QAPI and TapRooT®: The Bridge to Operational Excellence and Quality Care in our Nursing Homes
TapRooT® and QAPI
The Center for Medicare and Medicaid Services (CMS) defines QAPI as the coordinated application of two mutually reinforcing aspects of quality management systems: Quality Assurance (QA) and Performance Improvement (PI) = QAPI. Every nursing home in the U.S. is required to have a well documented QAPI program to be compliant with the Affordable Care Act. Nursing homes are required to continuously identify and correct quality deficiencies as well as sustain performance improvements.
TapRooT® is used to identify root causes of potential and actual risk to quality performance and prescribes corrective actions that will eliminate the risk or significantly reduce risk and consequences of incidents. TapRooT® training, tools and software are perfect solutions to implementing and maintaining a strong, compliant QAPI program.
Let’s first look at the QA portion of QAPI. QA is defined by CMS as the specification of standards for quality of service and outcomes, and a process throughout the nursing home for assuring that care is maintained at acceptable levels in relation to those standards. QA is ongoing, both anticipatory and retrospective in it’s efforts to identify how the organization is performing, including where and why facility performance is at risk or has failed to meet standards. TapRooT® processes ensure specification of standards by prescribing proven best practices for the root cause of any problem affecting quality of service, outcomes or breakdown of processes that assure quality of care. TapRooT® training, tools and software ensure the real root cause is identified by honing the teams’ skill in auditing and investigations practices that meet the criteria for both anticipatory and retrospective efforts in quality assurance. The TapRooT® Corrective Action Helper Guide will lead the team to proven best practices once root causes are identified and ensures the actions are effective. TapRooT® will also help teams measure and compare current performance against performance standards and goals.
CMS defines PI as the continuous study and improvement of processes with the intent to better services or outcomes, and prevent or decrease the likelihood of problems or barriers to improvement. TapRooT® Root Cause Analysis for Audits and Proactive Performance Improvement training, tools and software will lead QAPI teams through implementation of a continuous improvement program. There are countless good QAPI teams out there that are great at identifying problems but struggle with prescribing, implementing and measuring the effectiveness of corrective actions. They typically prescribe the weakest of corrective actions which generally include the “re” actions:
- Re-write the procedure or process
- Re-peat warnings, discipline training, etc.
The strongest corrective actions include putting new or additional safeguards in place, or even better, removing the risk or removing the patient from harms way.
Using TapRooT® to identify the real root causes of quality and performance issues through strong audit and investigation techniques and implementing effective corrective actions that lead to continuous improvement will help the QAPI team achieve Operational Excellence. The big winners are our loved ones who took care of us and now need our commitment to providing them the quality care they deserve.