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Last edition we focused on the new QIS (Quality Indicator Survey) process and what changes you have to look forward to within your organization. This week, we take a look at some care centers that have experienced QIS first-hand to see what their "perspective" is on the new survey process.
As you may recall, the new survey has four main goals:
1. Improve consistency and accuracy of the survey process.
2. Comprehensively review more regulatory areas within current
survey resources.
3. Enhance documentation through automation.
4. Focus survey resources on facilities with the greatest quality
concerns.
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Some distinct differences were noted between the traditional methods as opposed to the new QIS process. However, those Directors of Nursing (DON) interviewed agreed that the process is much more consistent than the traditional method because surveyors have formatted questions to ask the residents and the staff, which is the main goal of QIS.
Consuleo Chillman, Director of Nursing at Anoka Care Center in Minnesota, found that the whole survey process was more randomized and not based on QI data, as prior surveys were. When preparing for a survey prior to QIS, she could look at her residents and the indicators and have a good idea of whom the survey team was focusing on. Now, with the automated process, the survey team receives a complete list of current residents from which the computer randomly selects 40 to survey. Of those residents, each surveyor has a list of yes and no questions to ask during the interview process. Each surveyor asks the same questions, which makes the process uniform and more concise.
Another difference that was noted in two Minnesota residences was the fact that there is no longer the "verify/clarify" process within the survey. This "lack of opportunity to have the verify/clarify process in regards to being able to provide additional information," was one of the least appealing things noted by Libby Lindberg, Director of Nursing at Jones-Harrison residence in Minnesota.
Chillman agreed that this was a major shift in how the survey was completed and stated that she was glad that a mock survey team came and assisted with the process prior to the actual survey. "There is no verify/clarify process," Chillman stated, "when the surveyors go into Phase II, they don't directly tell you the areas of concern, but it is inferred based on the questions they ask staff members during Phase II. This is the best indicator of the areas of concern for potential deficiencies." Even though there is no longer a specific verify/clarify part of the survey, staff is still able to prepare for questions that the surveyors may ask.
Chillman also noted that during the survey all areas of a care center were included, and not just those individuals in long term care. For instance, if your care center houses long term care residents, an Alzheimer's unit and a Rehab floor, all are included in the survey process.
Overall, individuals found the new process was successful in maintaining consistency between surveyors with the additional benefit of standardizing the questions asked of residents and staff. The data is more accurate and streamlined because of the automated process. The downside that was stated most was the lack of a specific "verify/clarify" process for the staff.
What's your "Perspective?"
This article highlights only a couple of opinions about QIS from Directors of Nursing. What's your "perspective?" As the new process continues to roll out in more states, more questions and comments about the process are bound to arise. Do you have an experience with the new QIS process that you would like to share with your peers? What did you like or dislike about it? Please contact Joely Wertz, editor of Pathway Perspectives, to schedule an interview or to share your thoughts at joely.wertz@pathwayhealth.com.
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