Leveraging Quality Assurance and Performance Improvement for High Reliability in Aging Services

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Long-term care facilities that participate in Medicare and Medicaid are required to establish a quality assurance and performance improvement (QAPI) program to identify opportunities for improvement, develop and implement interventions or countermeasures, and continuously monitor the effectiveness and sustainability of the improvements. This requirement has been in place since 2010; still many struggle to navigate the ever-changing situation regarding regulations, resident and family needs, and the environmental landscape. QAPI programs can provide the needed framework and infrastructure to sustain continuous quality improvement (CQI) through the following key features:

  • Leveraging high-reliability organization (HRO) principles to sustain and optimize quality improvement initiatives
  • Using quality and safety data to develop and prioritize performance improvement projects (PIPs)
  • Supporting person-centered care principles by improving resident health outcomes, quality of life, and resident and worker safety
  • Engaging residents, their families, and staff to inform PIPs, evaluate progress, and provide feedback
  • Applying analysis frameworks—such as root cause analysis (RCA) —to identify sources of problems and develop action plans for CQI

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