Home Health & Hospice Week

Follow these four steps to make HHQI a boon rather than a burden. 

You might not want to set your watch by it, but the rollout of the home health quality initiative, under which your home health agency's patient outcome figures will be made public in newspapers and on the Home Health Compare Web site, is planned for Thurs. Oct. 30 and Fri. Oct. 31.

The launch originally was slated for Oct. 21, but was pushed off to accommodate HHS Secretary Tommy Thompson's schedule, a Centers for Medicare & Medicaid Services spokesperson says. The new date still could change based on the whims of Thompson's calendar.

But right now, CMS plans to hold a press conference about the measure Oct. 30, the same day the Home Health Compare Web site will go live. On Halloween, ads will run in newspapers around the country listing agencies' scores for three patient outcomes - bathing, ambulation and oral medications (see Eli's HCW, Vol. XII, No. 36, p. 282).

In the meantime, you can follow these steps to help your agency benefit, rather than suffer, from the public dissemination of your patient outcomes:

1) Know your numbers. If you haven't already done so, now's the time to get cozy with your patient outcomes figures, recommends Mary St. Pierre with the National Association for Home Care & Hospice. CMS placed agencies' Home Health Compare data in their QIES mailboxes at the beginning of October, points out Chicago-based regulatory consultant Rebecca Friedman Zuber.

2) Identify problem areas. Don't automatically assume subpar outcomes are a result of poor quality of care, advises consultant Linda Rutman with LarsonAllen Health Care Group headquartered in Charlotte, NC. It's likely that documentation problems or assessment techniques are causing your undesirable numbers.

In fact, HHAs that want to see quick improvements to their scores should focus their energies on addressing OASIS collection and submission methods rather than care processes, suggests Bob Wardwell with the Visiting Nurse Associations of America. "Many unhappy outcomes have been traced back to errors in OASIS coding and input rather than problems in care," Wardwell says.

3) Formulate your improvement plan. Whether the problem is tricky OASIS questions or care processes, you should address the issue and the way you plan to correct it, counsels Ann Howard with the American Association for Homecare.

HHAs should immerse themselves in the complete outcome-based quality improvement process, which directs them on how to formulate such a plan, St. Pierre notes.

If you are confused about how to implement OBQI strategies, turn to your state's Quality Improvement Organization for technical help, recommends Joie Glenn with the New Mexico Association for Home Care. "Our QIO was so very helpful and the agencies were given instruction, tools and direction," says Glenn, whose state's HHAs already have undergone public dissemination of their patient outcomes in the HHQI pilot project this May.

4) Prepare your public relations strategy. Judging from the pilot project, HHAs are unlikely to see an overwhelming interest in their numbers from consumers, notes Wardwell, a former CMS official. But plenty of local press may cover the event, and if your outcomes are particularly high or low compared to your peers', you can expect some public attention drawn to that fact.

You should brief your staff on the basics of your numbers, and ready your strategy for handling questions from the press, referral sources or other interested members of the public, Wardwell advises. Develop and distribute standard responses so that everyone knows how to respond to questions, says Zuber, who also advises the Illinois Home Care Council.

Agencies should seize the opportunity to educate the masses "about this high quality, cost effective, consumer preferred health care modality," Howard instructs.

Plan to highlight your strengths and get the word out about how home care can help folks, says Mary Schantz with the Missouri Alliance for Home Care. Sharing basic background information about home care in your community and state can garner positive press attention, as can explaining what the Medicare home care benefit is and how seniors can access it, says Schantz, whose state was also part of the Phase I pilot project.

Emphasizing how important your services are to families in the local area is always a plus, says Pat Kelleher with the Home & Health Care Association of Massachusetts, in another Phase I state.

"Spending time visiting with the health reporter at the local newspaper in advance of the rollout is time well spent," Schantz judges. You can arrange a home visit for the person if they wish. "HHAs should relax and enjoy the opportunity to get home care in the spotlight," she says.

"Accentuate the positive," agrees Wardwell. "Home health is a fantastic service and we are engaged in continuous quality improvement."

Remember that your media message may differ than that of CMS', which wants to stress accountability and competition, Kelleher advises.

Editor's Note: More HHQI information from CMS is available at www.cms.hhs.gov/quality/hhqi/default.asp.