about how to engage the front-line of care as well as anticipated outcomes.

  3. Presentation Objectives: • Explain the genesis of QAPI. • Differentiate quality assurance (QA) and performance improvement (PI) within LTC. • Identify resources that support QAPI. • Evaluate the advantages and potential barriers related to CNA engagement. • List potential roles for caregivers to play in the QAPI process. • Describe examples of where CNAs are being effectively engaged in the quality journey. • Challenge participants to commit to engaging the front-line of care in root-cause analysis (RCA) and performance improvement projects (PIPs).

  4. LTC Journey Toward Quality • History of Quality Initiatives: • 1960s – Quality = Structure, Process and Outcomes • OBRA 87 – Quality = Life & Care (Holistic View of Care) • ACA 2010 – Quality = Quality Assessment and Assurance & Performance Improvement (Addresses both reactive and proactive approaches to quality)

  5. Performance Improvement Resources Florence Nightingale: nineteenth century apostle of quality Dr. W. Edward Deming: Father of Quality Evolution “Put everybody in the company to work to accomplish the transformation. The transformation is everybody’s job” QAPI at a Glance: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/QAPI/Downloads/QAPIAtaGlance.pdf

  6. CNA Engagement • Advantages: • Operationally engaged • Largest employee group • Intimately committed to quality • Institutional knowledge • Unique perspective which spans all three shifts • Cognitively processes on a practical level • Engagement breeds ownership • Engaged staff are statistically more satisfied • Disadvantages: • Potential disruption to care • Organizations culture • Requires an initial investment • Not accustom to strategic processing • Change paradigm • Silo perspective • Peer attitudes

  7. Potential Roles for CNAs in QAPI • QAPI Champion – Chiefly responsible for chairing the QAPI Steering Committee • QAPI Steering Committee member • Performance Improvement Project (PIP) – Leader • Root Cause Analysis (RCA) - Leader • PIP Member • PIP Reporter • QAPI/PIP educator(Peer Teacher)

  8. Examples of CNA Engagement in QAPI • Brent – Courtyard • Skin Care – Arkansas • NLT – Greenbrier • Julie – Hawkeye Care Center • http://www.ltlmagazine.com/article/12-steps-qapi-step-2-teamwork

  9. Root Cause Analysis (RCA) • Five Whys – Simplest of RCA strategies • Herringbone – Slightly more complicated and useful in categorization • CNA Participation Strategies • Facilitator of the process • Recorder of the process • Participant in the analysis process

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