The Key Requirements of a Successful QAPI Program
Author: Maxwell Healthcare Associates
Posted: October 17, 2023
Edited: November 15, 2024
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Post-acute care is characterized by a focus on improving the quality of life for people in the programs. The industry requires an intense level of documentation, interest, and passion from caregivers and operators at the agency level. In recent years, CMS has increased the level of analysis and possible scrutiny through new rulings, OIG mandates, and budget cuts. The main goal of these changes is to reduce fraud, waste, and abuse in the industry; overall, this has successfully transitioned industry focus from volume to value. However, these beneficial changes ultimately increase the burden of caregivers to formulate best practices and operate with minimal margin of error. To adhere to these intense standards and provide the best possible care, agencies must consider the utilization of a sound Quality Assurance and Performance Improvement (QAPI) plan. Essentially, QAPI is a data-backed approach to gain insight on and improve the quality of all services offered by a facility. When properly implemented, these plans lead to improved quality of life, higher standards of safety, and enhanced care outcomes. Additionally, a strong QAPI program covers an agency’s bases and protects operations from unneeded OIG scrutiny. With these things considered, the implementation and adherence to a comprehensive QAPI plan is essential for agencies that wish to excel in the modern day. There are many deciding factors of the plan’s success that transform operational excellence when fully considered.
Commitment from Leadership
As true with most updates and implementations in the post-acute space, efforts will only be as successful as the company allows. If employees refuse to “buy-in” to new implementations, or if the agency culture has little interest, the implementation will become an under-utilized money pit. The cultivation of company culture and beliefs begins at the leadership level. A true adherence to increased quality must stem from leadership commitment. Once leaders have created an environment that will accept and support QAPI efforts, adoption strategies can begin. Leaders in the agency create opportunities for communication between the patients, caregivers, and administration, ultimately increasing transparency and satisfaction among all involved parties.
Concentrated Data Collection
Data is an essential aspect of quality improvement. Data analysis and feedback is the backbone that allows agencies to monitor and enhance quality of care, identify areas of improvement, and optimize patient outcomes over time. Comprehensive data is unparalleled in providing clarity of operations, some of the most important metrics for QAPI include the following:
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Clinical Data: Health and medication records, documentation, and progress notes assist clinicians in enhancing the value of patient care.
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Outcome Measures: Overall patient outcomes, readmission rates, and satisfaction scores provide a comprehensive overview of current care quality.
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Staff Performance: Overall staff feedback provides a window into competency and satisfaction. This metric is instrumental in crafting a future-focused training plan.
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Process Measures: Data related to care processes and control protocols provide unparalleled insight into proper best practices for increased satisfaction and success.
Data can be collected through custom dashboards, statistical analysis, daily surveying, or natively within the agency’s EMR. Regardless of the preferred method of collection, an understanding of proper data points and practices provides unparalleled clarity when creating a QAPI program.
Identification of Root Causes
Often, an agency that lacks a comprehensive QAPI is stuck in the endless cycle of addressing issues as they arise without any deeper analysis. This creates a cycle of burnout as clinicians spend countless hours attacking problems that continually recur. As the issues reoccur, it’s common for the frequency to increase without the true causes ever being addressed. Simply attacking surface-level symptoms is a reactionary fix. Working towards proactive improvement is one of the most important actions in saving clinician time and increasing quality. To effectively identify the root cause of an issue, agencies need a data-driven team that fully understands the nuances of all operational fronts. From there, continuous questioning occurs to identify the prevalence and depth of immediate issues, ultimately providing clarity to the root causes of detrimental flaws in operations.
Continued Improvement
Once the structural groundwork is created, scalability must stay front and center to achieve continued improvement. To achieve scalable and continuous growth, it is essential to receive continued support from operations. Initiatives of improvement across growth patterns allow agencies to fight stagnation. Ultimately, the organization that is unprepared for upcoming growth will experience growing pains or overall net negative impact. Planning for scalability within the quality initiative will lead to healthy and continued growth no matter the issues that arise. To ensure continuous alignment amid growth, a few factors should remain at the front of conversations.
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Scalability of processes: At the forefront of growth, all processes and plans must be scalable. Considering the goals and values of your agency will assist in this step. From the beginning, plans should be made with growth in mind. Accommodation for increased data collection and improvement drives the scalability of processes.
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Flexibility of improvement: A flexible approach will maintain alignment across all facets of operations. Strategies that are developed with adaptation in mind will successfully support all degrees of growth.
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Continuous staff training and education: At the center of all outcomes lies the efforts and abilities of staff. To remain compliant amid growth, it is essential to ensure staff are motivated and satisfied with any process updates. Education programs that are on continuous rollout assist in ensuring all staff remain up to date and satisfied while growth occurs.
The MHA Difference - QAPI Assessment
Historically, quality and QAPI programs were seen as a requirement that was unfortunately revenue depleting. As the post-acute industry continues to grow in difficulty and nuance, QAPI is finally transitioning towards a value-add. With this transition, a strong QAPI initiative is even more essential for agencies wishing to grow and thrive. A comprehensive plan that remains viable throughout growth is no easy feat to create or adopt. Luckily, MHA is here to help your agency adapt throughout any growing pains that appear. Our team of industry experts have experience throughout all aspects of an agency’s back office and clinical operations. Beginning with an assessment, we provide a complete overview of any gaps and areas for improvement. From there, your team will receive the necessary tools, training, and recommendations to cement quality-driven success. If you have any questions, or would like to learn more, visit www.maxwellhca.com or contact us at [email protected].
This blog was originally published as The Key Requirements of a Successful QAPI Program by Maxwell Healthcare Associates on 10/17/23. The MHA team has since updated this article to ensure accuracy and relevance.