Many home health care agencies disregard QAPI or a Quality Assessment and Performance Improvement program because they feel they are too busy to deal with it. However, it is a key component of a well-run organization. It not only assists in minimizing risk, but it also increases an agency’s quality and efficiency. In order to be effective, an agency needs to identify what data should be monitored, compiled, analyzed and trended. Then action plans must be implemented based on the data collected. Once an agency does decide to implement a quality improvement program they will be amazed at how simple it is!
Accredited home health care and hospice agencies already are mandated to implement QI or Quality Improvement Programs. These plans can be very simple and should focus on high risk, high volume, and problem-prone areas. They should be incorporated into everyday operations with as many field and office staff possible in plan reviews. A QI program is the basis for the Conditions of Participation or CoPs for a QAPI program.
So where do you start with a QAPI program? First, a Homecare Agency Assessment that evaluates the agency should be completed. It will help to identify the high volume, high risk, problem-prone areas as mentioned previously. Next, regulatory compliance based on State, CoPs, Accrediting Agencies, OSHA, CDC, etc. should be incorporated. Also customer satisfaction should be measured via CAHPS or the Consumer Assessment of Healthcare Providers and Systems, which supports and promotes the assessment of consumers’ experiences with health care. Finally, outcome measurements should be developed via CASPER or Certification and Survey Provider Enhanced Reporting.
Mock Surveys should be instituted too as part of a QAPI program. They can be performed for a variety of reasons such as clinical record reviews or human resources file reviews covering competency, orientation, and in-service education.
Home visits should be included in an agency’s QAPI program too. For best results they should be conducted quarterly. Prior to the visit, the clinical record should be reviewed. During the actual visit the patient and/or caregiver should be interviewed and the home folder should be located and reviewed. Patient and caregiver interaction should be observed, and finally the procedures conducted should be compared with physician orders and notes.
This high-level overview is just the start of what a strong QAPI program can entail. A properly implemented and thorough QAPI program can supply much data. This data should be turned into actionable items that easily can improve upon any deficiencies and help all of the staff. Remember that a QAPI program is not just busy work, but a true tool to enhance an agency’s outcomes.