What is QAPI
QAPI is the merger of two approaches to quality management, Quality Assurance (QA) and Performance Improvement (PI). Both involve seeking and using information, but they differ in key ways:
QA is a process of meeting quality standards and assuring that care reaches an acceptable level. QA is a reactive, retrospective effort to examine why a facility failed to meet certain standards.
PI (also called Quality Improvement or QI) is a pro-active and continuous study of processes with the intent to prevent or decrease the likelihood of problems by identifying areas of opportunity and testing new approaches to fix underlying causes of persistent/systemic problems. PI in nursing homes aims to improve processes involved in health care delivery and resident quality of life.
Care systems based on a QAPI philosophy is to ensure a systematic, comprehensive, data-driven approach to care. The approach may prevent adverse events, promote safety and quality, and reduce risks to residents and caregivers.
QA + PI = QAPI
QA and PI combine to form QAPI, a comprehensive approach to ensuring high quality care. QAPI is a data-driven, proactive approach to improving the quality of life, care, and services in nursing homes. The activities of QAPI involve members at all levels of the organization to:
- Identify opportunities for improvement
- Address gaps in systems or processes
- Develop and implement an improvement or corrective plan
- Continuously monitor effectiveness of interventions
QAPI includes components that emphasize improvements that can elevate the care and experience of all residents, and improve the work environment for caregivers. With QAPI, your organization will use a systems approach to actively pursue quality, not just respond to external requirements. Look at the following list of QAPI features and assess how many you are already implementing:
- Using data to not only identify your quality problems, but to also identify other opportunities for improvement, and then setting priorities for action
- Building on residents’ own goals for health, quality of life, and daily activities
- Bringing meaningful resident and family voices into setting goals and evaluating progress
- Incorporating caregivers broadly in a shared QAPI mission
- Developing Performance Improvement Project (PIP) teams with specific “charters”
- Performing a Root Cause Analysis to get to the heart of the reason for a problem
- Undertaking systemic change to eliminate problems at the source
- Developing a feedback and monitoring system to sustain continuous improvement
QAPI and Nursing Home Quality Care Collaborative Learning
The Nursing Home Quality Care Collaborative Learning series has QI and QAPI focused tracks that guides nursing homes through meeting their QI responsibilities in ways that maximize the benefits of QAPI principles. Please go to Nursing Home Quality Care Collaborative Learning for highlights, recordings, tools, materials, resources, and a myriad of topics including operationalzing QAPI, engaging residents in QI, how to implement proven QI programs, how to spread and scale improvement and much more.
Links below will feature more about the QAPI topic and useful tools.
- QAPI In Action
- Steps To QAPI
- Elements for Framing QAPI in Nursing Homes
- QAPI Tools
- QAPI Self-Assessment – Used to evaluate the extent to which components of QAPI are in place.
- Goal Setting Worksheet – Helps organizations set goals that are specific, measurable, attainable, relevant, and time-bound.
- Guide for Developing a QAPI Plan – Used to steer the organization’s quality efforts and serves as the main document to support implementation.
- QAPI at a Glance - A Step-by-Step Guide to Implementing Quality Assurance and Performance Improvement (QAPI) in Nursing Homes