This guide will explore a curated collection of essential QAPI resources, categorized for easy navigation, to help long-term care providers effectively implement and optimize their QAPI programs. These resources are designed to foster a systematic, data-driven, and proactive approach to performance management, ultimately leading to improved quality of life and care for residents.
Essential Guides to Quality Improvement in Long-Term Care
These guides offer foundational knowledge and practical strategies for implementing robust QAPI programs within long-term care settings. They cover various aspects of quality improvement, from change management to practical implementation steps.
1. Implementing Change in Long-Term Care: A Practical Guide to Transformation
While initially focused on culture change, this guide from the Pioneer Network, supported by the Commonwealth Fund, provides a valuable framework for managing change within long-term care facilities. Understanding the dynamics of change is crucial for successful QAPI implementation. This resource offers practical insights into navigating the complexities of organizational transformation, essential for fostering a culture of continuous quality improvement.
Click here to access Implementing Change in Long Term Care – Opens in a new window
2. National Nursing Home Quality Care Collaborative Change Package (NNHQCC)
Developed by CMS and Medicare Quality Improvement Organizations (QIOs), the NNHQCC Change Package is a treasure trove of actionable strategies and concepts for enhancing resident care and quality of life. It draws upon successful practices observed in high-performing nursing homes across the country. This package is designed to inspire and guide nursing homes in identifying and implementing changes that lead to tangible improvements in their QAPI initiatives. It’s a practical toolkit filled with ideas to elevate the standard of care.
Click here to access The NNHQCC Change Package (PDF)
3. QAPI at a Glance: Understanding the Fundamentals
“QAPI at a Glance” serves as an introductory guide to the core principles of QAPI. It demystifies the systematic, comprehensive, and data-driven nature of QAPI, highlighting its proactive approach to performance enhancement. This guide emphasizes the exciting potential of QAPI, driven by the unique experiences, priorities, and collaborative spirit of each nursing home team. It’s an excellent starting point for facilities new to QAPI or those seeking a clearer understanding of its fundamental components.
Click here to access QAPI at a Glance (PDF)
4. QAPI Written Plan How-To Guide: Essential for Compliance
As of November 28, 2017, nursing homes are required to present a written QAPI plan to surveyors. This guide, developed by the Lake Superior Quality Innovation Network, is specifically designed to assist nursing homes in creating a comprehensive and compliant QAPI plan. It outlines the essential processes for ensuring care and services meet acceptable performance levels and are continuously improved. This guide is indispensable for navigating the regulatory requirements related to QAPI planning.
Click here to access the QAPI Written Plan How-To Guide. (PDF)
Useful Websites for QAPI Implementation and Resources
These websites offer a wealth of interactive tools, training programs, and expert resources to support ongoing QAPI efforts in long-term care facilities.
1. Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS for Long-Term Care
TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is a program designed to optimize teamwork and communication among healthcare professionals. The AHRQ’s Long-Term Care version specifically addresses the unique challenges of nursing homes. By improving collaboration and communication, TeamSTEPPS tools contribute directly to enhanced patient safety and quality of care within the QAPI framework.
Click here to access TeamSTEPPS Tools – Opens in a new window
2. Department of Veterans Affairs – National Center for Patient Safety
The VA’s National Center for Patient Safety is a leading authority in patient safety practices. They offer valuable tools, including resources for conducting Root Cause Analysis (RCA) investigations. RCA is a critical component of QAPI, enabling facilities to systematically analyze adverse events and implement preventative measures. Leveraging these tools can significantly strengthen a nursing home’s ability to identify and address system-level issues impacting patient safety.
Click here to access Patient Safety Tools
3. Donna’s Diary: An Interactive QAPI Learning Website
Donna’s Diary is an engaging, interactive website created by Stratis Health to facilitate learning about quality improvement and enhance the quality of life for both residents and staff. Through realistic case studies presented as diary entries from a Director of Nursing (DON), the website explores common challenges faced by nursing homes. It offers best-practice solutions based on QAPI principles, making learning both practical and relatable.
Click here to access Donna’s Diary
4. Lean Goddess Video Series: Quality Improvement in Action
This video series, developed by The Colorado Foundation for Medical Care (CFMC), uses everyday situations to illustrate quality improvement strategies. By applying quality principles to familiar scenarios, the Lean Goddess series makes quality improvement concepts accessible and understandable for all staff levels. These videos are an innovative and engaging way to train staff on QAPI methodologies.
Click here to access the Lean Goddess Video Series (PDF)
5. Model for Improvement – Institute for Healthcare Improvement (IHI)
The Institute for Healthcare Improvement (IHI) promotes the Model for Improvement, a simple yet powerful framework for driving improvement initiatives. Developed by Associates in Process Improvement, this model emphasizes rapid-cycle testing using the Plan-Do-Study-Act (PDSA) cycle. Understanding and applying the Model for Improvement is fundamental to effective QAPI implementation and continuous progress.
