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QAPI 101
This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting theHome Health Quality Improvement National Campaign, under contractwith the Centers for Medicare & Medicaid Services (CMS), an agency of theU.S. Department of Health and Human Services. The views presented do notnecessarily reflect CMS policy. Publication number 11SOW-WV-HH-MMD-032117A
Objectives
▪ Distinguish the differences between Quality Assurance and Performance Improvement
▪ Identify all employees responsible for QAPI at agency
▪ Identify at least two functions for each of the 5 Standards of Home Health QAPI
Requirements
▪ This course is approved for 1.5 hours of Nursing Continuing Education– Approved by the Alabama State
Nurses Association, an accredited approver of the American Nurses Credentialing Center’s Commission on Accreditation (ANCC)
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What is HHQI?
Goal: Improve the quality of care home health patients receive
Special Project funded by Centers for Medicare & Medicaid Services
Free evidence-based tools and resource
Many networking opportunities with 17,000+ participants
More About HHQI
Focused on quality of home health care measured by:
• Reduction of avoidable hospitalizations
• Improvement in oral medication management
• Improvement of immunization rates
• Improvement of cardiovascular health
HH focus, but all care settings and patients participate
Underserved Populations Network (UP)
Home Health Quality Improvement
(HHQI) National Campaign
▪ Home health and cross-setting resources
▪ Four categories:
– Education
– Data
– Networking
– Assistance
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Conditions of Participation (CoP)
▪ Data-driven Quality Assurance & Performance Improvement (QAPI) program
▪ New CoP released January 13, 2017
Healthcare Today
On the Horizon &
Connection to Quality
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So What is QAPI?
Quality Assurance
Measure quality compliance standards
Assure care reaches acceptable levels
Focus on provider
Required and reactive
Performance Improvement
Improve processes to meet standards continuously
Decrease problems by identifying opportunity for improvement
Focus on patient
Chosen and proactive
QAPI Responsibility
Governing Body
Leadership
CliniciansSocial
Workers & Aides
Support Staff
Home Health QAPI Fact Sheet
▪ Focuses on the CoPframework for QAPI
▪ Integrate or modify performance improvement work your agency is already doing
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5 Standards of Home Health QAPI
QAPI Standard
Executive Responsibility
▪ Require the HHA’s governing body to assume responsibility for your agency’s QAPI program
▪ Define, implement, and maintain an ongoing agency-wide program for quality improvement and patient safety developed from evidence-based practices
▪ Ensure that performance improvement efforts are prioritized and evaluated for effectiveness to promote your agency’s integrity and quality
Executive Responsibility Action Items
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QAPI Standard
Program Scope
▪ Show measurable improvement in indicators for which there is evidence for improvement of health outcomes
– Examples: Reduction of hospitalizations and readmissions, safety, and quality of care for patients
▪ Measure, analyze, and track quality indicators, including adverse patient events and other performance indicators
Program Scope Action Items
QAPI Standard
Program Data ▪ Use quality indicator data, including measures derived from
OASIS or other relevant data – See the worksheet for more specifics
▪ Utilize data to: – Assess quality of patient care
– Identify and prioritize opportunities for improvement
▪ Focus quality assessment efforts, including data collection on high priority safety, and health conditions and other goals identified by your agency
▪ Monitor the effectiveness and safety of your agency’s services and quality of care
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Program Data Action Items
QAPI Standard
Program Activities
▪ Focus on high-risk, high-volume, or problem-prone areas of service, and consider the incidence, prevalence, and severity of problems in those areas
▪ Correct any immediate problems that directly or potentially threaten the health and safety of patients
▪ Continue to monitor the area(s) to assure that improvements are sustained over time
Program Activities Action Items
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QAPI Standard
Performance Improvement Projects (PIPs)▪ Conduct PIPs at least annually, reflecting the scope,
complexity, and past performance of your agency’s services and operations
▪ Utilize data collection and analysis to select focus areas: – Previous problematic performance issues
– Clear evidence of poor patient outcomes
– High-risk and high-volume
▪ Document QAPI project and progress
Performance Improvement Project
(PIP) Action Items
Questions?
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HHQI’s Topic-Specific PIP Tools
Hospitalization
Cardiovascular Health
Medication Management
QAPI & PIPs
Performance Improvement Project (PIP)
QAPI Plan
CVH PIP
Other PIPs
Infection Control
PIP
Home Health QAPI Summary
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Resources
▪ HHQI’s topic-specific Performance Improvement Project tools– Cardiovascular Health
– Hospitalizations
– Medication Management
▪ HHQI University
– Supplemental courses on the above topics
▪ CMS’s Conditions of Participation
– QAPI Standards (pp. 173-176)
HHQI University
Pave Your Path Series
▪ Pave Your Path: Designing a Systematic Approach to Quality Improvement
– 4-course series in HHQI University
• Focuses on IHI’s Model for Improvement
• Includes PDSA (Rapid Cycle Improvement)
• Collaboration with Institute of Healthcare Improvement
• Full series includes 8 hours of free nursing CEs
Data Resources
▪ CMS Data Reports
– OBQI (CASPER)
– OBQM (CASPER)
– Home Health Compare (Quality Measures, Star Reports)
– HHCAHPS
– HHQI Data Reports (ACH, Oral Medication, Immunization (both Flu & PNE), Cardiovascular Risk)
– Home Health Cardiovascular Data Registry
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Questions?
Evaluation
Thank You!
Contact Info:
Misty Kevech – [email protected]
Cindy Sun – [email protected]
www.HomeHealthQuality.org
This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health
and Human Services. The views presented do not necessarily reflect CMS policy. Publication number 11SOW-WV-HH-MMD-032117A