QAPI | Process-Based Quality Improvement

Have you struggled to implement change through your quality assurance program? Are you inspired by CMS’s QAPI initiative but not sure what to do next? Do you need guidance in determining the best bang for your resident-centered investment bucks?

Lean is a perfect methodology to embrace for compliance with the upcoming CMS mandate for QAPI (Quality Assurance and Process Improvement). By combining a rigorous, resident-centered process improvement philosophy with existing quality assurance program data, providers can not only meet CMS regulations, but also generate true value for residents by focusing on meaningful quality improvement and waste reduction in the pursuit of excellence.

We can help you design a Lean QAPI program to help you provide better care, drive resident satisfaction and improve the quality of life for everyone in your organization. Training is customized based on the particular needs of the organization, and can include:

  • Program design and implementation
  • Mystery shopping/ overnight observations
  • Key Performance Indicator selection and data collection
  • Lean philosophy and process training
  • Process auditing, including auditing of EHR implementations
  • Using analytics and predictive analysis to drive process inteventions
  • Resource guides and training (5S auditing, A3 problem solving and project management, root cause analysis, value stream mapping)

How does Lean fit in with QAPI?

Take a look at each of the five elements of QAPI and how Lean fits in with each:

Element 1: Design and Scope

Lean, by design, encompasses an entire organization and becomes engrained in the organization’s core leadership and mission. Providers must commit to relentlessly eliminating waste by practicing continuous, systematic improvement. By promoting a culture of improvement and developing people to understand and create more value in their work, a lean approach also helps ensure “everyone is on board.”

Element 2: Governance and Leadership

QAPI requires that the governing body and administration commit both in writing and in practice to a culture of quality improvement and excellence. A lean program starts with acceptance and promotion by the governance structure and is most successful with active administrative support. Lean takes leadership a step further and commits to a method of problem solving that respects people and creates lasting value in pursuit of the organization’s mission.

Element 3: Feedback, Data System, and Monitoring

Built on the principle of continuous improvement, lean provides a rich framework to monitor quality, measure improvements, and maintain gains. By focusing on data, lean is primed for compliance with QAPI. And by creating systems of quality and cultures of active participation and respect, lean can help organizations move beyond traditional nursing metrics to seize opportunities for value creation in dining, marketing, and ancillary services.

Element 4: Performance Improvement Projects

Using an A3 problem solving method, or by integrating Six Sigma project discipline, improvement activities will already be organized into measured, documented projects in compliance with CMS standards. But project-based improvement is only the beginning: lean is poised to create an engaged, responsive workforce that actively seeks out opportunities for continuous improvement. No more waiting month-to-month for a QA committee to test improvements and evaluate residents; lean empowers each employee to contribute to a stronger, more productive organization.

Element 5: Systemic Analysis and Systemic Action

Lean culture, through documented quality improvement, ensures an organization moves forward. As hospitals and health systems look more and more to partner with organizations that can prove their value, a lean base provides hard data on organizational excellence. Further, the program allows organizations to quickly attack any problem area with a focused, universal improvement discipline, increasing teamwork across functional silos and generating a stronger sense of togetherness across the organization.

Ready to get started? So are we!