To ensure a facility maintains the right amount of funding for residents, my recommendation is that there should be some ground level KPIs and metrics that ultimately feed into 3 broad objectives:
1) Appraisals are submitted in a timely fashion
2) Appraisals are submitted correctly
3) Risk is mitigated
As discussed in Part-1, a measure of efficient performance (as well as one that will ensure funding is received in the shortest time practicable) is the time taken to complete an ACFI appraisal.
Although for most organisations a realistic target is that the complete reappraisal process should be completed in less than one working day of ACFI staff time, the actual number of days between the moment a resident is identified until it has been submitted can vary significantly. When you consider any project (e.g. completing an ACFI Appraisal Pack), it’s always the task that takes the longest that determines the overall length of the project. In the ACFI, the critical path is the time taken to set-up, record, and review the information on the behaviour charts.
- If a behaviour chart is not completed correctly, and has to be restarted (e.g. after the third day), this extends the time taken for the entire project
- If the behaviour chart is completed correctly, you could do an assessment (like the PAS-CIS) wrong six days in a row and it would not affect the appraisal time-frame!
It is this area that often stops facilities from getting all required information together within 7-days
What makes this target possible? The approach where the residents’ clinical situation is clearly identified before the commencement of the process and only the relevant charts are implemented (as well as ensuring that staff are guided as to what they are looking for, as opposed to having them try to document all 64 behaviours!)