Quality Assurance (QAPI)   

         2) ALL monthly/quarterly report

         3) ALL Logs

DON/QA Staff: Template for Performance Improvement Data Collection/Analyzes:

QAPI Data collection  (al year long)                         PI Monitoring Log  (Quarterly)

DON: Performance Improvement Plan:                 Target for Improvement or Replication (quarterly)

Performance Improvement Plan  (annual)        PI target for improvement report  Pediatric PT target for improvementMeasurable Improvement report: (DON-quarterly)    Care Plan Compliance problem PI Report

Measurable improvement report                              Care Plan compliance Problem PI report

DON, Clinical Manager/QA: Performance Levels, Patterns, Trends, Variations:  (Quarterly)

PI: Performance, Patterns, Trends

DON, Clinical Manager: OBQI Analyzes LOG (OBQI report must be analyzed by the Agency on Regular BD meeting, this log documented the review of the OBQI (Casper) reports) (Quarterly)

OBQI Analyzes Log                              Adverse Event (OBQI Analyzes)

QAPI REPORTS:  

QA/DON/Clinical Manger: Monthly report about hospitalization, emergency care prevention (results of risk assessment)

  (QAPI PROJECT)

DON: Hospitalization LOG (Must be completed monthly)     Hospitalization Log

Hospitalization risk analysis: Hospitalization risk analysis  Emergency care risk analysis: Emergency Care risk analysis

QAPI Project Hospitalization/Emergency Care:  Hospitalization/Emergency care services risk Project   

QAPI Plan-Do-Study-Act (PDSA) Hospitalization/Emergency Care PDSA

Decreasing Hospitalization, Improvement report: Decreasing hospitalization/Improvement Report

Cardio Vascular Disease Project: CVD Project                     CVD Plan-Do_Study (PDSA) CVD PDSA

(Complete the DC Planning control log, and have the Total DC patients with High BP)

QAPI TOOLS:

DON/QA staff: Progress Note review form       Sign Up Package check up form         Improve Documentation:

Progress Notes Review Form                            Sign Up Package Check list                Prevent Conditionals Defficieny

DON/QA Staff: Chart Audit check list Q60 days (On Recert or Discharge)        

Record review tool: QA Audit Form      Private Duty:  QA Audit Form (PD)          Pediatric:  QA Audit Form (Ped.)

DON/QA Staff: POC Tips      POC TIPS (Orders/Goals)         Prevention Conditional level defficiency Assement/POC

PANIC VALUE list: (Verify that if any parameter is out of normal limit, the patient's physician was notified)                  

* Please be sure to add to the 485 Goals (box 22) realistics End Point goals

* Add Hospitalization & Emergency visit risks, Patient's identified goals, care preferences

* Add Advance Directives information in details to 485 (as was collected during sign up)

  PANIC VALUE  (Can be customized, if changed please replace that page in your Policy Manual)

QA Staff: Verification of visits/services patients random calls (Monthly)

Monthly QA Phone Calls      Patient Satisfaction Survey Patient Survey    Patient Survey Summary Summary

MD Survey MD Survey

QA Staff: Performance Improvement Bar Graphic Study sample:

BAR Graphic Hospitalization Risk                         BAR Graphic Generic

Administrator/DON: Survey Ready Check List

Survey Ready Check List

Covid-19 QAPI Report (Quarterly):  COVID-19 PI Report *** no longer mandatory after 05/11/2023

For use by PN System's QA Nurse only:

Consultant Report  (After visit as applicable)

Disclaimer: Every template is only your guide/AGENDA to type the Minutes of your meeting, your Agency Officials must assure that the meeting occur, the quorum is acceptable, and every member had active participation in the discussion