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Agencies Prepare for QAPI CoP with Quality Reviews and QI Training

Posted on Tuesday, April 4, 2017 2:08 PM

Agencies are working hard to make sure their getting performance improvement projects in place for the upcoming Quality Assurance and Performance Improvement (QAPI) requirement as part of the revised Home Health Conditions of Participation (CoPs).

The CoPs take effect July 13, however agencies now have until January 13, 2018, to start conducting performance improvement projects related to QAPI.

According to a DecisionHealth survey, more quality reviews and more QI training were among the top three changes agencies are making in preparation for QAPI.

Out of 323 respondents to a survey question on training, the results concluded the following:
• 69% said more QI training were on their short list to prepare for QAPI
• 62% said more quality reviews were on their short list to prepare for QAPI

Punxsutawney Home Health in Punxatawney, Pa., has started the QAPI preparation process with chart reviews to find its biggest problem areas, Director Diane Buck says. In addition, the agency is hiring a full-time employee who will help with those reviews.

The agency previously had an outside vendor doing chart reviews, but the results were provided quarterly so the information wasn’t timely, Buck says. Therefore, they’ve decided to bring chart reviews in-house for a quicker approach and to address any potential problems.

For Buck, his biggest concern is catching up to speed. “I’m a little leery,” she says. “Small agencies, you don’t have as many resources as the larger ones.”

Barbara Edwards, Director of Home Health at Trios Health in Kennewick, Washington, feels that their agency got an early start on QAPI since Washington is a value-based purchasing state.

The agency did their homework and started looking at Home Health Compare data, value-based purchasing scores and Outcome-Based Quality Management (OBQM) and Outcome-Based Quality Improvement (OBQI) reports.

“But they’re so old that they’re not terribly helpful,” Edwards says.

In addition, the agency uses ABILITY Network Inc. to pull reports while Edwards conducts her own records reviews.

“That, reinforced by outcomes on our reports … helps us focus in on where the areas of deficit are,” Edwards says.

“We have seen some improvement in our ambulation and transfer scores,” Edwards says.

It’s a long road ahead, Edwards says, and while the scores aren’t where she’d like them to be, they are headed in the right direction.

“We have not turned that corner yet, but we are doing an awful lot of review and reinforcement and training,” Edwards says.

Dekalb Regional Home Health in Fort Payne, AL has focused heavily on quality. In the past year, the agency’s quality of patient care star rating increased from 4 to 5 stars.

Knowing its quality numbers and making sure staff understand where the scores come from was a big part of the agency’s improvement, says Stephanie Hughes, an RN clinical supervisor.

The agency uses HomeCare HomeBase to pull regular reports. Looking at the information monthly allows Dekalb Regional to identify trends early, Hughes says.

“All quality measures are assessed every month, and if it’s two months in a row that we’ve scored low in an area, we have to do a quality improvement plan,” she says.

To prepare for QAPI deadline, make sure you do the following:
• Perform 10 chart reviews
• Make sure all your staff is on board
• Look for improvement opportunities outside the clinical
• Utilize resources available

“There’s a lot of good resources out there, but it takes time to get through everything. You have to sort of pick and choose what’s going to be the best investment for the time you have available,” Buck says.

For the full article, please see the April 3, 2017 Home Health Line Edition.

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