State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Overall Intent/Vision for Washington's Quality Improvement Program


Washington State views the QAN program as one part of a three part integrated system of quality assurance: "an objective survey process, a responsive complaint investigation process, and a proactive [QAN] process. Through these activities, Washington monitors, measures, and intervenes to ensure compliance with defined state and federal requirements."15 Quality assurance is thus closely tied conceptually to compliance with regulations. The QAN program is intended to contribute to quality through four key mechanisms: providing "an early warning system," providing "multiple opportunities throughout the year to proactively identify issues with potential for harm," collecting "meaningful data for" use by other segments of the quality assurance process, and "translating regulatory expectations for facility staff."16

The state's vision of the nature of the QAN program's information exchange (technical assistance) is detailed in the program manual:

"The QAN program is based on the concept that state agency staff members should set up a professional, supportive working relationship with nursing facility leaders and strive to keep the facility staff informed about potential compliance issues that are observed. Working closely with the facility Quality Assurance committee, resident's families and ombudsman, the QAN is effective in identifying potential problems and can provide technical assistance related to regulatory requirements and expectations. Correction of problems and achieving compliance is up to the discretion of facility staff. QAN staff do not consult on how to correct any issue. However, the frequent presence of QANs in the nursing facility helps to insure on-going, stable compliance with the intent of the regulations. This concept improves the survey process and is effective in preventing problems and ensuring on-going facility compliance to the ultimate benefit of the long-term care resident."17

  1. State of Washington, Residential Care Services, Aging and Adult Services Administration, Quality Assurance Nurse Program, 2001, p. 3.

  2. Ibid, p. 5.

  3. Ibid, p. 10.

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