QAPI Basics
What does QAPI stand for?
Quality Assurance and Performance Improvement
What tool is commonly used to track patient outcomes in home health?
OASIS (Outcome and Assessment Information Set)
What does PIP stand for?
Performance Improvement Project
What is an adverse event?
An injury caused by medical management rather than the patient’s condition.
Which federal agency mandates QAPI for home health?
Centers for Medicare & Medicaid Services (CMS)
Which two core components make up QAPI?
Quality Assurance (QA) and Performance Improvement (PI)
What is a benchmark?
A standard or point of reference for comparing performance.
What triggers a PIP?
Identified problems or opportunities for improvement based on data.
What is the most common adverse event in home health?
Falls
What document outlines QAPI requirements for home health?
Conditions of Participation (CoPs)
True or False: QAPI is optional for Medicare-certified home health agencies.
False – It is a CMS requirement.
What type of data should be collected for QAPI?
Both quantitative (e.g., infection rates) and qualitative (e.g., patient satisfaction).
Who should be involved in a PIP team?
Interdisciplinary staff including clinicians, leadership, and support staff.
What should be done immediately after an adverse event?
Ensure patient safety and report the event per policy.
How many QAPI program elements are required by CMS?
Five
What is the primary goal of QAPI in home health?
To improve patient outcomes and care quality through data-driven decisions.
What is the purpose of a performance indicator?
To measure progress toward a specific goal or standard.
What is the first step in a PIP?
Define the problem clearly using data.
What is a near miss?
An event that could have caused harm but did not, either by chance or timely intervention.
What must be documented in a QAPI program?
Program scope, governance, data monitoring, and improvement actions.
Name one key difference between QA and PI.
QA focuses on compliance; PI focuses on proactive improvement.
How often should data be reviewed in a QAPI program?
Regularly – typically monthly or quarterly, depending on the measure.
Name one tool used in root cause analysis.
Fishbone diagram or the “5 Whys” technique.
What is the purpose of a root cause analysis?
To identify underlying causes of an event to prevent recurrence.
What is the consequence of non-compliance with QAPI requirements?
Potential citations, corrective actions, or loss of Medicare certification.