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Q: How can I involve staff in the Quality Assurance and Performance Improvement (QAPI) program? 

A:The Centers for Medicare & Medicaid Services form CMS-20058, QAPI and QAA Pathway, which surveyors use, is a great way to structure staff QAPI education so it includes all necessary components. 

Staff must be engaged in the QAPI efforts and understand what QAPI efforts the facility is working on and why. Nurse leaders could post this information in the break room or provide it during staff meetings, being sure to identify a contact for questions on quality improvement efforts. 

Once staff understand what QAPI is and how the facility is implementing it, there are many ways to increase participation. First, highlight avenues to raise concerns  about processes or policies. Often, staff see potential issues before problems occur, but they must feel safe to share those issues.

Emphasize that all ideas and concerns are welcome so that facilities can make changes before problems occur. Consider designating a place where staff can submit comments and concerns about quality issues if they are uncomfortable coming directly to leadership. 

During the QAPI process, solicit staff feedback regarding changes that affect them. Staff can provide valuable input by helping test, sustain and reflect on changes. Since staff are closest to the work, they can advise on whether changes in practice work. Staff also can help monitor data trends. For example, the restorative nurse may be able to identify in real time any changes in activities of daily living so the facility can introduce interventions to mitigate further declines. 

Staff participation is a key component of a successful QAPI program. Look for ways to involve staff members at every step of the process. 

Please send your nursing-related questions to Amy Stewart at [email protected].