Post on 29-Mar-2015
description
1May 2008
Accessing OASIS Reports and Quality Resources
Via the Internet
2
Illinois Foundation for Quality Health Care (IFQHC)
Mission Statement
We optimize the quality of medical careand health through collaborative
relationships, education and healthinformation management
Values
Excellence, Integrity, Dedication, Community
3
IFQHC - Training Objectives
Accessing Information via the InternetRegulationOASIS TrainingOASIS Data/ReportsResources - Patient Care Resources - Staff Education
4
IFQHC - Training Objectives, continued
Review of OASIS Data/ReportsOutcome Based Quality Improvement (OBQI) Outcome ReportsOutcome Based Quality Management (OBQM) Reports (Adverse Outcome) Home Health Agency Survey Reports
Review OBQI CyclePlan of Action (POA)
5
IFQHC – Handouts
IFQHC Web site - Home Health ⇒ Resources ⇒ OBQI
• Power Point Presentation • Online Training Resources
Access: http://www.ifqhc.org/
Handouts
6
7
CMS - HHA Center
CMS SpotlightsBilling/PaymentCMS Manual & TransmittalsPolicies/RegulationEducational Resources
InitiativesDemonstration/ResearchMedical Learning Network (MLN) Participation and Enrollment Certification
8
CMS - HHA Center
CMS - Home Health Agency (HHA) Center
Access:http://www.cms.hhs.gov/center/hha.asp
9
CMS - Technical Resource
QIES Technical Support Office
Access: https://www.qtso.com/
10
11
CMS - Resource OASIS Training
Resource: Free Web-based training on the OASIS system Training Modules:
“Why OASIS”“OASIS and the Comprehensive Assessment”“Conducting a Comprehensive Assessment”“OASIS Items”
Application: Orientation tool for staff new to home health
12
CMS - Resource OASIS Training
OASIS Training
Access: http://www.oasistraining.org
13
CMS - OASIS OCCB
OASIS Certificate and Competency Board
Resource:The OASIS Certificate and Competency Board, Inc. (OCCB) is a non-profit organization dedicated to promoting greater reliability in OASIS data, through consistent application of guidelines provided by the Centers for Medicare & Medicaid Services (CMS).
Resource: OASIS Certificate Competency Board Website
14
CMS - OASIS OCCB
Application: Resource for providers responsible for:
Conducting comprehensive assessments Scoring OASIS items Auditing clinical records Educating or orienting staff Demonstrating their expertise and commitment to OASIS data accuracy
Resource: OASIS Certificate Competency Board Website
15
CMS – OASIS - OCCB
OASIS Certificate and Competency Board
Access:http://www.oasiscertificate.org/index.cfm
16
17
CMS - Quality Initiatives
Resource: Quality Initiatives
While the current home health assessment and reporting tool, OASIS, will remain in use, several new priorities have emerged and are expected to be part of planning for the future.
18
CMS - Quality Initiatives
Resource: Quality Initiatives Planning for the Future: 1) Pay for Performance – tying a portion of
reimbursement to delivery of care that has been proven to be effective
2) Standardizing assessment/quality measurement across (post-acute) health care settings
19
CMS - Quality Initiatives
Resource: Quality Initiatives
Planning for the Future, continued: 3) Integration of measures of process and
systems4) Electronic Health Records (EHRs)
20
OASIS - Reimbursement to Quality
21
OASIS - Reimbursement to Quality
22
Quality Initiatives Access:http://www.cms.hhs.gov/HomeHealthQualityInits/
CMS – Resource Quality Initiatives
23
24
OASIS – OBQI Outcomes
Outcomes:Outcomes are OASIS-based quality performance information showing how well home health agencies assist their patients in regaining or maintaining their ability to function.
Improvement and Stabilization Outcomes Utilization Outcomes
25
OBQI - Improvement Outcome
Definition: Improvement Outcome An outcome measure that assesses whether a specific health status attribute improves between two specific time points as measured by the OASIS scale.
If the patient’s status is optimal at Start of Care/Resumption of Care (SOC/ROC), it will not be included in the calculation.
26
OBQI - Improvement Outcome
MO780 - Management of Oral Medications 0 - Able to independently take correct meds
DS/Tran 1 - Able to take meds at correct times if:
a) doses prepared in advance
b) give daily reminders
c) drug diary or chart
SOC 2 - Unable to take meds - administered
27
OBQI - Stabilization Outcome
Definition: Stabilization OutcomesAn outcome measure that assesses whether a specific health status attribute does not worsen between two specific time points.
If a patient’s health status is at the most severely impaired level at SOC/ROC, it will not be included in the calculation.
