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QIS COMPLAINT PROCESS 101

QIS COMPLAINT PROCESS 101. Debora Barth, RN QIS/QR Supervisor September 13, 2012 dbarth@isdh.IN.gov. New process. Complaints investigated over 2011: 1852 Complaints investigated in first six months of 2012: 1045 Old process – copies, paper, more paper, more paper!!

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QIS COMPLAINT PROCESS 101

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  1. QIS COMPLAINT PROCESS 101 Debora Barth, RN QIS/QR Supervisor September 13, 2012 dbarth@isdh.IN.gov

  2. New process Complaints investigated over 2011: 1852 Complaints investigated in first six months of 2012: 1045 Old process – copies, paper, more paper, more paper!! New process – copies

  3. Sample selection OLD PROCESS QIS PROCESS • Tour • Paper notes • Compare notes to complaint – choose 3 residents for each area of complaint investigation • Roster sample matrix • Get side-tracked • Initial tour • Request lists • Initiate care areas/F tags • Corresponding to complaint • Sample selection of 3 residents for each area • STAY FOCUSED

  4. CARE AREAS • Abuse • Abuse Prohibition Review • Accidents • Activities • Activities of Daily Living, Cleanliness and Grooming • Admission, Transfer, and Discharge • Behavioral and Emotional Status • Bowel Incontinence • Choices • Colostomy • Communication and Sensory Problems • Community Discharge • Death • Dental Status and Services • Dialysis • Dignity • Dining Observation • Environmental Observations • Extended Survey • Fecal Impaction • Food Quality • Foot Care • General Critical Element Pathway • Hearing • Hospice and/or Palliative Care • Hospitalization • Hydration • Illeostomy • Infection Control and Immunization Review

  5. CARE AREAS • Infections (Non-UTI Related) • Kitchen/Food Service Observation • Liability Notices & Beneficiary Appeal Rights Review • Medication Administration Observation • Medication Storage • Notification of Change • Nutrition • Pain Recognition and Management • Parenteral Fluids • Participation in Care Planning • Personal Funds Review • Personal Property • Physical Restraints • Positioning • Preadmission Screening and Resident Review • Pressure Ulcers • Privacy • Prosthesis • Quality Assessment and Assurance Review • Rehabilitation • Resident Council President/Representative Interview • Resident Room • Respiratory Care • Skin Conditions (non-pressure related) • Social Services • Sufficient Nursing Staff Review • Tracheal Suctioning • Tracheostomy • Tube Feeding

  6. CARE AREAS • Unnecessary Medication Use • Ureterostomy • Urinary Catheter Use • Urinary Incontinence • Urinary Tract Infections • Ventilator • Vision • Urinary Tract Infections • Ventilator • Vision

  7. INVESTIGATION • Conducted in Investigative Documentation screen • Then copied on to the Clipboard and pasted into Citation Manager • Corrected for Quality Review • Pathways are provided for consistency • Guidelines provide guidance for areas without pathways

  8. CONCLUSION • New process for complaint investigation • Not CMS developed/approved • Intended to provide more consistency in the investigative process • Intended to promote more focused investigations.

  9. Questions??? dbarth@isdh.IN.gov

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