Ask the nursing expert ... about QAPI implementation

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Angel McGarrity-Davis, RN, CDONA, NHA
Angel McGarrity-Davis, RN, CDONA, NHA

There has been a lot of talk about QAPI. What is the director of nursing's role? Where should we start?

First off, do not be alarmed by learning about this “new” program. It is not new. It is the Quality Assurance Performance Improvement plan, which has been in the federal regulations and most state regulations for a long time. The difference is we are now just going to streamline some aspects of the program, as described in the Affordable Care Act. 

The five elements of QAPI are: Design and Scope; Governance and Leadership; Feedback, Data Systems and Monitoring; Performance Improvement Projects (PIPs); and Systematic Analysis and Systemic Action.

You have to start in your facility by assessing the quality of care. Use the tools and resources provided by the Centers for Medicare & Medicaid Services and other organizations to establish your foundation. Then discuss your purpose. This will help you in making decisions and identifying your facility's priorities in quality improvement. 

A team effort is needed to build this implementation. As the DON, you should help the team set goals that are specific to your facility. It should be a written plan, and part of Element 2 is designating one or more persons to be accountable for QAPI in the facility.

Remember to set a date for accomplishing each goal and identify how you will measure it. By developing solid processes based around your goals, you will improve the quality of care and the quality of life for your residents.  

We educate to ensure staff members are competent, as facility-wide training is a part of QAPI.  

Be proactive with the residents and their families. You should have a comprehensive, proactive program that focuses on ensuring quality and continuous improvement of the care provided. 


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