Editor’s note: This article is sixth in a series describing the 12 steps to implement Quality Assurance Performance Improvement (QAPI) in long-term care organizations.
Commitment, proficiency and awareness are words sprinkled throughout the Quality Assurance Performance Improvement implementation guide for nursing homes, QAPI at a Glance. Words like these were chosen because they accurately depict the depths and theme of QAPI. Words like these are coaxing QAPI to life in America’s nursing homes (NHs). Dedicated leaders inspire employee loyalty and loyal employees tend to stay. Proficiency with a particular skill builds confidence, which can motivate continued building of expertise. Awareness is knowledge and knowledge is power. The sixth QAPI action step is: Conduct a QAPI Awareness Campaign.
The previous action steps lay the foundation for this one. Without leadership responsibility and accountability (Step 1) efforts to change can’t be effective or sustainable. Change efforts depend on effective teamwork (Step2). Evaluating your nursing home’s current systems and processes is a necessary part of the QAPI planning process.
Take Your QAPI “Pulse” with a Self-Assessment (Step3). Completing the self-assessment tool helps NHs prioritize improvement efforts and visualize its current place in the implementation process. Knowing their current location is a crucial component when creating a plan for moving forward. In Step 4, Identify Your Organization’s Guiding Principles, the mission, vision, purpose and guiding principles unite and rally the members of the organization. To do this, these goals need to be identifiable. The guide provides a tool for guidance and written examples of a mission statement, a vision statement, a purpose statement and some guiding principles.
After writing the mission, vision, purpose and guiding principles, Step 5 is Develop Your QAPI Plan. The written plan details how the nursing home will spread the identified mission, vision, purpose and guiding principles into the nursing home’s departments and services manifesting in the daily professional lives of the staff and the quality of life for the residents.
GENERATE QAPI AWARENESS
This sixth action step focuses on communicating with two focus populations—caregivers and residents and families. There are seven guidelines for communicating with all caregivers. A guideline for conducting a QAPI awareness campaign is to frequently let everyone know about QAPI using multiple strategies. People receive information in various ways. Reading, listening, and watching, are all viable ways for communication with caregivers. Newsletters, flyers, information brochures and even texting are ways for conveying information by written media. Videos, webinars and face-to-face meetings are other ways information is conveyed by watching and listening.
To conduct an awareness campaign for caregivers, QAPI at a Glance suggests that NHs inform everyone about the QAPI plan often and in multiple ways, conveying the message that every caregiver is expected to raise care concerns and think about systems. Download copies of QAPI at a Glance and place in throughout the facility for residents, visitors and employees to access. QAPI updates, progress reports and next steps should be on the agenda of every meeting, included in every huddle and stand up, on the agenda of every resident council meeting and every department or team meeting. For QAPI to become ingrained into the nursing homes culture, every employee, every caregiver, every resident and every family member should develop a taste for QAPI. It must be talked about, heard about and seen every day. It should be thought about and felt in every service that is provided and all care that is delivered. QAPI is a lot of new information requiring learning new skills as well as implementing changes in daily practices. Change has to be introduced incrementally, allowing one part to be embedded before introducing another. The same is true about QAPI.
High-quality care is dependent on the care delivery system. Each resident’s care depends on groups of caregivers across disciplines and in various roles. For all this variation to come together into a high-functioning system that does what it is designed and intended to do requires strong commitment, unwavering dedication and unambiguous effective communication. There are numerous ways to improve the care delivery system, which include interdisciplinary brainstorming sessions focusing on improving how each discipline influences the care delivery system. This is also a good forum for a caregiver awareness campaign.
In addition to residents, family and in house care staff, any consultants, collaborating agencies, contracted care providers and contracted services also have to be aware of the NH’s QAPI plan and agree to practice accordingly. This means the NH’s hospice provider, supplemental staffing agencies, any contracted care suppliers must practice the same protocols as hired staff. The NH’s awareness campaign and training strategy has to include contracted care providers.
Although there may be some overlap between the awareness campaign for caregivers and the one for residents and families, special attention has to be given to the resident-centered focus of the NH population. Resident voice must be a living component of QAPI in every NH. This requires NHs to know and understand the residents they care for and their families. Knowing the audience is a key component for any campaign and the same is true about the QAPI awareness campaign.