Healthcare organizations continuously assess, and optimize their processes to deliver the best possible outcomes for patients and residents. Performance improvement in healthcare refers to the systematic process of identifying, analyzing, and enhancing the various aspects of healthcare delivery to improve patient outcomes, safety, and satisfaction.
The ultimate aim of performance improvement in healthcare is to optimize healthcare delivery by focusing on patient care outcomes, client safety, efficiency, cost reduction, and minimizing risks and liability. Healthcare staff will typically set such goals, monitor progress, evaluate results, and implement changes based on feedback and data-driven insights.
It should be noted that performance improvement activities are mandated by various external regulatory and credentialing agencies, such as:
- State departments of health – These are the primary regulatory agencies responsible for overseeing healthcare facilities and services within their respective states. They mandate performance improvement activities to help identify and address areas of concern. For example, the Minnesota Department of Health website offers technical assistance to local and tribal public health organizations as well as a Public Health and QI Toolbox with step-by-step instructions to assess, make decisions, and plan projects.
- The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) – This is an independent, non-profit organization responsible for accrediting and certifying healthcare organizations across the planet. One of the key requirements for maintaining JCAHO accreditation is the implementation and ongoing evaluation of performance improvement activities.
- The Centers for Medicare and Medicaid (CMS) – The CMS mandates performance improvement activities designed to align with the agency’s goals of enhancing patient safety, reducing healthcare-associated infections, and improving patient outcomes. Section 6102(c) of the Affordable Care Act mandates that all skilled nursing facilities establish Quality Assurance and Performance Improvement (QAPI) programs.
A good way to measure one’s understanding of performance improvement in healthcare and risk management principles is the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination.
Performance Improvement: Healthcare and the Role of Data
Data plays a crucial role in driving performance improvement. Healthcare organizations can gather and analyze relevant data to better identify trends, measure progress, and make evidence-based decisions. Common types of data used for performance improvement in healthcare include the following:
- Patient level data – Blood glucose levels, body temperature, laboratory test results, or stated preferences in a care plan
- Service level data – Wait times, patient outcomes, recurring themes in complaints, or aggregated patient experience feedback
- Organization level data – Staff experiences or financial performance
- Population level data – Considers factors such as mortality rates, quality of life, employment status, and air quality
Let’s now take a look at effective strategies for utilizing the gathered data:
- Setting priorities with baseline data: Baseline data provides a snapshot of the current state of care, highlighting areas where improvement is needed. By collecting and analyzing this data, healthcare organizations can identify their strengths and weaknesses, and prioritize their improvement efforts accordingly.
- Gathering data for important clinical goals: In some cases, data may not be readily available for specific clinical goals. When this happens, healthcare organizations can request special data runs or chart audits to gather the necessary information and, in the process, establish a solid foundation for improvement efforts and ensure that their goals are rooted in evidence-based practices.
- Integrating clinical and non-clinical goals: Considering both clinical and non-clinical goals in improvement efforts can foster creative thinking and innovative solutions. By identifying ways to address multiple aspects of performance improvement in healthcare simultaneously, organizations can streamline their processes and maximize the impact of their improvement efforts.
- Selecting performance measures based on needs assessment: To ensure that improvement efforts are targeted and effective, long-term care organizations should focus on changes in an evidence-based system to ensure that the chosen measures are relevant and actionable. Striking a balance between the number and variety of measures can help avoid overwhelming staff with data collection and tracking while still providing a comprehensive picture of performance.
- Tracking measures throughout the improvement process: Monitoring progress is crucial for maintaining team motivation and ensuring that improvement efforts are on track. By consistently tracking performance measures, healthcare organizations can identify areas of success and opportunities for further improvement. This information is then used to adjust strategies and drive continuous progress toward desired outcomes.
- Building performance measurement capacity: Maximize data measurement efforts by leveraging existing IT infrastructure, creating efficient processes, and demonstrating a return on investment. Organizations can drive sustainable and meaningful improvements by engaging stakeholders and investing in performance measurement capabilities.
- Utilizing patient-centered data registries: To enhance clinical quality and efficiency, employ patient-centered data registries, such as the Chronic Disease Electronic Management System (CDEMS). These registries offer a comprehensive view of resident needs, allowing providers to plan care and demonstrate improvements in processes and outcomes proactively. By adopting resident-centered long-term care software, organizations can optimize their data collection efforts and better meet the diverse needs of their resident populations.
Data-driven performance improvement in healthcare is essential for organizations seeking to enhance patient outcomes and streamline their operations. By implementing the seven strategies outlined above, both acute and post-acute care providers can harness the power of data to drive meaningful, lasting change.
Contact us here if you would like to demo a long-term care EHR that can assist your facility with performance improvements.
Understanding Quality Assurance Performance Improvement (QAPI)
Quality Assurance Performance Improvement (QAPI) is a data-driven and systematic approach to improving the quality of care and services provided by healthcare organizations. By implementing QAPI, healthcare providers can monitor, evaluate, and optimize their processes to enhance patient outcomes, safety, and satisfaction, leading to significant performance improvement in healthcare.
QAPI is designed to help healthcare organizations identify, measure, and promote quality improvement in healthcare for the benefit of patients and was first launched in September 2011 by the CMS. QA (Quality Assurance) focuses on maintaining a consistent level of care and services by identifying and correcting problems, while PI (Performance Improvement) is dedicated to ongoing efforts to enhance performance and achieve measurable improvements.
Together, these processes create a proactive and continuous cycle of assessment, action, and evaluation to drive positive change and performance improvement. Healthcare organizations should be aware of the five key elements of QAPI, which are:
- Design and Scope
- Governance and Leadership
- Feedback, Data Systems, and Monitoring
- Performance Improvement Projects (PIPs)
- Systematic Analysis and Systemic Action
By embracing QAPI principles and processes and understanding what is performance improvement in nursing, long-term care providers can create a proactive and continuous cycle of assessment, action, and evaluation that drives meaningful, lasting change.
Best Practices for Performance Improvement in Healthcare
In today’s rapidly changing healthcare landscape, organizations face increasing pressure to improve patient outcomes, enhance operational efficiency, and reduce costs. Performance improvement in healthcare is crucial for meeting these challenges and ensuring the delivery of high-quality care.
Some best practices that one should observe when it comes to performance improvement include:
- Analyze your data and outcomes
- Set goals
- Create a balanced team during performance improvements
- Consider human factors and limitations
- Create an executable plan
- Become familiar with the PDSA cycle
- Communicate goals and progress
- Research other organizations and collaborate
By implementing these best practices, nursing homes, and other long-term care providers can optimize their processes, enhance patient outcomes, and drive lasting success.
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