QAPI Program Utilization_Manual

PERFORMANCE IMPROVEMENT FINDING/SOLUTIONS REPORT (TO IMPROVE PATIENT CARE) Quarter: 9 I 9 II 9 III 9 IV year: _______ Report Date: _____________________ Report done by Name/Title: _______________________________________________ Deficiency Finding: 9 Performance in providing quality , timely home health care and services, Physician Order followed ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 9 Fall prevention program and other Safety risks, Infection Control/handwashing, Use medication safely, reconciliation, high risk ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 9 Coordination and management of Care between all disciplines (Nursing and Therapy services), Reporting Guidelines, Supervision, Communication and participation in care of patient/family/caregiver ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 9 Other identified problem: _____________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Solution , identify improvement opportunities, how opportunities for improvement were prioritized: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ _________________________________ ____________________ Signature Date 145