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Streamline Your QAPI: Plan, Do, Study, Act (PDSA)

    With the upcoming expanded Home Health Value-Based Purchasing (HHVBP) in 2023, the importance of the Quality Assurance Performance Improvement (QAPI) program is highlighted even more. Since QAPI is instrumental in improving quality scores, home health agencies must take advantage of it to stay ahead of the game amidst the new HHVBP landscape. However, implementing a QAPI program can get confusing and burdensome.

    Simplifying QAPI

    There are proven effective frameworks designed to improve processes that can be used to simplify QAPI and test the implemented changes. Generally, many risk areas and deficiencies can be identified after accurately assessing key performance areas. The transition towards improvement can then commence once a priority area is determined. Subsequently, each priority area should have its own QAPI plan.

    In order to build and execute your process improvements, one effective method that can be utilized is the Plan-Do-Study-Act (PDSA) cycle. In the case of a survey, PDSA is a recommended approach that gives surveyors a comprehensive view of an agency’s QAPI initiatives. Having PDSA in your QAPI documentation can provide an excellent impression to surveyors.

    Going through the prescribed four steps can help break down a task into steps and evaluate the outcome, improve on it, and test again. 

    • PLAN – Like with everything else in business, planning should be the first step to achieving a goal. After determining your agency’s priority areas, record the background and current state of the challenges at hand. And then, identify improvements that need to be made, prioritize specific areas of concern, and determine which ones to tackle first. 
    • DO – Once you have gathered the necessary information, implement your plan of action with a strict timetable for everyone in your team to adhere to. A data system with a centralized location where all members of your team can store and easily access items like data, records, and tools is highly recommended. 
    • STUDY – Analyze the consolidated data from the previous phase to determine whether there is an improvement or not. To do this, you will need to compare areas where no interventions were implemented (the control group) versus those with the PDSA intervention. If there is a significant change in the sample where PDSA was implemented, then your performance improvement was a success.
    • ACT – This phase includes plans for the next steps your agency will take based on the results and hypothesize even further how to improve. Was the improvement as high as expected? Could adjustments to the initial plan yield greater results? Were the outcomes not as expected and is a new course of action needed? Asking these questions will drive you to act on the answers.

    Further Guidance

    Since QAPI programs and areas for improvement are always changing, PDSA is most definitely a continuous cycle. To know when to move forward to a new subject and plan accordingly, steady improvement must be achieved for three consecutive cycles. It is key to choose among high-risk areas by reviewing previous reports since most agencies have additional process improvement areas awaiting a QAPI program. Keep in mind, though, to choose more than one area at a time when implementing performance improvement plans as the PDSA process takes time and might be delayed in official reports since it relates to STAR ratings or preparing for HHVBP.

    Leveraging QA Functions

    Amidst industry changes and hurdles, establishing a QAPI program can be challenging. To flourish in the HHVBP landscape, agencies must leverage their QA functions to drive performance improvement initiatives. The OASIS review team or provider must be able to provide actionable insights on the clinicians’ competency in patient assessment documentation. Assessing an agency’s quality of care as early as now can result in positive patient outcomes and business growth.

    Free Download: PDSA Worksheet

    Incorporate PDSA cycles in your QAPI initiatives using our free PDSA worksheet. Download here ⭳