Oversight, Right, and More Mishegas

Dear Dr. Steve: While I participate in my facility’s quality improvement efforts, I am puzzled about the approach. It seems to be almost exclusively based on survey issues and CMS quality measures. The staff and management seem to want to stick closely to the CMS script about how to interpret measures, and they seem reluctant to delve too deeply into performance and practice issues that the QAPI approach doesn’t cover. For example, they don’t want to look beyond the measure on antipsychotics to consider the many adverse consequences of all categories of medications.