Teamwork is a core component of Quality Assurance and Performance Improvement (QAPI). Leadership must convey that it is everyone’ job to contribute to the organization’s Performance Improvement initiatives through clear guidelines identified in job descriptions. Responsibility rests with the leadership to provide training and a complete understanding of the concepts of QAPI and each individual staff members’ responsibility. They must also support this idea through action and resources to enable staff to complete daily assignments, provide clinical care and also participate on QAPI teams.
Characteristics of an effective team include the following:
- Having a clear purpose
- Having defined roles for each team member to play
- Having commitment to active engagement from each member
The roles of team workers may grow out of their original discipline (e.g., nurse, social worker, physical therapist) or their defined job responsibilities.
QAPI relies on teamwork in several ways:
- Task-oriented teams may be specially formed to look into a particular problem and their work may be limited and focused
- Performance Improvement Project (PIP) teams are formed for longer-term work on an issue
- Family members and residents may be team members, though for confidentiality reasons, they may not review certain data or information that identifies individuals.
PIP teams need to plan for sufficient communication—including face-to-face meetings to get to know each other and plan the work. The team should also plan for the way each team member will review information that emerges from the PIP. Careful consideration must be given to the purpose of the PIP and type of members needed to achieve that purpose. Generally, each team should be composed of interdisciplinary members. For example, a concern with medication administration should include nursing and pharmacy team members. However, even other disciplines or family members may bring a different perspective to understanding this issue and should be considered for this type of team. Here are some additional examples:
- A PIP team with the goal of helping residents get out of doors more often decided that grounds personnel needed to be on that team so that procedures for snow removal, sun protection, and outdoor seating could be considered
- After a PIP team began working on the problem of anxiety among residents, the members realized that many of the affected residents reported reassurance from the pastor and asked the QA committee to add him to the team that was planning the approach.
- A PIP team working on reducing falls asked that the housekeeping department be involved as it considered root causes of falls and realized that equipment in the corridors and clutter in the bathrooms contributed
A PIP is more than a casual effort – it entails a specific written mission to look into a problem area. The team will be entrusted with a mission, and it will report back to the Steering Committee at intervals. Being part of a formal PIP team must be interpreted as an important assignment that team members and their supervisors must take seriously. Clear communication of this responsibility adds strength, importance, and formality to the PIP process.