OASIS Alert

Once a home health agency decides to bring physical therapists fully into the OASIS loop, they must tackle the training challenge.

HHAs that haven't had therapists on board with OASIS from the beginning will have some catching up to do when it comes to training, warns Ann O'Sullivan, family caregiver specialist with the Agency on Aging in Portland, ME and former rehab manager at a large visiting nurse association.

There will be a major gap between nurses, who now are well-versed in OASIS, and therapists just picking it up. One good way to bring therapists up to speed is through joint training sessions.

"We must develop a team mentality within the home care agency family of professionals and work together to do what's right for our patients," insists consultant Pam Warmack with Clinic Connections in Ruston, LA. Interdisciplinary training is a good tool not only because it unifies the clinicians in an agency, but because therapists and nurses can learn a lot from each other, O'Sullivan adds.

Have nurses and therapists conduct a joint visit, complete separate OASIS assessments, and then compare results it's a good way to gauge inter-rater reliability, identify areas that need work and acclimate therapists to the tool, O'Sullivan says.

Agencies also should provide therapists new to OASIS with "written information describing each OASIS item and its intent; require that they observe other professionals with proven expertise in the assessment process; require return demonstration of their assessments; and conduct ongoing testing of their knowledge," Warmack tells Eli.

"Therapists need to demonstrate competence in conducting a review of a broad range of patient health needs that may not have been a routine part of their past patient assessments," notes consultant Linda Krulish with Home Therapy Services in Redmond, WA. Agencies probably will need to pay special attention to refreshing therapists on drug regimen review, she predicts.

When considering the best way to integrate therapists into the OASIS process, be prepared for a couple of challenges beyond training. You'll need to re-evaluate your productivity expectations and how the therapists are paid, O'Sullivan says.

Keep in mind that the assessment likely will add about an hour to a visit, at least until the therapist gets used to the tool, she says. And you could catch resistance from contract therapists and those paid per visit "that's a lot extra to put on someone who's being paid by the visit," she notes.