Simplify quality programs for better outcomes. A few sustainable steps can improve patient experience and team caregiving. Quality need not be a chore
There are really only a few steps to executing a solid QAPI (Quality Assurance and Process Improvement) or as many states have been referring to a CQI (Continuous Quality Improvement) program that is simple, sustainable, and in compliance with regulatory guidelines and standards for accrediting bodies. And maybe even more important, actually beneficial to your patients, their care, and your team's ability to provide it.
Here they are:
Define your policy and procedure for quality programs and use it as a guide
Identify your core team. Include staff from different disciplines and direct care staff.
Decide the areas you'll monitor. Set your baseline for desired outcomes. Include clinical and administrative areas like satisfaction surveys, incidents, staffing, complaints, and grievances. Keep logs to monitor and have your QA information ready at a glance.
Meet and review the data and document your discussion and the data reviewed. Make sure you include your medical director.
Create an action plan, (like a Performance Improvement Plan or PIP) around the areas needing improvement and not meeting goals. Reflect a measurable time and expected results.
Conduct routine record reviews (audits) and keep staff involved in the process. Staff should be able to name an active quality program initiative to a surveyor.
Where many quality programs fail is in underestimating the need for engagement of the people who do the day-to-day actions and care that create the quality metrics. If your core team isn’t involved enough to take over the program when the leader is out sick, then they aren’t involved enough.
A few more reasons for pitiful quality programs:
The whole program rests on one person. One person collects the data, creates the plan, and holds the "meeting".
Like above, quality management is “for show”, just going through the motions with no meat, for example, setting goals that have no real significance, using random data to have quality metrics to show.
Quality is another box to check and feels like a chore. There's no innovation.
Too. Many. Audits. Quality does not equal audits. More audits do not equal higher quality. Action does.
Conversation around quality is limited to a few metrics and the same old data. Not enough education, revision, and evolution is happening within the team to really understand and improve anything that translates to practice.
I’m sure there are many other reasons for poor quality programs and many more for the excellent ones. Tell me about yours!