Home Health Preparing for Future Success Today
4/18/2017
Home Health Preparing for Future Success Today
BUILDING
Quality Assessment and Performance Improvement (QAPI)
INFRASTRUCTURE
Christine Smith,
Director Alignment and Performance Improvement
UPMC Home Health and Hospice
smithca4@upmc.edu
Thelma Dibble,
Vice President Quality
UPMC Home Health and Hospice
dibbletl@upmc.edu
Objectives
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Integrate the new COP into QAPI Policy and Procedure
Discuss the utilization of easy to use performance improvement tools including
Lean Startup Methodology, elements of a business model canvas, and a key drivers
diagram to design and build QAPI infrastructure
Discuss techniques used to address QAPI drivers through specific strategies
including:
¨C
¨C
¨C
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Standardized data/reporting techniques
Stakeholder education, collaboration, and communication methods
Establishment of ownership and engagement responsibilities
Articulate the positive organizational impact of building a robust, yet streamlined,
QAPI infrastructure in a Home Health/Hospice organization as demonstrated by
results and expansion opportunities
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4/18/2017
QAPI Defined
? What is QAPI?
QAPI is the unification of meeting quality standards
of care (QA) and identifying areas in which
performance can be improved (PI).
? QA is reactive
? PI is proactive
QAPI and COP
? Broken down into 5 expectations
¨C Program Scope
¨C Program Data
¨C Program Activities
¨C Projects
¨C Executive Responsibilities
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4/18/2017
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Program Scope
Organizational wide
Reflects the complexity of the organization
Encompass all services provided by the organization including contract
services
Focus on high©\volume, high©\risk, and problem©\prone areas
Considers the frequency and severity of problems
Should be related to improving health outcomes, patient safety, and quality
of care
Include improvement in emergent care, hospital admissions, and reduction /
prevention of medical errors
Must include the measurement and tracking of quality indicators
Program Data
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OASIS / CASPER / Home Health Compare
Quality indicators
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Home Health Quality Improvement
Hospice Item Set Data
Pepper Reports
Record Reviews
Clinical Documentation System Data
HHCAHPS
3
4/18/2017
Program Data
? Set a plan for collection and establish benchmarks
? Frequency and detail of data collection must be approved by the
governing body
? Must be used to identify and prioritize areas for improvement
opportunity
? Must be related to the quality of care provided and the effectiveness /
safety of services
? Make it meaningful
Program Activities
? Immediately correct any identified items that pose a risk to the health
or safety of patients
? Patient adverse events or incidents may need Root Cause Analysis to
identify the true underlying issue
? Use data to rank / prioritize performance improvement initiatives
(focus on high©\volume, high©\risk, problem©\prone areas)
? Implement performance improvement projects
? Track and analyze data to determine if improvement occurred and is
sustained
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4/18/2017
Performance Improvement Project
? The number of projects undertaken annually should be reflective of the
scope, complexity, and past performance of the organization
? On annual basis review and update your prioritization list
? Get everyone involved / team approach / PIPs aren¡¯t just for leaders
? Ensure adequate documentation of the project and measurable
progress
? Project should be clearly defined and have timelines ¨C know what
you¡¯re working on and don¡¯t deviate
? Projects should have a distinct endpoint ¨C measurable goal
Governing Body
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Governing body / board (legal board; not the PAC) is responsible to ensure
that the QAPI plan is defined, implemented, maintained, and reflects
complexity of organization / reduction and prevention of medical errors
All projects need to be approved by the governing body
Must present to the board
¨C Rationale for project including data, priority ranking, and goal
¨C Clearly state how it relates to patient safety / quality of care
¨C What services are affected (include services under contract)
¨C Routinely update board to progress
¨C Closure of the project, plan for sustainability
¨C Findings of fraud / waste and how they were addressed
5
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