QAPI: Avoiding the cost of non-compliance

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Bill Lampe, PT, DPT, MS
Bill Lampe, PT, DPT, MS

An initiative that should be top of mind for facilities is the Quality Assurance and Performance Improvement (QAPI), an extension of the Affordable Care Act that is focused on improving quality of care for residents.

This new provision significantly expands what is required of facilities to ensure they are continuously identifying and correcting quality deficiencies and improving performance. For the first time, facilities that do not comply with federal standards will be penalized. Although it may appear daunting, QAPI offers facilities the opportunity to differentiate themselves as a provider of quality outcomes. QAPI regulations are scheduled to be announced in late 2013 to early 2014, but care providers should start to prepare their course of action now to avoid the consequences of non-compliance.

The intent of QAPI is that care providers will make operational changes that will result in lasting improvements in the quality of care delivered in care homes by identifying and addressing the root cause of issues, rather than implementing just quick fixes. As a result, QAPI is focused on data-driven and measured results across several areas of health care to enhance the safety and dignity of residents, and will hold facilities accountable to demonstrate tangible improvements in performance and outcomes.

Among the steps that facilities should be taking to prepare:

  • Build a steering committee and interdisciplinary team to help ensure leadership accountability, and cross-functional participation
  • Develop a flexible plan that outlines the company's strategic approach to QAPI and ensure that staff are fully informed
  • Outline a process for data collection from various sources, including staff, residents, and families, and for data analysis to identify gaps in existing care processes
  • Conduct Performance Improvement Projects (PIPs) to examine and improve care or services in areas that are identified as needing attention

This last point is particularly important. For care homes, capturing and analyzing data, and tracking improvements will be crucial to success. But that's just the first step. Facilities will need to conduct performance projects which hone efforts in on a specific area, such as continence management, to make lasting improvements. This is where many facilities hit a roadblock. While the obvious problems to fix are easy to see, facilities aren't always able to uncover the root causes of more complicated issues. In many cases, an in-depth analysis is needed to evaluate every aspect of a clinical problem in order to identify the factors and drivers at its heart.

Today, tools, resources and support services exist that can help facilities manoeuver QAPI and kick-start their compliance efforts. TENA® QAPI programs by SCA Personal Care offer long-term care and skilled nursing facilities a breakdown of their current operations and processes, help identify and prioritize problem areas, and provide clinical support and product knowledge to enhance outcomes across a range of health aspects related to continence care – from night time care to leakage to personal hygiene and skin care. The programs walk facilities through a step-by-step, root-cause analysis of each issue, create and track PIPs, and build roadmaps for improvement.

SCA's approach to QAPI is to examine many aspects of health care within a facility and address how factors – such as proper continence care – can improve areas where incontinence or personal hygiene are not always seen as the root cause. 

Care providers who take the above steps will experience more fluid QAPI-compliance and be able to differentiate and market themselves as a sought-after solutions provider for care. They will have a much higher ability to market to hospital partners, ACOs and managed care partner organizations around quality outcomes, overall lower total costs, and increased satisfaction scores.

Bill Lampe, PT, DPT, MS, is the Clinical Director United States, Personal Care - North America,  at SCA Americas.

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