The function of quality management within long-term care facilities includes increasing overall performance by enhancing the managing, planning and training for all key operations and assessing the outcomes. It also means securing the links between continuous improvement, quality and resident satisfaction, and utilizing feedback to drive necessary change. The overlying goal is to develop systematic approaches that focus on the mission, vision and values, and promote consistent results to assist the organization in maximizing its strengths.
Quality Assurance Performance Improvement (QAPI)
QAPI is the synchronized application of two underpinnings of a quality management system: Quality Assurance (QA) and Performance Improvement (PI). QAPI takes a systematic, comprehensive, and data-driven approach to maintaining and improving safety and quality in nursing homes while involving all nursing home caregivers in practical and creative problem solving.
- QA (Quality Assurance) is the specification of standards for quality of service and outcomes, and a process throughout the organization for assuring that care is maintained at acceptable levels in relation to those standards. QA is on-going, both anticipatory and retrospective in its efforts to identify how the organization is performing, including where and why facility performance is at risk or has failed to meet standards.
- PI (Performance Improvement also called Quality Improvement or QI) is the continuous study and improvement of processes with the intent to better services or outcomes, and prevent or decrease the likelihood of problems, by identifying areas of opportunity and testing new approaches to fix underlying causes of persistent/systemic problems or barriers to improvement. PI in nursing homes aims to improve processes involved in health care delivery and resident quality of life. PI can make good quality even better.
As a result, QAPI amounts to much more than a provision in Federal statutes or regulations; it represents an ongoing, organized method of doing business to achieve optimum results, involving all levels of an organization.
To better understand the extent of such a system, the following are Key Elements of QAPI
- Design and Scope - self-assessment and monitoring tool
- Governance and Leadership - promote engagement and commitment of staff at all levels of the organization
- Feedback, Data Systems and Monitoring - develop, collect and monitor key measures/indicators
- Performance Improvement Projects - a project charter that captures the problem to be solved, the background leading to the identification of a need for this project, and related project expected outcomes and goal(s)
- Systematic Analysis and Systemic Action - consistent evaluations, including the evaluation of the extent (or scope) of the issue