Quality Improvement (QI) in Nursing Homes

Quality improvement is an on going strategy for assessing gaps in organizational systems and processes, and identifying opportunities for improvement. QI practice instills a quality and performance improvement culture; collaboratively working to eliminate Healthcare-Acquired Conditions (HACs), and dramatically improve resident satisfaction by focusing on the systems that impact quality such as: staffing, operations, communication, leadership, compliance, clinical models, quality measures and specific clinical outcomes (i.e. inappropriate antipsychotics in persons living with dementia, falls, pressure ulcers, physical restraints, urinary tract infections, and healthcare acquired infections).

IPRO’s Quality Improvement Specialists offers key tools, resources, and materials to assist nursing homes hard-wire consistent improvement practices into day-to-day work, and achieve sustained positive outcomes. Visit our Quality Improvement (QI) resource page to learn more about how we are working with nursing homes to enhance their QI practices, and for additional tools and materials.


QAPI is the merger of two approaches to quality management, Quality Assurance (QA) and Performance Improvement (PI). Both involve seeking and using information, but they differ in key ways:

QA is a process of meeting quality standards and assuring that care reaches an acceptable level. QA is a reactive, retrospective effort to examine why a facility failed to meet certain standards.

PI (also called Quality Improvement or QI) is a pro-active and continuous study of processes with the intent to prevent or decrease the likelihood of problems by identifying areas of opportunity and testing new approaches to fix underlying causes of persistent/systemic problems. PI in nursing homes aims to improve processes involved in health care delivery and resident quality of life.

QA and PI combine to form QAPI, a comprehensive approach to ensuring high quality care. QAPI is a data-driven, proactive approach to improving the quality of life, care, and services in nursing homes. The activities of QAPI involve members at all levels of the organization to:

  • Identify opportunities for improvement
  • Address gaps in systems or processes
  • Develop and implement an improvement or corrective plan
  • Continuously monitor effectiveness of interventions

Care systems based on a QAPI philosophy is to ensure a systematic, comprehensive, data-driven approach to care. The approach may prevent adverse events, promote safety and quality, and reduce risks to residents and caregivers. Visit our Quality Assurance Performance Improvement (QAPI) page for a step-by-step process to implementing QAPI in Nursing Homes.


Last updated: Thursday, April 14, 2016