Key Focus Areas for Home Health QAPI
Is your Home Health Agency’s QAPI program making a positive impact? QAPI can seem challenging at times, but the benefits of a robust QAPI plan can significantly improve the quality of care that your patients receive.
QAPI (Quality Assessment and Performance Improvement) is required for home health agencies as a condition of participation. 484.65 Condition of participation: Quality assessment and performance improvement (QAPI).
What are the 5 Elements of QAPI?
QAPI involves ongoing action including activities related to development, implementation, ongoing evaluation and maintenance. In addition to being ongoing, QAPI must be data driven.
“The HHA must develop, implement, evaluate, and maintain an effective, ongoing, HHA-wide, data-driven QAPI program. The HHA’s governing body must ensure that the program reflects the complexity of its organization and services; involves all HHA services (including those services provided under contract or arrangement); focuses on indicators related to improved outcomes, including the use of emergent care services, hospital admissions and re-admissions; and takes actions that address the HHA’s performance across the spectrum of care, including the prevention and reduction of medical errors. The HHA must maintain documentary evidence of its QAPI program and be able to demonstrate its operation to CMS.” But wait, there’s more:
5 Standards of QAPI per the Conditions of Participation (COPs).
- Program Scope
- Program Data
- Program Activities
- Performance Improvement Projects
- Executive Responsibilities
Program Scope
An Agency’s QAPI program must show measurable indicators of performance and that the applicable indicators target improved outcomes, patient safety, and quality of care. Essentially, QAPI must objectively measure the factors being addressed and those factors must be helpful to patients and the agency. Agencies then should track quality indicators “including adverse patient events” and other key indicators in order to demonstrate efforts to track improvement in outcomes and operations.
Program Data
Agencies should use OASIS driven data, along with other relevant metrics to track QAPI indicators. But for true effectiveness, the agency must go a step beyond monitoring and actually act on the data to drive performance improvement.
Program Activities
QAPI must focus on high risk, high volume, or problem prone areas. Agencies should determine the what, where, how, how much and how often, and why of operational challenges that could impact patient health and safety. QAPI should including procedures for tracking adverse patient events and assessing root causes of what and how those events happened with follow up corrective action plans put in place to eliminate or reduce the risk of recurrence in the future.
Performance Improvement Projects
Agencies must act on identified priority improvement opportunities through Performance Improvement Projects (PIPs). These projects should reflect the complexity of the agency, document the projects undertaken, why they were undertaken, and the measurable progress achieved from the projects.
Executive Responsibilities
Home health leadership must be involved in the QAPI program and its oversite. Management needs to make sure that the program is defined, implemented, and maintained. In addition, leaders should set priorities for QAPI and its efforts to improve the quality of care, patient safety, and operational excellence. Leadership is responsible for ensuring that improvement actions are evaluated and should fraud or waste be discovered, to ensure that it is immediately addressed and corrected.
Key Areas of Focus for Home Health QAPI Programs:
- Chronic Disease Management such as diabetic care and heart failure management
- Wound Care
- Falls
- Infections
- Timely Initiation of Care
- Hospital Readmission Rates
- Patient Satisfaction
- Overall Quality of Care Delivered in the Home (Key OASIS Outcomes)
Contact Proactive today for assistance in developing a QAPI plan or conducting ongoing QAPI or interim auditing and monitoring activities to ensure your agency’s success.
Written by:
Nichole McClain, RN
Principal Consultant of Home Health Services
Contact Proactive to learn more about Five-Star Improvement support services and develop a road map to Five-Star success in 2025.