Home Care and Hospice QAPI: Root Cause Analysis (RCA)

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Video Runtime: 42 Minutes; Learning Assessment Time: 29 Minutes

The role of the clinician in the quality assurance and performance improvement process is often overlooked, thus making the achievement of lasting performance improvement challenging. This course is designed to provide an understanding of the home health and hospice QAPI (Quality Assurance and Performance Improvement) program, utilizing the RCA (root cause analysis) tool while focusing on the role of the clinician in each step. The course will conclude with an organizational case study to give participants the opportunity to see the process, tools, and concepts applied to an actual home care/hospice scenario.

Meet your instructor

Georgia Hockenjos

Georgia Hockenjos, BSN, RN, is vice president and COO of Aleckna and Associates, Manalapan, New Jersey. Ms. Hockenjos has more than 40 years' experience in the home care industry, with more than 15 years in a management or director-level position at a large multibranch nonprofit home care agency (VNA) and 20 years as vice…

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Chapters & learning objectives

1. What Is QAPI?

The Medicare home care and hospice-specific Conditions of Participation (COPs) are used as the foundation of this chapter, which is designed to introduce participants to the evolution, purpose, and terminology associated with QAPI (Quality Assurance and Performance Improvement) in home care and hospice. The information in this chapter is presented to ensure that participants have a basic understanding of QAPI as they continue through the course.

2. Five Standards for QAPI and the Role of the Clinician

This chapter illustrates that quality is the responsibility of all staff, including clinicians, which is often the barrier to organizations achieving and maintaining high-quality performance. It presents the five standards required of a QAPI program and includes strategies and examples of the role of the staff in each element. The elements that are discussed are: • Standard 1: Program Scope • Standard 2: Program Data • Standard 3: Program Activities • Standard 4: Performance Improvement Projects (PIPS) • Standard 5: Executive Responsibilities

3. Executing the RCA (Root Cause Analysis)

Utilizing the RCA as part of a performance improvement process is a standard methodology used to identify and improve deficits; however, it is often done quickly, incorrectly, or with key staff missing. This causes lost productivity and frustration, and often, true and lasting improvements are not realized. The purpose of this chapter is to discuss the methodology used to conduct an RCA, including the use of tools and follow-up to identify, implement, and sustain organizational improvements.

4. Organizational Case Study

This chapter is an organizational case study that illustrates the QAPI process and methodology, and execution of the RCA. This is based on an actual scenario common to both home care and hospice, which is the management of pain in our patients. This case study illustrates the best practices taken from many home care and hospice organizations and is designed to offer participants the opportunity to visualize the operationalization of the true QAPI process.

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