Click here for to access the IHI website
6. National Nursing Home Quality Improvement Campaign (NNHQIC)
The NNHQIC offers long-term care providers and quality improvement professionals free access to evidence-based resources and model practices. It provides valuable tools such as tracking systems, customizable graphic displays, and a help desk to support data-driven quality improvement projects. This campaign serves as a central hub for resources and support, empowering nursing homes to effectively manage their QAPI initiatives.
Click here to access the National Nursing Home Quality Improvement Campaign
7. Quality Improvement Organizations (QIOs) – Find Your Local Support
Each state is served by a Quality Improvement Organization (QIO) that offers tailored resources and tools to nursing homes within their region. QIOs provide localized support and expertise to assist facilities in implementing and sustaining effective QAPI programs. Connecting with your state’s QIO is a crucial step in accessing personalized guidance and resources.
Click here to find your Quality Improvement Organization
Topic-Specific Resources for Focused QAPI Initiatives
These resources address specific areas critical to quality care in long-term care settings, allowing for targeted QAPI interventions and improvements.
1. Adverse Events Resources
CMS provides a compilation of resources specifically focused on identifying and preventing adverse events in nursing homes. These resources are essential for facilities seeking to proactively minimize harm and enhance resident safety. Addressing adverse events is a core component of any robust QAPI program.
Click here to access Adverse Events Resources.
2. Change in Condition Management – INTERACT II
INTERACT II (Interventions to Reduce Acute Care Transfers) is a comprehensive toolkit designed to improve communication among nursing home caregivers regarding changes in resident conditions. Effective communication is crucial for timely intervention and preventing unnecessary hospitalizations. INTERACT II can be considered a complete QAPI process toolkit for managing changes in condition and promoting resident well-being within the facility.
Click here to access INTERACT II.
3. Infection Control Resources
-
AHRQ Nursing Home Antimicrobial Stewardship Guide: This guide assists nursing homes in optimizing antibiotic use and mitigating the harms of inappropriate prescribing. It offers tools for starting, monitoring, and maintaining antibiotic stewardship programs, a critical aspect of infection control and resident safety.
Click here to access the Nursing Home Antimicrobial Stewardship Guide.
-
CDC Core Elements of Antibiotic Stewardship for Nursing Homes: The CDC’s core elements provide practical steps for initiating or expanding antibiotic stewardship activities in nursing homes. Implementing these elements is crucial for reducing adverse events, preventing antibiotic resistance, and improving resident outcomes.
Click here to access the CDC’s Core Elements of Antibiotic Stewardship for Nursing Homes.
-
CDC Infection Control Assessment Tool for LTCFs: This CDC tool assists in evaluating infection control programs and practices in long-term care facilities. Regular assessments are vital for identifying areas for improvement and ensuring effective infection prevention strategies are in place.
Click here to access the CDC’s Infection Control Assessment Tool for LTCFs
-
National Healthcare Safety Network (NHSN) for Long-Term Care: The CDC’s NHSN provides a customized system for tracking infections and infection control practices in long-term care facilities. Data from NHSN enables facilities to identify prevention opportunities, monitor progress, and contribute to national infection prevention goals.
Click here for more information on tracking infections using NHSN
-
CDC Nursing Homes and Assisted Living-Infection Control Resources: This CDC webpage offers guidance documents and links to resources on common infections in long-term care, such as C. difficile and UTIs, and their prevention. It’s a comprehensive resource for clinical staff and residents seeking information on infection control.
-
QIO Nursing Home Training Sessions – Antibiotic Stewardship and C. difficile Prevention: This CMS-sponsored website provides training tools and resources specifically for implementing antibiotic stewardship and preventing C. difficile infections. These sessions offer continuing education contact hours for nursing professionals.
4. Person-Centered Care Resources – Picker Institute Publications
The Picker Institute offers publications, including Long-Term Care and Patient-Centered Care Improvement Guides, emphasizing person-centered approaches. These guides, authored by Susan Frampton and others, promote care that is respectful of and responsive to individual resident preferences, needs, and values, a cornerstone of quality long-term care.
Click here to access Picker Institute Publications
5. Pressure Ulcer Prevention – AHRQ On-Time Pressure Ulcer Prevention (OTPP)
AHRQ’s OTPP program is an evidence-based program for nursing homes using electronic medical records (EMRs) to prevent pressure ulcers. OTPP utilizes EMR-generated reports to identify at-risk residents, facilitate multidisciplinary communication, and implement proactive interventions. This data-driven approach significantly enhances pressure ulcer prevention efforts and improves resident quality of life.
Click here to access the On-Time Pressure Ulcer Prevention program
By leveraging these comprehensive QAPI tools for long term care, nursing homes can effectively strengthen their quality assurance and performance improvement programs. These resources, provided by CMS and other leading healthcare organizations, offer invaluable guidance, practical strategies, and topic-specific support to drive continuous improvement and ensure the highest standards of resident care. Remember that while these tools are incredibly helpful, consistent effort, data-driven decision-making, and a commitment to quality from all staff levels are essential for achieving sustainable success in QAPI and ultimately, in enhancing the lives of residents in long-term care.
