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The holiday season and the end of the year are rapidly approaching,
but quality improvement should never end and should be incorporated
into your daily activities. Now would be a good time to start
planning next year’s activities and setting up an implementation
schedule. Here are some recommendations to start the new year off
to a powerful start:
OASIS
Start holding OASIS refresher workshops to review the
questions and ensure everyone is consistent with the answers.
Web-based OASIS training can be found at
http://oasistraining.org.
OBQI / HH Compare
Know the results of your OBQI reports and review them
quarterly. Trend your data so you get a picture of where you are
heading and where you’ve been. Review your tally and case mix
reports to identify your patient population that is at risk for
re-hospitalization and decreased outcomes. Monitor your Home Health
Compare numbers and see what your competitors are achieving. HH
Compare is updated quarterly (next update – December) and can be
accessed at
www.medicare.gov/HHCompare/Home.asp.
Plans of action
If your rates have not improved since October 2004 by at
least 25% in the Acute Care Hospitalization outcome and by at least
17% in the Improvement in Bathing outcome and you have not written
and implemented plans of action, start writing. Across the country,
this has been proven to be an effective way of improving rates by
keeping you focused and on track. Plans of action do not have to be
elaborate, but there are key areas which are consistently
successful: like assessing for high risk factors, helping patients
monitor their symptoms for deterioration and stressing the
importance of contacting you before going to the Emergency Room.
Telehealth
Consider implementing some form of telehealth. Even
something as simple as phone monitoring has proven to be successful,
particularly with your high risk population and those patients
and/or diagnoses that frequently return to the Emergency Room.
2006-2007 Toolkit available at
www.medqic.org.
Target Setting
Now that you are looking at your OBQI reports and have a plan
of action in place, you will want to set internal targets of where
you want to be by a certain date. The Home Health STAR website at
www.hhqi-star.org is a great place to start. It allows you to track
and trend four quarters of HH Compare data and will calculate
targets for you based on criteria you select.
Immunizations
Incorporate flu and pneumonia immunization status into your
comprehensive patient assessment. Develop policies and procedures
for you to track your patients who need immunization to ensure they
receive them in a timely manner. Communicate with your physicians
so they can make arrangements to immunize your patients and update
their records. 2006-2007 Toolkit available at
www.medqic.org.
Culture of quality
Does your agency have the infrastructure necessary to develop and
support effective care coordination, communication, leadership and
teamwork? Assessing your agency should be a group effort and your
staff’s perception is important. Improvement must go in a sequence
with each step building on the previous step. A strong, solid base
is necessary for all things to come together successfully.
We hope you implement our recommendations. None of them are
elaborate, time consuming projects but when combined, they represent
positive commitment to quality and improvement.
If you would like more information on any of the above topics,
please contact either Jane or Donna. They will be happy to assist
you in jump starting your program and fast track your agency to a
successful year. We, at LHCR, would like to wish everyone a happy
and safe holiday season.
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