QAPI Program Utilization_Manual

Resource Utilization • Disciplines Is discipline use appropriate? Is there unnecessary use of disciplines? Is discipline use in line with OASIS responses? What is the process for follow-up of therapy visits? Tips to monitor therapy use - Conduct baseline audit: % of patient with/without therapy. - Determine average visits made. - Drill down reasons for adjustments. - Determine dollars lost/appropriate to care. - Audit the clinical record for plan of care implementation. • Visits Is the number of visits ordered congruent with patient need? Is the number of visits appropriate to the HHRG? Do discipline visits overlap unnecessarily? Are patients satisfied with visits planned? • Supplies Are the type and number of supplies used appropriate to patient need? To use of evidence- based practice? For example, is moist wound treatment ordered for pressure ulcers? » Using Evidence-based Practice to Improve Outcomes Evidence-based practice interventions that are based on healthcare research includes those provided by national associations and organizations, such as the American Heart Association, American College of Cardiology, American Diabetes Association, National Council on Aging, and the Wound, Ostomy and Continence Nurse Society, to name a few. For example, the new recommendation for hypertension is to obtain an accurate blood pressure reading; one that can be enhanced by having avoid exercise, caffeine and smoking for 30 minutes prior to taking the reading (National Institutes of Health, “Seven Report”). The application of this evidence-based practice intervention can help improve accuracy of the reading, which can in turn allow the physician to more aptly treat the diagnosis. »Using Cause and Effect to Improve Outcomes Realizing that OBQI outcomes result in part due to the natural progression of disease, one should focus on the factors or causes that the agency can change that also affect these patient outcomes. The Cause and Effect diagram is a simple performance improvement tool that can be extremely helpful in identifying and exploring possible causes of specific problem or outcome. Using a Cause and Effect Diagram is also a successful method for documenting your efforts and demonstrating performance improvement analysis that is conducted for the accreditation process. 10 Key Steps in Developing a Cause and Effect Diagram 1. Identify the main problem or outcome that needs remedy or reinforcement. 2. Form a small group of people whose line of work place them “closest to the problem” to brainstorm all possible causes. 3. List each cause given by the group. 4. Place each cause into one of four following categories: • Man • Machine • Method • Material 102