Tip Sheet

Overview: Using the PELI for Your Quality Assurance and Performance Improvement (QAPI) Program

Effective November 28, 2017, federal regulations require nursing homes to implement Quality Assurance Performance Improvement (QAPI) programs that take “a systematic, comprehensive, data-driven approach”1 to improving quality of care and quality of life for residents. A hallmark of QAPI programs is that they involve “all nursing home caregivers in practical and creative problem solving” (Centers for Medicare and Medicaid Services, University of Minnesota, Stratis Health, QAPI at a Glance). This work must be supported by the senior management team at your organization.

This tip sheet is the first in a series that outlines how to use the scientifically validated Preferences for Everyday Living Inventory (PELI) assessment tool as the basis for QAPI project that can increase your community’s responsiveness to resident preferences and promote person-centered care.

Why focus your QAPI initiative on meeting resident preferences?

Using the PELI will help your community honor individual preferences, as well as empower residents, promote their meaningful engagement in daily life, and enhance psychosocial wellbeing. These benefits accrue in important ways:

  • Staff members who know a person’s preferences can understand and anticipate resident needs, become more trusted and responsive caregivers, and work more efficiently together.
  • Communities can gain referrals from residents and families who have had satisfying experiences.
  • Recording and sharing positive feedback can be a powerful marketing strategy and help your community stand out as a quality provider to consumers.
  • Staff retention, job satisfaction, and morale may improve due to strong relationships between staff and residents.
  • Using the PELI to assess preferences, and integrate them into resident care plans, enhances compliance with federal regulatory guidelines and incentives for person-centered care in some states.

What happens in a QAPI project focused on preferences and person-centered care?

Team members in your community learn to:

  • Use the PELI to assess resident preferences routinely
  • Integrate information gained from PELI assessments to craft more personalized and successful resident care plans
  • Track and document progress to assure that assessments and care plans are carried out consistently and effectively
  • Assure continued emphasis on preference fulfillment and resident satisfaction as part of daily practice across shifts.

How the PELI QAPI tip sheet series is organized

The first tip sheet provides advice about how to get started in establishing a preference-focused Performance Improvement Project (PIP) as part of your QAPI program. Subsequent tip sheets offer guidance for each stage of the initiative based on the Plan-Do-Study-Act (PDSA) continuous quality improvement method recommended by the Centers for Medicare and Medicaid Services (CMS). The detailed tip sheets in the series show how to:

  • Start your PELI PIP and implement a SWOT analysis to understand your community’s current strengths, weaknesses, opportunities and threats when it comes to assessing and fulfilling resident preferences.
  • Develop and launch a plan for change through a PIP.
  • Use audit tools to study, track and achieve improvement goals.
  • Refine approaches and support a sustainable process for continuous improvement.
  • Explore PDSA resources from the Institute for Health Care Improvement and other organizations.


What’s Next

Getting Started: PELI Performance Improvement Project (PELI-PIP)

Once you’ve decided to focus on preferences assessment and services as part of your community’s QAPI program, make sure you have ingredients in place for success. This tip sheet walks through the initial steps: assure that you have top management support, establish a PELI-PIP committee, and introduce concepts of preference assessment and fulfillment to everyone involved.

Getting Started: PELI Performance Improvement Project (PELI-PIP)

About the Series

This is one in a series of Tip Sheets on using the Preferences for Everyday Living Inventory (PELI) to improve person-centered care. Topics include: How to Get Started, Interview Tips, Working with Proxies, Helping Staff Engage, Integrating Preferences into Care Plans and more. View our full series of Tip Sheets.

Have questions or comments? Please e-mail us at PELI-Can@miamioh.edu or call our helpline at 513-529-3605.

Katherine Abbott, Ph.D., Alfred Ryan, & Kimberly Van Haitsma, Ph.D. This work is licensed under the Creative Commons Attribution-NoDerivatives 4.0 International License. Based on a work at https://preferencebasedliving.com/. To view a copy of this license, visit http://creativecommons.org/licenses/by-nd/4.0/.