28
OBQI - Stabilization Outcome
MO700 - Ambulation/Locomotion 0 - Able to walk independently
SOC/DS 1 - Requires use of device
2 - Able to walk with supervision
3 - Chairfast,unable to ambulate
4 - Chairfast, unable to wheel self
5 - Bedfast
UK - Unkown
29
OBQI - Utilization Outcomes
Utilization Outcomes
Utilization outcomes indicate whether the patient has experienced an event or change in condition requiring medical intervention, including acute care hospitalization and emergency care, discharge from home health care with the patient remaining in the community.
30
OBQI - Utilization Outcome - Episodes
Numerator = Total number of episodes in a 12-month period that end with an acute care hospitalization (MO855, Response 1)Denominator = Total number of episodes that began and ended (due to discharge and transfer) in a 12-month period Equals = ACH percentage
Hospital Hospital HospitalDischarge
SOC ROC Transfer
3Episodes
31
P4P OASIS Measures
Incidence of Acute Care Hospitalization
Incidence of any Emergent Care
Improvement in Bathing
Improvement in Ambulation/Locomotion
Improvement in Transferring
Improvement in Management of Oral Medications
Improvement in Status of Surgical Wounds
32
33
OBQI Reports
Resource:Reports are generated from OASIS submissionUpdated around the 15th of each month Displays one year of informationAccessed through the CASPER system using same name and password as OASIS submission
.
34
OBQI Reports
Application:
Reports available to HHAs include:
OBQI 2- or 3-Column Report
Case Mix Analysis Summary
OBQM Reports-Adverse Outcome Reports
HHA Survey Reports
35
36
37
Sample OBQI Risk-Adjusted Outcome Report
38
39
40
OBQI - Case Mix Analysis Summary
Resource:Designed to provide a summary of the case mix factors among patients who achieve or notachieve each outcome.
Application: A review of case mix differences between patients helps identify the need to modify or add clinicalinterventions.
41
42
43
44
45
46
IFQHC – Handouts
IFQHC Web site - Home Health Resources OASIS Reports
OBQI Implementation Manual, Supplement, 5/2003Quality Monitoring Using Case Mix and Adverse Outcome Reports, 2001Home Health Agency Risk Adjusted and Descriptive Outcome Reports: Description and Definitions
Access: www.ifqhc.orgHandouts
47
48
Home Health Compare
Resource:Home Health Compare gives detailed information about Medicare-certified home health agencies.
Application: These quality measures provide information about how well home health agencies provide care for their patients.
49
Home Health Compare
Two New Quality Measures:
NEW! Percentage of patients whose wounds improved or healed after an operation.
NEW! Percentage of patients who need unplanned medical care related to a wound that is new, is worse, or has become infected.
50
Home Health Compare
Home Health Compare
Access: http://www.medicare.gov/HHCompare
51
52
Quality Initiatives
OBQIReports
HH Compare Staffing HH SurveyReports
Staff EducationPatient Satisfaction Budget
Quality??
Regulation
53
Quality Initiatives
Quality Assurance - Focuses on detecting serious problems or seeking out poor performers
Quality Improvement - Focuses on methods to improve organizational processes
OBQI - Uses the changes in patient health status over time (outcomes) to evaluate and focus the need for care process change
54
OBQI CYCLE
The Outcome Based Quality Improvement
Process
(OBQI)
Investigate careprocesses
Identifyproblems/strengthsand best practices
ImplementPOA
MonitorPOA
Outcome Analysis
Specify target outcome(s)
Interpret outcome reports
Measure patient outcomes
Collect & transmit OASIS data
Develop a plan of action (POA)
OutcomeEnhancement
55
OBQI Plan of Action (POA)
A POA is developed to improve the care currently being delivered in the agency. The activities outlined in the plan are necessary to actually enhance patient outcomes.
- Identifies the recommended care processes (best practices)
- Includes implementation approaches.
*Sample POAs are available at IFQHC Web site
56
57
MedQIC Resources
Resource: MedQIC provides effective and timely quality improvement tools, literature and resources for health care professionals serving Medicare beneficiaries in a variety of settings including hospitals, physician offices, nursing homes and home health.
Application: HHAs can access and download free quality improvement resources, access a nationwide directory of professionals and get firsthand knowledge from experts and peers.
59
Training Follow Up
√ Explore Internet Sites
√ Access OASIS Reports/Data
√ Spread Knowledge
60
IFQHC Home Health Team
Leslie E. Kolb - Director (630) 928-5809Becky Chirillo - Administrative Assistant (630) 928-5829Michi Cain - Home Health Coordinator (630) 928-5817Janet Lane - Home Health Coordinator (630) 928-5834Donna Serrett - Home Health Coordinator (630) 928-5878
Illinois Foundation for Quality Health Care (IFQHC)
61
Questions
Complete Poling Questions
This material was created by the Illinois Foundation for Quality Health Care, the Medicare Quality Improvement Organization for Illinois, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. IL-8SOW-HH-427-04/08