Opinion

What’s in the name? 

Rechristening QAPI 

QAPI is Quality Assessment and Performance Improvement Committee -  an approach endorsed by CMS

"A rose by any other name would smell as sweet" said Juliet trying to make a point we all understand.

So I ask again: What's in the name?

Everything.

A name is often the first thing we learn about a thing or a person and falling to our humaneness, we form judgments about it; so I would say that this first piece of information is especially important.  It can lean someone in a positive or a negative direction.  And those first impressions can set the stage for future interactions. 

For our means and purposes the name QAPI is okay for a group that is sitting somewhere assessing performance and pondering on ideas that may or may not lead to improvement (apologize for dull clichés). People like to spell it as QUAPI giving it an extra U probably because they like to spell a thing by how they think it sounds – if it sounds like the irritating noises a wet duck would make then it must spell like that too. Or maybe because the decisions or actions in “QUAPI” move so slow that it’s only natural to compare it to a duck’s gait. Of course who wants to miss an opportunity to call something futile without actually calling it futile, especially if it’s a meeting?

I know of a story where a medical director of a clinical service in an attempt to sound witty mocked in a QAPI meeting full of members at the precise time when the power point presentation stuck – as they sometimes do in meetings: sloppy “QUAPI” and oh the room cracked up! What a powerful reclaiming of the ground by the know-all of the clinical processes – doctors! These quack-quack-quapi meetings have done an excellent job PDSAing at various hospitals and departments and, in the ugly development phase, the name is not helping. You can’t really blame the high school kids for that, can you?

Instead of further diminishing the importance of the QAPI committees let’s look at why are the quality professionals self-inflicting themselves with a title that only reminds them of their lame moments. Let’s take a stab at renaming the slow duck.

How about COAST? Clinical Outcomes and Systems Excellence Team. I am sure there can be many renditions with multiple clever sounding acronyms, but it’s a start. Notice that it also removes the term “committee” from the title – which made the whole thing, I think, very stiff and unapproachable. How can the bourgeois proletariat staff get closer to lawmaker- Mr. Moneybags? They form their own team because you win a football match with a team (not committee but a team!). We’re always in search of a David vs a Goliath story. Not to disappoint anyone, but there’s none to be found here. Except that, David birthed Goliath and now it’s being having to manage.

Acronym COAST may remind you of the coast of a battle field where you’re side won, vacation memories (okay may be counterproductive because might have to thinking why you are here, not there), or something else, anything, but a slow moving wet duck.