Systemic Action is often the most challenging step in improving performance. After identifying root causes to an issue, it is important to implement changes or corrective action that can improve or reduce the chance of an event happening again. These actions should be tightly linked to the root causes in order to have a higher likelihood of being effective. It is vital to avoid quick fixes. The goal is to make strong changes that will result in lasting improvement. Actions can be defined in the following ways.
- Weak: Actions that depend on staff to remember training or policies. These actions enhance or enforce existing processes.
- Intermediate: Staff must remember to do the right thing, but these actions provide tools. These modify existing processes.
- Strong: Actions that do not depend on staff to remember to do the right thing. Strong action redesign the process.
Pilot testing is one tactic nursing homes can use to carry out to test systemic change ideas. Think about testing or "piloting" changes in one area of your facility before launching something facility wide. Sometimes, changes can have unintended consequences.
For more information on the different types of actions and examples for each, read page 19 of QAPI at a glance.