Home Health & Hospice Week

Don't forget to look at the big picture in your efforts to coordinate care and make the most of your therapists' skills.

Problem: With agency attention focused on the financial ups and downs associated with answering "yes" or "no" on M0825 (therapy need), you may be failing to choose the right therapist for the right case.

"Focus your goals on the client, not the disciplines involved," advises occupational therapist Karen Vance, consultant with BKD in Springfield, MO. This means considering which therapist can meet the patient's needs, regardless of whether that therapist is a physical therapist or an OT, she says.

"Everyone on the team has his or her own specialties, and you can't fall for the common assumption that PT deals with the lower body and OT deals with the upper body," Vance told attendees at a recent American Occupational Therapy Association Annual Conference in Charlotte, NC. "Sometimes the therapists are the biggest barrier to care--we're talking about the patient's goals, not your goals."

Examples: If you have a PT with interest and training in treating incontinence issues, that would be the person to have on your team focusing on improvement in incontinence, suggests PT Cindy Krafft, director of rehabilitation services for Peoria, IL-based OSF Home Care.

Are your therapists involved in treating patients with congestive heart failure, or chronic obstructive pulmonary disease? If not, they should be, Krafft told listeners during a June 13 teleconference "Turning Negative Perceptions of M0825 Into Positive Treatment Plans," presented by Eli Research.

Strategies for Success

Vance and Krafft provide these tips for integrating therapy into your quality improvement efforts:

• Shift your practice pattern along with examining your disciplines. Concentrate on how a patient looks, not on what you do. Think about doing therapy with the patient, not to the patient. And use integrated interventions, Vance says.

• Introduce therapists to Home Health Compare. Be sure your therapists know how your agency's outcomes compare to your peers', Krafft suggests. Include therapists as you plan QI efforts.

• Provide skill improvement opportunities. Therapists need to be able to assume case management responsibilities when they are the only team member still visiting the patient, Krafft explained.

Note: For a detailed discussion of therapy issues, order a tape or CD of Krafft's teleconference at http://codinginstitute.com/conference/tapes/cgi.