Systems Based Approach to a Quality Care Environment

As seen in the Consultant Connection July 2013 Issue
by SM Cleveland, BSN, RN Director of Nursing Services
The Centers for Medicare and Medicaid Services (CMS) Department of Health and Human Services issued a memorandum in December 2012 addressing the Nursing Home Quality Assurance & Performance Improvement (QAPI) guide. This guide is detailed to enable nursing homes to understand QAPI principles to begin incorporating these principles into their systems of care by July 1, 2013.
So what is QAPI? It is the merger of two complementary approaches to quality management, Quality Assurance (QA) and Performance Improvement (PI). These approaches differ in the way they seek and utilize information.
QA is a process of meeting quality standards and assuring that care meets an acceptable level.
PI is a pro-active and continuous study of processes with the intent of preventing or decreasing the likelihood of problems by identifying opportunities and testing new approaches to fix the underlying causes.
Once established, people report it as a rewarding and enjoyable way of working. Rewards such as ability to solve quality problems and prevent recurrence; ability to seize opportunities to achieve new goals; caregivers become active partners in PI and overall better care and better quality of life for residents.
Using the five elements framework, your facility may undergo a culture change. This requires a possible paradigm shift in Leadership responsibility and accountability, the development of a deliberate approach to teamwork, a whole house ‘self-assessment’, identified organizational principles, a QAPI plan, communication campaigns, data collection and usage strategies, gap and opportunity identification, prioritization, a definitive problem solving model, dedication to root cause discovery, and a systematic approach to action. Also bravery, don’t be afraid to try new things or re-try old things in a new way.
For further information visit CMS website

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