Suggested Diagram of QAPI Activity

Utilization review conducted→            High volume service identified

                                                                                             ↓

                                                            (Diabetes, hypertension, etc.)

                                                                                             ↓

                                                           Improvement priority - diabetic patients

                                                                                             ↓

                                                                                          ←

Based on protocol, patients should
receive annual eye and foot exam;
blood should be drawn to check
glucose level quarterly.

            ↓

Randomly pulls a number of
charts (25) of the diabetic
patient population.

            ↓

Objective data: Chart review shows that only
50% of patient population had glucose
levels checked and 40% followed up on
eye and food exams (this gives the
clinic a baseline). This identifies a
problem or an area that needs
improvement.

            ↓

Intervention made to address the problem
Identified: Improvement project designed and
implemented. This can be designed by the
clinic or by outside sources.

            ↓

Measurement of the effectiveness of the
Intervention: Based on a quarterly progress
check, 80% of all patients had glucose tested
and 60% of patients followed up with eye and
foot exams.

Note:  Surveyors should expect a clinic to have documentation of a QAPI program that describes the program; assessment information (data); the rationale for the prioritized

performance improvement projects; and discuss what progress is being achieved.