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

Measurable Improvement report: (DON-quarterly)

Measurable improvement report

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

Progress Notes Review Form                            Sign Up Package Check list

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

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

* Add Hospitalization & Emergency service risks

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

QA Audit Form                         Private Duty:  QA Audit Form (Private Duty)

DON/QA Staff: POC Tips      POC TIPS (Orders/Goals) 

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

  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

QA Staff: Performance Improvement Bar Graphic Study sample:

BAR Graphic Study Sample

Administrator/DON: Survey Ready Check List

Survey Ready Check List

For use by PN System's QA Nurse only:

Consultant Report

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