Staying compliant with the Conditions of Participation (CoPs) set by the Centers for Medicare and Medicaid Services (CMS) is a common but crucial challenge faced by hospices, nursing homes, and long-term care facilities. Maintaining Quality Assessment and Performance Improvement initiatives, or QAPI, is one aspect of the CoPs that may seem especially daunting. There’s a common misconception that quality improvements are only achievable through complex, structural changes in business processes. However, in actuality, QAPI programs become much simpler to implement and keep up with if you approach them with the Plan, Do, Check, Act (PDCA) cycle in mind.
Also known as the Deming cycle, the PDCA cycle is a method used to pinpoint problems in a process and identify the necessary changes to make in order to improve it. This cycle is based on the scientific method and is widely used in multiple industries, including healthcare. The PDCA cycle involves following a step-by-step process:
The first step is to identify a problem or an opportunity for improvement. After identifying the problem, brainstorm some possible changes that can solve the issue and enhance overall performance.
Choose one of your possible solutions and turn it into an actionable plan. Then, launch your plan on a small scale, similar to a pilot test. Take the opportunity to gather data and find any unexpected issues that may arise as a consequence of the new plan. Continue testing under different conditions, such as morning versus night or weekdays versus weekends.
Evaluate the results and data gathered from your pilot test to decide if your plan solves the original problem. Ask yourself if the changes provided meaningful solutions. If further adjustments are needed, refine the changes by conducting more tests.
If the results of the “Do” stage are successful, you can begin to incorporate the new plan system-wide. If not, cycle back to step 1 or 2, making the necessary adjustments until you’re satisfied that the original problem has been fixed.
Hospice care environments are often rapidly changing due to policy and technological shifts. This makes having a robust improvement plan in place all the more important. By utilizing hard data gathered from a systemic, step-by-step approach, the PDCA cycle creates a solid foundation for a CMS-compliant continuous improvement process. An increased emphasis on positive change enhances overall quality of care and increases patient and family satisfaction, leading to reduced costs and elevated growth for hospice programs.
Hospice care involves as much business as it does healthcare. Qualis offers behind-the-scenes operational support along with a robust DME vendor network.
Long wait times for DME evaluations, slow turnaround on test results, and other delays are not unusual in the hospice care space. The PDCA cycle can reduce the instance of these cases by helping you systematically analyze what causes the delays, whether it's a staffing issue, communication blocks, or mismanaged resources, and come up with an efficient plan for addressing them.
A high percentage of readmissions typically indicates a low standard of care, which may be caused by inadequate follow-up care, medication issues, the patient’s socioeconomic status, and a myriad of other factors. By engaging the PDCA cycle, you can isolate each contributing issue, identify at-risk patients, and eliminate the problems that contribute to readmissions in the first place.
As technological advancements bring new medical equipment to the market, the PDCA cycle can reduce user error by standardizing workflows. This maximizes consistent outcomes while minimizing user error.
Not only does the PDCA cycle take staff performance into consideration, but it also requires a high degree of staff input. By contributing and participating in improvement efforts, your staff will feel more empowered and motivated.
At Qualis, we provide full-spectrum business management services, such as centralized reporting, tools and analytics, and general advisory support for the PDCA framework. To ensure that your facility remains compliant while delivering quality improvement in hospice care, choose a partner that straddles both the economic and medical aspects of the business.
Streamline QAPI even further by involving your staff in the PDCA process. Consider assigning different responsibilities under each step of the cycle, asking for feedback, and encouraging collaboration between teams. Recruit those in leadership positions to provide additional support from the top down. To learn more about DME and hospice management, leverage Qualis’ resource library of whitepapers and ebooks.
Along with training your staff, provide the necessary tools and resources for data collection during the “Do” phase. This may include software for consistent data analysis, adequate funding, and additional time away from normal duties. Emphasize good record-keeping practices, such as mandating regular check-ins, to collect as much quantifiable data as possible.
Understand what makes an ideal pilot project for the “Plan” phase. Your target problem should be well-defined, and your possible solutions should be achievable within a realistic timeframe.
Ready to build continuous improvement into your DME workflows? Let’s talk. Contact us for answers to your DME-related questions, client testimonials, and more information about Qualis.