QAPI Program Utilization_Manual

LEVELS OF PERFORMANCE, PATTERNS, TRENDS, AND VARIATIONS Quarter: _______________ Quality Assurance, Performance Improvement Program Page 1 PERFORMANCE : Care and treatment: 9 Plan of Care and modifications, including Medication Management reviewed and compliance achieved during the quarter: _______ % 9 Supervisory Plan compliance, patients needs identified, hand hygiene, universal precautions followed at _______ % 9 Patient Educational, training need achieved at ________ % 9 Assessment completed on time, staff assigned within 48 hrs after referral at _____ % 9 Coordination of care in multi-discipline cases compliance at _____ % 9 Therapy cases documentation following new regulations, outcomes compliance at ____ % 9 Progress Notes/reports, Case Conference, Summaries turned back to the Agency on time and reflected POC compliance at _____ % 9 Other: __________________________________________________________________________________________ at _____ % Patient and Staff Safety: 9 Patient identified by at least 2 identifiers before treatment/care in all services at _____ % 9 Fall risk assessment, reassessment completed as needed, order obtained, prevention at _____ % 9 Pressure ulcer risk completed at needed at _______ % 9 Hospitalization risk assessed at _______ % High risk medication assessed _____ % 9 Use of Personal Protected Equipment (PPE) by our staff at all time at ____ % 9 Infection control measures compliance at _______ % 9 Hand Hygiene compliance at _____ % 9 Disaster Plan, exercise, drill completed, education, training at _____ % 9 Accidents, Incidents free at _________ % Comment: __________________________________________________________________________________________________________________ Outcomes: 9 Treatment Care Goals reached as planned at _______ % Medication Management goals at _____ %. 9 Wound, ulcers healed at __________ % 9 Pain Management implemented, compliance at _______ % 9 Diabetes Education, independent in care at _________ %, reason for low compliance if applicable: _________________________________________. 9 Other: ___________________________________________________________________________________________________________________. 152