QIO Program Overview

December 6, 2012

About VHQC

• Private, non-profit healthcare consulting and quality improvement organization

• More than 60 experienced professionals Quality Improvement Consultants Case Managers Physicians Information Technology / Management Professionals

• Regional Extension Center• Two nationally recognized coordination centers:

Improving Health for Populations and Communities Care Reinvention through Innovation and Spread

VHQC

• Federally designated Quality Improvement Organization (QIO)

• Focus on three critical aims to improve care for everyone: Better patient care Better population health Lower health care costs through improvement

Four QIO Aims

• Beneficiary Centered Care – Case Review and Patient and Family Engagement

• Improve Individual Care – Healthcare Acquired Conditions, Healthcare Acquired Infections, Adverse Drug Events, Data Reporting

• Integrate Care for Populations – Care Transitions

• Population Health – Prevention: screening and immunizations

Providers and other health care stakeholders, including beneficiaries, working together to implement change and spread best practices through peer-to-peer learning and solution sharing.

• Improvement collaboratives• Online interaction, tools, resources • Educational opportunities

Learning and Action Network

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Designed to promote the highest quality of care for nursing home residents and will strive to instill quality and performance improvement practices, reduce healthcare-acquired conditions, and dramatically improve resident satisfaction.

The Virginia Nursing Home Quality Care Learning Network

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• Provide the foundation for nursing homes to focus on quality, data-driven, resident-centered care

• Support the development of strategies for overall quality

• Identify opportunities for improvement• Address gaps in systems through planned

interventions to improve the overall quality of care

The Virginia Nursing Home Quality Care Learning Network

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Benefits of Participation:• Educational, collaborative sessions with other

participating facilities• Networking, learning and sharing opportunities

with Virginia nursing home staff and quality improvement experts

• Information, tools and resources for Quality Assurance Performance Improvement (QAPI)

• Intervention development ideas and assistance

The Virginia Nursing Home Quality Care Learning Network

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Quality Improvement Focus Areas:• Staff Stability• Consistent Assignment• Inappropriate Antipsychotic Medication Use In

Residents With Dementia• Pressure Ulcers• C. diff• Hospital Readmissions

The Virginia Nursing Home Quality Care Learning Network

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Requirements for Participation:• Commit to remain active in the project through

July 2014• Apply strategies and principles of overall nursing

home quality• Collect and submit data to measure the impact

of change• Form an interdisciplinary team to work with

VHQC

The Virginia Nursing Home Quality Care Learning Network

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Requirements for Participation:• Develop strategies for QAPI• Participate in Learning & Action events as well

as educational and sharing conference calls/webinars

• Actively share best practices and lessons learned

• Sign on to the Advancing Excellence Campaign

The Virginia Nursing Home Quality Care Learning Network

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Background• Existing Quality Assurance & Assessment (QAA)

provision• March 2010 – Congress passed the Affordable

Care Act Section 6102 (c)

Quality Assurance and Performance Improvement (QAPI)

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• QAPI programs in other Federally certified programs

i.e. hospitals, transplant programs, dialysis centers, ambulatory care, hospice

• Nursing home QAPI to be consistent with other settings at high level

• Nursing home QAPI to take into account issues unique to nursing home setting

Quality Assurance and Performance Improvement (QAPI)

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• Facilities must submit a plan to the Secretary • Meet QAPI standards • Implement QAPI best practices

QAPI Regulation Requirements

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Data-driven and pro-active approach to quality improvement. Activities of this comprehensive approach are designed to involve all members of an organization to continuously identify opportunities for improvement, address gaps in systems through planned interventions in order to improve the overall quality of care and services delivered to nursing home residents.

QAPI Defined

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• Design and Scope• Governance and Leadership• Feedback, Data Systems and Monitoring• Performance Improvement Projects (PIPs)• Systematic Analysis and Systemic Action

Five Elements of QAPI

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• Summer of 2011 – CMS established a prototype QAPI program & tested in 17 pilot nursing homes in 4 demo states (FL,MA, MI, CA)

• Summer 2012 – CMS Nursing Home QI Questionnaire sent to 4,200 facilities Obtain baseline information & identify potential

barriers to implementing quality programs

QAPI Progress to Date

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• The Virginia Nursing Home Quality Care Learning Network QAPI Resources Quality and Performance Improvement Processes &

Techniques Best Practices

Support to Facilities for QAPI

Leading the way to better healthcare

Contact VHQC

Amy Lenz, VHQC

alenz@vaqio.sdps.org

or

Sheila McLean, VHQC

smclean@vaqio.sdps.org

804-289-5320

www.vhqc.org