Capitalize on QAPI now, experts say

Kramer said providers shouldn't wait to integrate QAPI
Kramer said providers shouldn't wait to integrate QAPI

There's no better time for providers to tackle Quality Assurance and Performance Improvement, one of the hottest topics in long-term care, experts said during a McKnight's webcast on Wednesday.

The Centers for Medicare & Medicaid Services' recently proposed rules for LTC reform offer the perfect opportunity to dive in, said Andrew Kramer, M.D., chief executive officer of Providigm.

“I would argue that QAPI is underlying the entire evolution of the regulations because it is really the means by which providers will be able to accomplish the changes in care that are included in these revisions,” Kramer said.

Integrating QAPI requires a four-step process, where facilities collect data, analyze and investigate the data, identify issues, make improvements and monitor performance. But the process isn't over once QAPI has been implemented, Kramer said.

“It's not something that you can sort of do for a window and then you're set, that would be a little bit like taking blood pressures once and saying ‘Ok, we got it, we got all the blood pressures done and now we don't have to do it,'” he said. “You have to continue to do those kinds of things.”

Many providers have been waiting for official QAPI guidelines from CMS. But since the process can help nursing centers reduce adverse events, decrease deficiencies and boost occupancy rate, experts said there aren't downsides to adopting QAPI now, even though the LTC regulation proposal may still be in the draft phase.

“The worst that's going to happen is that you're going to have improved quality,” Kramer said. “No use in waiting for something to get spelled out in some perfect regulatory language.”

Discussions around QAPI integration should involve all department heads. But training the entire staff should be an incremental process, spread over the first three to six months of integration, to take into account varying levels of skill and comfort among employees, said Michael Lin, MPH, Ph.D, chief scientific officer at Providigm.

“One of the biggest hurdles for nursing centers using a technology intensive QAPI approach is computer proficiency,” Lin said. “Just as some people recognize there are nursing center employees who are not adept at typing, there are other employees who may not have much comfort looking at a computer screen to monitor and structure staff completion.”

For multi-facility organizations of all sizes, Lin recommends synchronizing QAPI integration throughout the company.

To view an archived version of the webcast, sponsored by Medline, click here.